Connect
Comment receiving replies
@tweetypie13 Yes, I use paracetamol as well for tampering withdrawal pain and DOMS which I suffer from a lot. It's effective for non-PMR pain, and at the moment can't even get close to pred doses where adrenal insufficiency could happen. Unfortunately, if adrenal insufficiency does occur, paracetamol won't help much as an artificial cortisol supplement is required as it is no longer just pain management which is an issue. As people are mostly still on pred, then treatment can involve increasing the dose, but sometimes hydrocortisone is substituted.
Once you get to a low level of pred, it can become difficult to distinguish between PMR inflammatory pain, DOMS (if you are relatively active), or adrenal insufficiency when it starts to occur.
Replies to "@tweetypie13 Yes, I use paracetamol as well for tampering withdrawal pain and DOMS which I suffer..."
Connect
"... at the moment can't even get close to pred doses where adrenal insufficiency could happen."
------------------------
Significant adrenal suppression happens at 3-4 weeks after starting prednisone at a dose in excess of 5 mg daily. Symptoms of adrenal insufficiency and even an adrenal crisis can happen at any dose of prednisone. Symptoms of adrenal insufficiency can happen whenever a prednisone dose is not high enough to compensate for the amount of stress a person experiences.
Measuring the amount of stress a person may experience at any given time is complicated. We can't always anticipate when stress might occur so we have no idea how much prednisone we should take.
https://www.endocrine.org/clinical-practice-guidelines/glucocorticoid-induced-adrenal-insufficiency
----------------------------
People report that PMR "flares" happen when they are stressed. I have often wondered if my flares were actually symptoms of adrenal insufficiency rather than PMR. Perhaps my symptoms were a combination of both conditions given how difficult it is to distinguish between the two and how the symptoms overlap.
Artificial intelligence says:
"Distinguishing between a polymyalgia rheumatica (PMR) flare and symptoms of adrenal insufficiency can be very difficult, especially for those on long-term steroid therapy. Stress can trigger both PMR flares and adrenal insufficiency symptoms, and the conditions can overlap."