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← Return to PMR Flair up From a Virus?
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Hi, Christopherc, Okay, so this is how I understand it. A healthy person has working adrenal glands, which produce cortisol and send it out to your body as needed. So, when you become emotional, or active, or sick, the adrenals recognize this and they send out more cortisol to get you through your current "crisis". But when we take prednisone, your adrenal glands basically shut down and don't produce cortisol, because they sense that the prednisone is doing their job for them. The difference is, WE are controlling the amount of prednisone your body is getting and it's a stable amount every day. There is no producing more or less based on your changing needs each day. So if you get sick, or are more active than usual on a given day, or having something else that is stressing you out, the prednisone might not be enough to take care of those "special" occasions like your adrenal glands normally would. So this is why, it's a good idea when you're sick to up your dose of prednisone. (Of course, you would need to discuss this with your doctor.) Further it's also a good reason why you should pace yourself - not doing too much physical activity that is unusual for you two days in a row, and if your are fatigued, you need to allow yourself to rest. Recently I had covid, so I upped my prednisone by 5 mg/day (with my doctor's blessing) for 6 days. Then went right back down to my normal dose within 2 steps. No problem. I hope this answers your question. Just a little bonus aside - they also gave me Paxlovid and I rebounded on it. Covid for over 2 weeks. But again. All went well.
Replies to "Hi, Christopherc, Okay, so this is how I understand it. A healthy person has working adrenal..."
I find everyone’s experience, so interesting and different from one another. My naturopath recommended Cortrex, which is an adrenal support complex. Thorn is the company that makes it. I believe this has helped my tapering off prednisone considerably. My PMR started in June 2022 and I started on prednisone in July going up to a maximum of 8 mg. I just tapered off as of the end of December 2022. The jury is still out but so far I’m feeling pretty good. Prednisone really messed with my bone density… down by 8% in some areas. If the PMR returns, I may consider naltrexone …my doctor suggested that. Does anyone have any experience with that?
Thanks for your helpful and clear explanation. I find both Covid and polymyalgia rheumatica are still not fully understood and your information helped me to put my current experience into context. I tested positive for Covid three days ago and started anti-viral medication. My Covid symptoms are light, but the PMR flareup is quite painful so I am also upping my cortisone as I've been instructed to do by my doctor when I have flareups.
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Aspine ,
Thank you so much for the thoughtful, clear and thorough response. It makes infinite sense. I have had the same experience as you regarding Covid. I didn’t realize initially that the covid rebound I had a few days after completing the five day course of Paxlovid that it was more l than just a cold. Since I wasn’t on the antivirals this time I felt a great deal of pain throughout my body and thought it was mostly due to PMR. Your explanation sounds right on the money. I completed a one year course of prednisone in the middle of March and I’m now on Celebrex to lessen the residual pain I have every morning and whenever I’m stressed. I’ve been anxiously waiting for my natural cortisol to kick in and come back to normal levels but it’s been almost imperceptibly slow. I’ve read that it could take from 6 to 12 months to return to normal. I’d be interested in whether anybody has any feedback on how long they think it took in their case once they went off prednisone. Thanks again for the great response. Good luck to you in your treatment.