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Prednisolone Withdrawal - Is it Dangerous?

5/21/2020

Why Prednisolone withdrawal may sometimes be as dangerous as the treatment itself? So, this week I was asked by somebody in the Prednisolone warriors with dr. Megan Group: what would happen if they were on Prednisolone and they had withdrawals? And so I'm here today to answer that question. What is adrenal insufficiency and what does it feel like? What should we look out for and why do we care? So, I'm basing this of an article from the European Journal of internal medicine. And I didn't make up that title. I just substituted Prednisolone for Google corticoid, why treatment with Prednisolone can be as dangerous.

The withdrawal from Prednisolone can be as dangerous as the treatment itself. So, in this article I'm going to point out the important parts and translate it from medical ease into more simple language for you.

Adrenal System

First of all, what is the adrenal system? So, first of all Prednisolone is a similar structure to your body's hormone cortisol. Cortisol is made in the adrenal cortex. So, that’s about your body. I'm not going to make you learn all this stuff, which we had to learn. But, basically, this is your brain. It talks to your pituitary, which talks to your adrenal gland, which is on top of your kidney. And all of that is being interfered with, Prednisolone is saying: “No brain, you're not talking to my kidneys, right above my kidneys.” and so, when that happens, it turns off your adrenal gland from making cortisol.

Why do we care if we're making cortisol or not? Well, cortisol is our stress hormone? So, when any stress will happen, for example, you're cut off in traffic, or you found out that somebody you love died, or you get fired from your job, or you get really sick, you need cortisol to deal with that stress, to deal with the high blood pressure and all of the terrible things that happen. When you're stressed out, the cortisol has to kick in or you can die.

You can go into shock, and that's called adrenal crisis. So, this is the reason you never stop taking Prednisolone without slowly tapering it off and following your doctor's orders. It can literally kill you. It can put your body into adrenal crisis, shock, like zero blood pressure. You die and you don't want that. So, always slowly go after Prednisolone. Never stop taking it suddenly.

So, now we've covered, why we care about cortisol and the adrenal system. What does it look like? What is adrenal insufficiency? So, a lot of people might have heard of adrenal fatigue. That is not this. Adrenal insufficiency is when your adrenal gland is not working. Adrenal fatigue might be something like: your body's not as receptive to cortisol as it used to be, and so you feel tired all the time. That can happen among stressed out people, who aren't on Prednisolone. That's a totally different thing. We're talking about adrenal insufficiency, and this is caused by the drug Prednisolone or one of its sister drugs, like Hydrocortisone or Dexamethasone. So, once it's caused this damage, basically, to your signaling system, it won't make cortisol at all until it remembers to do so. Basically, you need to give it time. That's why you go down slowly, as you need to give your adrenal system time to kick back into gear.

What Does it Feel Like When You are Having Adrenal Insufficiency?

I'm going to read this information directly from the article. It says: “fatigue loss of energy, hypoglycemia (low blood sugar), hypertonic (that means like you're not very strong), reduced strength (also not very strong), nausea, muscle pain, sleep disturbance and weight changes. So, this basically means that you feel like you got hit by bus. You feel like you have the flu. You feel terrible. So, essentially, what everybody needs to look out for taking Prednisolone is to realize whether you feel that way? Even if you're still on it, do you feel any of those things? And if so, you might be having a little bit of adrenal insufficiency. As for that everybody, who's been on any dose of Prednisolone, even a small dose, even for a short amount of time, should be looking out for adrenal insufficiency symptoms.

Prednisolone Withdrawal - Is it Dangerous?

There's nobody, who is completely exempt. It can happen to anyone at any time, at any dose. You could have just taken three days worth, and it could cause the adrenal insufficiency. You could just have used inhaled steroids, like people with asthma use. You could have just used topical steroids, like people with rashes and eczema. They can cause adrenal insufficiency.

Always be looking out for it. Always be talking to your doctor. If you're feeling unwell, then you need to point it out. So, who can like who actually has this happen well. According to that article, anywhere from fifty to a hundred percent of people have adrenal insufficiency the next day after taking Prednisolone. Basically, everyone can get it now.

How many people have it a year later? Not as many. It's more like three percent of people. So, one in 30 people, who take Prednisolone, can still be feeling the effects a year later. They feel exhausted with joint pain, with muscle pain, with less grip strength. All of those things can happen even a year later. That's a possibility. Or it can be even longer, as says the article.

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