I was on oral prednisone (20-80 mg/day) plus occasional injections of methylpred or dexamethasone for about 2 years for severe RA. About 1.5 years ago I weaned off the steroids. I have had low level, but increasing anxiety since then. Recently I developed severe anxiety and depression.
Is it possible that my adrenal glands never fully recovered and have been just puttering along? Or would I have had a major crash much sooner than this. My PCP says there is not chance this is from the steroids.
After two years - the steroids should be out of your system. However, you would not be the first person to have had problems after taking high doses.
It can go a couple of ways - your adrenals could be a bit atrophied. Do you find that you are nauseous when you are sick, crave salt, have a tan, or have lost weight?
Or it could have triggered a case of high cortisol. Some of my Cushing's buddies found after a dose of high steroids or steroid use like shots, inhalers or whatever, they found that their Cushing's symptoms jumped to the forefront. Did you gain weight, have problems healing, glucose or cholesterol elevations, purple stretch marks or get acne?
Symptoms can vary on both - and oddly high and low cortisol overlap on fatigue, anxiety and depression. Your PCP sorry may not know these complex disorders well. I only know them as I had them both. I also know that they can have very atypical presentations as well.
Unfortunately, most doctors don't have a clue about adrenals.
The nausea is a sign of a low - so it is more likely that your adrenals did atrophy on the adrenals. The tan occurs when the pituitary is trying to signal the failing adrenals - and ACTH can cause increased melanin so you get a tan, spots or a dirty knuckle look (one or all). If the source is pituitary, the ACTH is low. You need an endocrinologist to do testing - 8am cortisols, 24 hour urine tests, renin, aldosterone, sodium potassium and a stim test eventually to see if the adrenals react to stress - then based on that put you on replacements which may be hydrocortisone and perhaps florinef.
Is your BP high or low? If low - do you try salt or salty things and does that make you feel better?
Oddly, the docs that give all those high doses of steroids really have no idea what the long term effects can be... and everyone reacts differently some have no reaction while others can be permanently ruined for life. I wish there was a test to know beforehand so the docs could know - or steroids had a black box caution or restriction so that they were not given as freely as they are!
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