Does prednisone make you tired and weak?
Even though it can save your life, many people find prednisone causes fatigue.
So If you’re struggling with adrenal fatigue prednisone may be to blame!
If you suffer from an autoimmune diseases like Crohn’s, colitis, rheumatoid arthritis, MS among others, chances are you’ve been on prednisone. Or maybe you were prescribed prednisone for a severe allergic reaction. That’s because prednisone works. At times it can save your life.
Prednisone stops your immune system in its tracks. But it needs to be prescribed carefully. The overuse of prednisone quickly results in a wide range of unwanted side effects. One of which can be debilitating adrenal fatigue. If you’re suffering from adrenal fatigue prednisone may be to blame – read on to learn how they are connected and how to reclaim your energy!
Are you at risk for adrenal fatigue?
If you’re using a drug like prednisone adrenal fatigue is definitely a risk. Prednisone is a glucocorticoid, or steroid hormone. This type of steroid has a profound effect on your hormonal system. Especially your hypothalamic-pituitary-adrenal (HPA) axis.
The HPA axis is your body’s stress adaptation network. It’s also the epicentre of adrenal fatigue. Adrenal fatigue actually has more to do with your HPA axis and not your adrenals.
The use of glucocorticoids is going to suppress your HPA axis so much that it’s hardly functioning. All too often, you as the patient and even your prescribing physician don’t realize the risk of a prednisone prescription. Unfortunately, that is only discovered after you start exhibiting adrenal fatigue symptoms.
There are a number of corticosteroids that are used for different health issues. Below, are the percentages of patients who go on to develop adrenal fatigue after corticosteroid therapy: (1)
- Nasal steroids: 4.2%
- Inhaled steroids: 7.8%
- Topical steroids: 4.7%
- Oral steroids (like prednisone): 48.7%
- Intra-articular injections (cortisone injections): 52.2%
It is estimated that 1.2% of the American population use glucocorticoids like prednisone for more than five years. (2) That’s more than three million people in the United States alone. If 50% of those people develop adrenal fatigue, you’re looking at more than one million people dealing with adrenal fatigue from prednisone.
The take away here – if you’re taking a glucocorticoid like prednisone adrenal fatigue is a definite risk.
How to prevent adrenal fatigue
To better prevent adrenal fatigue from prednisone use, we need to do two things:
- Take a better history
- Have your cortisol levels tested before prescribing drugs like prednisone
By taking a more detailed history, your doctor will know all about your past use of glucocorticoids. If you’ve taken them before, especially over the long-term, you should proceed cautiously. At the very least, move on to step two. Ideally, look at other medications that can alleviate your symptoms without affecting your HPA axis.
Before prescribing a glucocorticoid, you should have a baseline cortisol reading done. Use a test that checks your cortisol levels at multiple times throughout the day. Read more on how to best measure your adrenal function. Doing this will show your doctor if your HPA axis can handle the stress of taking a drug like prednisone. If your HPA axis is flattened before taking prednisone, you can guarantee that you’ll go on to develop adrenal fatigue.
Why prednisone causes fatigue
Prednisone is more powerful than your body’s own cortisol. This means that prednisone will outcompete your own cortisol for receptor sites in tissue.
When you take prednisone over the long term, your body goes through a phenomenon known as feedback inhibition. The extra cortisol from the prednisone tells your body to stop making its own cortisol.
If this continues for many years, the part of your adrenal gland known as the zone fasciculata will shrink. If this occurs, not only will you be profoundly fatigued, you will need glucocorticoid drugs to keep your cortisol levels up. Your body can no longer create its own cortisol.
What do you do if you have to take prednisone?
I’m not advocating you avoid prednisone at all costs. Prednisone saves lives. It’s an incredible drug. I’m advocating you make an informed and educated decision before taking prednisone. Check to see how many glucocorticoids you’ve taken in the past. Run your cortisol levels before starting your prescription. This is the best way to avoid any associated adrenal fatigue symptoms.
When you do have to take prednisone, you need to know how to safely and effectively stop taking the drug. Do not stop prednisone cold turkey. If you do this, you’re going to experience intense levels of adrenal fatigue. Prednisone needs to be tapered very slowly.
Talk with your physician and pharmacist. It should take months to safely taper off of prednisone. This is dose dependent. Higher doses require more time. Lower doses require less time. Just be sure you taper gradually and according to the recommendation from your health professional. If you start experiencing fatigue, you’re tapering too fast.
You can make coming off of prednisone a lot less exhausting with targeted supplementation. I’ll tackle this topic in the next section.
Coming off of prednisone? Take these supplements
Pregnenolone is considered the mother hormone. Meaning it gives birth to many other hormones, one of which is cortisol. So logically, you would assume that if you take pregnenolone you will prevent adrenal fatigue after prednisone use. Bye bye fatigue!
Unfortunately, pregnenolone does not effectively treat adrenal fatigue.
Instead of pregnenolone, focus your supplementation on the following:
- Adrenal glandulars
- DHEA
- Licorice extract
Adrenal glandulars
Adrenal glandulars are desiccated adrenal glands of cows or pigs. The thought is that the gland will contain small amounts of the cortisol hormone which will help to increase levels in someone dealing with adrenal fatigue. Full disclosure, this part on adrenal glandulars is coming from my clinical experience. There isn’t much research confirming or denying their efficacy.
However, I’ve had great success using adrenal glandulars to help prevent adrenal fatigue when coming off of prednisone. I recommend taking one dose of adrenal glandular immediately after waking. This will help to trigger your cortisol awakening response and increase your daily cortisol total. If you’re feeling most fatigued in the afternoon, consider adding a second dose of adrenal glandulars with lunch.
DHEA
DHEA was originally thought to be a panacea for aging. While that didn’t pan out, researchers soon learned the benefits DHEA has on your HPA axis. Taking DHEA while you’re taking prednisone may help to blunt the catabolic effects of cortisol. (3, 4) Remember, prednisone is flooding your body with extremely high levels of cortisol. Taking DHEA could protect you from the harmful effects of elevated cortisol.
I don’t recommend supplementing DHEA without laboratory testing. Before supplementing, check your blood levels. Base your DHEA dose on the results of your blood test. Re-check DHEA levels after supplementing for a few months.
Licorice extract
Glycyrrhiza glabra is the common ingredient in liquorice root. It just so happens to have a chemical structure similar to glucocorticoids like prednisone. That chemical structure makes licorice root well suited to help increase your cortisol levels following prednisone use! (5, 6)
Be careful as licorice can also raise your blood pressure. If you’re taking more than 100mg per day, keep a close eye on your blood pressure. And please make sure you confirm via laboratory testing that you have adrenal fatigue before supplementing licorice! Otherwise, you’re going to feel much, much worse.
Go for a deeper dive into the supplements for adrenal fatigue.
Ok, now you know the deep rooted connection between prednisone and adrenal fatigue.
It’s time for me to hear from you!
How did prednisone affect your energy levels?
Leave your answers in the comments section below!
I’ve been dealing with CFS & Fibro for 20 years. As such my mental capabilities have been greatly affected,
Your articles and suggested tests, supplements & doses are the first ones I’ve been able to follow.
I would love to hear more from you and what you do.
Thank you & Bless
Thank you for the kind words, kelli.
You can find out all about how we help with CFS here – https://fatiguetoflourish.com/chronic-fatigue-syndrome-calgary/
M
No energy irritated moody
I had unexplainable hives from head to toe for 18 months and prednisone was the only thing that gave me any relief. I eventually was able to taper my dosage from 20mg per day to 10mg and the hives eventually went away on their own, mysteriously. I wasn’t informed that I shouldn’t stop taking prednisone, cold turkey, until after I began suffering with severe fatigue and joint pain, especially my knees. I did my own research and now I’m taking 5mg of prednisone per day along with calcium and adrenal support supplements. My knee pain is still very much a thing, though; to the point that I have to pull myself up from a sitting position and nearly crawl up a set of stairs. Because I also have hypothyroidism, I’ve heard I should not take licorice root. Any suggestions or advice would be greatly appreciated.
Hey, Stacie!
I recommend trying some adrenal glandular supplements.
M
I’m 47 and have started a short term prednisone treatment for post surgical stiffness and inflammation. I had both my hips extensively repaired, not replaced 8 months ago. After initial physical therapy I still have significant soreness and stiffness in my hips. My surgeon has put me on a high dose regimine for 3 weeks. 60 mg/3 days, 50mg/3 days, etc. to 10mg/3 days to try to crush my inflammation. I’m on day 5 and have noticed I’m terribly tired all the time. After reading this article I realized I’m not losing my mind. I do have a young living supplement called cortistop that I’m thinking of taking. Are you familiar with that?
I am 75 with RA since age 30. Slow progression of joint issues. Now the RA is causing more joint problems. Etc.
I have been taking 10 to now, 9-8!mg prednisone for at lease 20 years. Took other string RA drugs over the years. Now my body reacts to much so I just stay with prednisone.
I also have Eaton Lambert Myasthenic syndrome . Please respond with ideas! Thank you.
Dr. Volmer, I was diagnosed with PMR on Feb 14, 2022. Doctor prescribed 15mg Prednisone and I’m now on 7 1/2mg. I am beyond tired, sleeping 7-10 hours at night and must lay down after lunch for an hour. I’m on 5mcg Cytomel Tabs, 50 mcg Synthroid and creams for progesterone and testosterone. Blood pressure is fine. Surgery December 2019 to remove an acoustic neuroma with lingering dizziness and some tiredness before Prednisone but the dizziness and tiredness are now off the charts. I just purchased Pure Adrenal, whole adrenal 300 mg & cortex 160 mg. Can I take this to help with my extreme fatigue as I titrate off Prednisone or will it mess up my thyroid meds?? I’m getting no help from my rheumatologist or my endocrinologist. Thank you so much!!!!
I have a mast cell disease called mastocytosis and after facing a number of issues earlier this year (mild case of covid, stepson diagnosed with epilepsy, and father passing away unexpectedly) my body went into major reaction mode and I was in a terrible flare. My doctor ran some labs and my ANA came back positive, along with having a high CRP level and a high monocyte count. I was having terrible pain in my neck, muscle spasms in my neck and shoulder, knee pain, terrible fatigue and shortness of breath. I was diagnosed with asthma last year. Everything went haywire. My doctor thinks I might have an autoimmune issue going on. He put me on prednisone for a month (40mg/7 days, 30mg/7days, 20mg/7days, 10mg/7days). I haven’t felt this amazing in a VERY LONG time. I think I forgot was feeling normal was like until I started the prednisone. I haven’t had any of the negative side effects. No mood swings, no increased appetite, etc. It has been absolutely wonderful. The fatigue is gone and my neck is so so so much better. I can sleep at night without pain and can make it through a day without needing Tylenol or Excedrin. I’m down to just 10 mg a day now and the fatigue is setting in mildly and my neck pain is creeping back in. What would you suggest?
Hi, Coty,
I’m not familiar with said supplement. But I say it’s still worthy of you giving it a go!
M
Hi, Marybeth,
That sounds like the perfect plan to help you come off prednisone.
M
Hi, Sarah!
Your condition sounds a lot like CIRS.
I think you should look into it further. Here’s a link to get you started – https://fatiguetoflourish.com/?s=CIRS
M
I am 80 years old and for 9 months my doctor was unable to diagnose my problem and had me on a 6 pack of Prednisone, then a 10 pack 2 different times all while sending me to physical therapy and for an MRI starting in Fall of 2019. After hours on the internet I found every one of my symptoms in the description for PMR. My doc agreed. So for the last 2 years i have been on prednisone, again starting with a 10 pack (40mg tapering to 10mg) and then on a daily dose of 10 mg. I have finally managed to taper to 6.5mg and while my tiredness was tolerable for the last 2 years, what I feel now since going below 7mg is horrible. I have never been a napper but right now I think I could sleep all day. I have just started the diet suggestions for jump starting my adrenals and have ordered my adrenal glandular supplement and will also pick up some DHEA. Plan to eat plenty of Omega 3s too. I feel so blessed to have found your site. Looks like there is light at the end of the tunnel.
Thank you for the kind words, Diane.
I’m hopeful that increased energy is just around the corner for you 🙂
M
I took prednisone for 1 week. The taper off pack. It’s been 3 days and I still feel horribly weak. I have RA and fibromyalgia. I have not taken this in a very long time ( years) but I do use a steroid asthma inhaler. I wish I could get over this weakness.
Is budesonide the same as prednisone does it stay in the gut or does it go into the bloodstream budesonide for to control diarrhea I’d like to know if it’s safe to take long-term and does it go into the bloodstream thank you okay
Hi My name is Mary! I developed rheumatoid at 50! After 20 years went off medication for9 years! Started having some problems again (not severe) Was put on 10 milligrams o prednisone then five milligrams! I am so tired I don’t want to get out of bed and weak in arms and legs!! Do you have any suggestions?
I took it for 5 days – 50 mg. Now that I am done with it I am extremely fatigued and I hate it. I am 71.5 years young and usually full of energy this is very disappointing to me. I hope it does not last long.
Hey, Dorothea,
Budesonide is a corticosteroid whereas prednisone is a glucocorticoid.
M