Prednisone can save your life. But it can also leave you burnt out and exhausted.
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 sever 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 way you’ll best 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
- Licorice extract
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 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.
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!