Prednisone can save your life. But it can also leave you burnt out and exhausted.
If you’re struggling with adrenal fatigue, make sure you check your history of prednisone use!
The last time you got a severe allergic reaction, prednisone was the prescription given to help you out. Same goes for autoimmune diseases like Crohn’s, colitis, rheumatoid arthritis, and many more. Prednisone works.
Need to suppress an immune system?
Reach for prednisone. I’m not saying this tongue in cheek. At times, suppressing immune system function is life saving.
Prednisone is amazing at stopping your immune system in its tracks. But it needs to be prescribed judiciously. Overuse of prednisone quickly results in a wide range of unwanted side effects. One of which can be debilitating adrenal fatigue. Today, I’ll show you how that happens and how to reclaim your energy should it happens to you!
Are you at risk for adrenal fatigue?
If you’re using a drug like prednisone, you sure are. Prednisone is what is known as a glucocorticoid. Glucocorticoids are steroid hormones. Meaning they exhibit 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 the epicentre of adrenal fatigue. Adrenal fatigue is really an HPA axis issue, not an adrenal issue.
Glucocorticoid use is going to suppress your HPA axis to a level where 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.
Below, are the percentages of patients who go on to develop adrenal fatigue after corticosteroid therapy: (1)
- Nasal steroids
- Inhaled steroids
- Topical steroids
- Oral steroids (like prednisone)
- Intra-articular injections (cortisone injections)
It is estimated that 1.2% of the American population are using glucocorticoids like prednisone for more than five years. (2) That’s more than three million people in the United States alone. If 50% of them go on to develop adrenal fatigue, you’re looking at more than one million people dealing with drug-induced adrenal fatigue.
The take away here – if you’re taking a glucocorticoid like prednisone, you’re at risk of developing adrenal fatigue.
How to prevent adrenal fatigue from ever happening
To better prevent adrenal fatigue following 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. More info on how to best measure your adrenal function here. 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 makes you fatigued
Picture one of those huge Mr. Universe contestants. You know, the abnormally large men competing in the sport known as body building. Those fellas look the way they do thanks to anabolic steroids.
Anabolic steroids look a lot like your own testosterone. The steroids affect your body in a similar to naturally produced testosterone – like helping you build big muscles. When you take a ton of these drugs – as bodybuilders do – you get really big muscles.
Since your body has been getting mega-doses of testosterone in the form of steroids, it decides it no longer needs to produce its own testosterone. This is all well and good until you stop taking the drugs. When you stop, your body is unable to produce its own testosterone and you start experiencing symptoms of very low testosterone. This is when unwanted effects like gynecomastia (man-boobs) occur.
Taking a glucocorticoid like prednisone creates a very similar phenomenon inside your body. Instead of your body stopping testosterone production, your body will stop cortisol production. You see, drugs like prednisone are more powerful than your body’s own cortisol. Meaning 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 excess cortisol brought on by the prednisone signals your body to stop making its own cortisol. Much the same as testosterone in a bodybuilder taking anabolic steroids.
Should this continue for many years, you’ll actually experience the shrinking of a specific part of your adrenal gland known as the zone fasciculata. If this occurs, not only will you be profoundly fatigued, you become dependant on glucocorticoid drugs to keep your cortisol levels up. Your body can no longer create it’s 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. Here’s what not to do – 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. Most people need 9-12 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. 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
I know what you’re thinking, pregnenolone will prevent adrenal fatigue after prednisone use. Pregnenolone is considered the mother hormone. Meaning it gives birth to many other hormones. One of which is cortisol. Ergo, increase pregnenolone levels via supplementation and you’ll increase cortisol levels. Bye bye fatigue! Alas, pregnenolone has not been shown to be effective in treating 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.
I’ve had great success in 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 (CAR). Do so will 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.
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!