Concerns About Prednisone Withdrawal
Subject: 60-year-old female diagnosed with Graves' Disease (currently in remission), severe fibromyalgia, IBS, and complex PTSD. She is presently taking Metoprolol and prednisone, in addition to vitamin D, calcium, a general multivitamin, and a low dose of aspirin. Also using medical marijuana for treatment purposes, if that holds relevance to the situation. I fear I may have made a significant mistake, and I’m seeking guidance on the potential consequences of my actions. At the moment, I am in the process of gradually lowering my prednisone dosage—starting from a daily intake of 10mg, reducing by 1 mg each month. Now into the second month, I should be taking 8 mg daily. However, I suspect I mishandled my last prescription refill; rather than consuming 8 mg of prednisone for the last week, I inadvertently took 8 tablets of low dose aspirin instead. Consequently, the number of remaining pills until my next refill is becoming a concern. It seems I may have inadvertently gone a week without prednisone, putting me at risk of experiencing withdrawal symptoms associated with stopping the medication abruptly. I’ve just taken my standard dose once more (including a bit extra to help alleviate the severe fatigue). My concern is—are there specific symptoms I should be vigilant about? While I'm feeling quite unwell, it’s not markedly worse than the experiences I’ve endured on my toughest days dealing with various autoimmune conditions. Seeking immediate medical attention is not feasible for me, so I’m hoping to endure this situation and stabilize my condition once again.
Answers (1)
6/21/2025, 5:10:40 PM
OpenHealth AI
It's understandable to feel anxious about your prednisone dosage and the possibility of experiencing withdrawal symptoms. You've done the right thing by resuming your prescribed dose, and it’s important to stay informed as you navigate this.
Main Points:
- Abruptly missing prednisone can lead to withdrawal symptoms, but resuming your dose can help stabilize your condition.
- Monitor for specific symptoms that could indicate withdrawal or a flare-up of your autoimmune conditions.
- Prioritize careful management of your doses moving forward to prevent future issues.
Explanation:
Prednisone is a corticosteroid used to manage inflammation and suppress the immune system in various conditions, including Graves' Disease. Missing doses, especially after a gradual taper, can lead to withdrawal symptoms, which may include fatigue, weakness, joint pain, muscle stiffness, and fever. Additionally, if your autoimmune conditions flare up, you might experience worsened symptoms related to fibromyalgia or IBS.
Next Steps:
-
Monitor Symptoms: Over the next few days, keep a close watch for any unusual symptoms like increased fatigue, body aches, fever, or any change in your typical symptoms. This will help you and anyone you might consult in the future assess your situation.
-
Continue Resuming Your Dose: Stick with the 8 mg dose of prednisone until your next prescription refill. If you feel unwell after a few days at this dose, it may be a sign that further adjustments are needed.
-
Diet and Hydration: Make sure you stay well-hydrated and maintain a balanced diet. Adequate nutrition can help your body cope better during this period.
-
Stay Organized: Clearly label your medications and set reminders for taking them, especially with high-stakes medications like prednisone. This can help avoid similar errors in the future.
-
Develop a Plan: Consider creating a plan for your prednisone taper, documenting dosages and any side effects you experience. This will aid in tracking your progress and assist in long-term management.
-
Seek Support: Connect with your support system or consider a wellness group online focused on Graves' Disease or chronic pain to share experiences and strategies for managing your conditions.
If things feel overwhelming or symptoms worsen significantly (like severe fatigue beyond usual levels, shortness of breath, or new symptoms), please consider reaching out for medical advice even if it's not in-person. Your health should always come first.
Related Questions
Understanding Abnormal EBV Blood Test Results
I’m a 42-year-old woman, standing at 5'2" and weighing 140 pounds. I’ve been diagnosed with generalized anxiety disorder (GAD), major depressive disorder (MDD)—though I have my doubts about that—and panic disorder. Currently, I am on Pristiq at a dosage of 100mg. My journey with antidepressants began roughly five years ago. Other than a minor Vitamin D deficiency, all my recent blood tests have returned normal results. However, I’ve consistently faced persistent fatigue since starting the medication. Over the past couple of years, various health professionals have described my blood work as nearly flawless. Despite this, I underwent another test recently due to my ongoing exhaustion and lack of motivation, which revealed some concerning EBV levels. The test results showed: - EBV Early Antigen Antibodies, IgG: 21.6 U/mL - EBV Antibodies VCA, IgG: 181 U/mL According to the reference ranges provided by Labcorp, these figures are significantly elevated. Naturally, I turned to the internet to seek answers, which has left me feeling quite anxious about dire possibilities such as cancer or severe chronic Epstein-Barr virus (EBV) issues. While I’ve read various articles on this subject, I’m not a medical professional. Should I be deeply concerned? Is this kind of elevated reading typical for someone who has contracted the virus and carries it throughout their life? Any advice or insights would be greatly appreciated.
Strategies for Managing Seizures
Age 30, experiencing Psychogenic Non-Epileptic Seizures (PNES), along with challenges including major depressive disorder, generalized anxiety disorder, insomnia, complex post-traumatic stress disorder (c-PTSD), and borderline personality disorder. Current medications include Cymbalta at 90 mg, Abilify at 5 mg, Klonopin at 0.5 mg taken twice daily, and Seroquel at 100 mg. Although I recently enjoyed a few days without seizures, they have returned more intensely than before. I've noticed my blood pressure dipping slightly, causing me to feel unwell throughout the day. There are moments when I feel faint, and I’m seeking advice on how to alleviate the simultaneous issues of chest discomfort and seizures. What steps can I take to manage these symptoms effectively?
A Mysterious Multisystem Illness Affecting Three Family Members: A Six-Year Quest for Answers
Greetings, I am reaching out to this community in search of insights, questions we might have overlooked, or guidance toward a potential solution. Our medical journey has stumped numerous healthcare professionals. Let me introduce our family: I’m a 57-year-old woman with two sons aged 25 and 33. We are of Caucasian descent and hail from Europe. Our family does not partake in smoking, alcohol, or recreational drug use. Here are our physical details: - My height and weight: 162 cm / 60 kg - Older son: 185 cm / 77 kg - Younger son: 180 cm / 64 kg Until 2019, we enjoyed robust health and an active lifestyle. However, within a brief span of five months six years ago, all three of us suddenly developed a perplexing multisystem illness with symptoms progressively worsening and new ones emerging. There was no identifiable catalyst—no infections, vaccinations, toxic exposures, or travel events that preceded the onset of our symptoms. Current Shared Symptoms Among Us: - Severe food intolerances affecting almost all foods and medications - Gastrointestinal issues: includes belching, constipation, bloating, rumbling intestines, and acid reflux - Neurological symptoms: debilitating headaches, severe eye strain (even without the use of screens), muscle twitching - Cardiovascular/autonomic issues: heart palpitations, signs consistent with POTS - Dermatological problems, joint discomfort, and persistent fatigue What We Have Dismissed: We have thoroughly tested for numerous conditions using PCR, serologies, imaging, and functional assessments, all yielding negative or normal outcomes: - Infectious agents: ruled out H. pylori, Lyme disease, EBV, CMV, HSV, HHV-6, Parvovirus B19, enterovirus, Mycoplasma, Chlamydia, tuberculosis, as well as various bacteria, viruses, and parasites - Gastrointestinal diseases: excluded IBD, eosinophilic esophagitis/gastroenteritis, celiac disease, Whipple’s disease - Endoscopic procedures revealed inflamed gastric lining, attributed to bile reflux, yet doctors have not traced the source of this abnormal reflux. - Autoimmune and allergic disorders: tests related to ANA, ANCA, MCAS, and others all returned negative or normal - Toxic exposure: tests for mold/mycotoxins, heavy metals, and environmental toxins came back negative - Metabolic/genetic disorders: eliminated possibilities such as Wilson’s disease, porphyria, hemochromatosis, and various inborn metabolic errors - Nutritional evaluations, along with treatments involving PPIs, antibiotics, probiotics, anti-parasitics, restrictive diets, and antihistamines, failed to yield improvements. Peculiar Test Findings: Despite the lack of conclusive results, we have noted several persistent abnormalities: - Immunological & Inflammatory markers: - Heightened levels of eosinophilic cationic protein (ECP) despite normal levels of eosinophils, tryptase, and histamine - Increased oxidized glutathione, while reduced glutathione remains normal - Elevated TNF-alpha, neopterin, and TGF-beta1 levels - Mild immune dysregulation (without fulfilling autoimmune disease criteria) - Specific findings for each family member: - Younger son (25): elevated IgG4 and fluctuating ALT (up to 100 u/L) - Older son (33): heightened total bilirubin (39 μmol/L) and direct bilirubin (10 μmol/L), along with increased total IgM and slightly elevated IgG4 - Myself: mildly raised amylase (120 u/L) and elevated total IgM We find ourselves at a standstill. We desperately hope to connect with anyone who may have faced a similar situation involving multiple family members and multisystemic symptoms, or who might recognize an uncommon pattern. We would greatly appreciate any thoughts, questions, or even unconventional ideas. Thank you for your time.
Seeking Help for My 2-Year-Old Daughter's Unexplained Illness
Greetings, everyone. I find myself in a state of anxiety as a parent, searching for guidance regarding my child's health. My daughter, aged 2.5 years (approximately 92cm tall and weighing 14.2kg, without any ongoing medications), was born through an emergency cesarean section without any complications. About two and a half weeks ago, she became visibly yellow, resembling jaundice, although it does not affect her eyes. This was soon accompanied by a sudden high fever reaching 39.5 degrees Celsius, persisting for two to three days before subsiding. Since then, she has experienced a notable decline in appetite, disturbed sleeping patterns, and a spreading rash that resembles small pimples in her groin area. Her usual playful demeanor has diminished, and the yellow tint persists. Additionally, she has lost around 700g and developed diarrhea this past Monday. We have consulted our local physician, visited an after-hours clinic, and made three trips to the leading children's hospitals over an hour away. Extensive blood tests (three in total) have been conducted, yet we remain without answers. They evaluated her stool for 16 different intestinal infections, but not one test has returned positive, leaving us puzzled about the source of her diarrhea. Some blood results showed minor elevations, but nothing definitive that could pinpoint an issue. Her bilirubin levels, liver function, and kidney analyses all fall within normal limits. Thyroid and cortisol levels are also normal, and carotene is at expected levels. The senior medical staff, with decades of experience, have expressed their confusion, stating that they have not encountered a case like this in their careers. Her diarrhea has intensified, now watery rather than solid, while the rest of her symptoms remain unchanged, except for the fever which has not returned. The doctors have concluded that they have exhausted their testing options, yet are hesitant to proceed with scans—which is understandable as we are uncertain of what we should be investigating. We reside in New Zealand, where our healthcare system, thankfully, is predominantly public and mostly free. However, like many other systems around the world, it is severely strained at this time. For context, she has a history of resolved laryngomalacia and cow's milk protein allergy, as well as multiple cafe au lait spots, despite a negative test for neurofibromatosis type 1. Additionally, she had an undiagnosed movement disorder from six months old, and an MRI revealed two cysts with no discernible cause. It appears her movements may be related to potential neurodiversity. We feel lost and are willing to do anything to help our daughter recover. Thank you for your support and any advice you may have.
Unexpected Hematuria in Semen
I am a 22-year-old man, standing at 5’11” and weighing 195 pounds. I maintain a clean lifestyle, avoiding alcohol, smoking, or illicit drugs. My medical background includes a diagnosis of papillary thyroid cancer, for which I underwent a partial thyroidectomy in March 2024. After a follow-up, my endocrinologist concluded that I do not require levothyroxine. I have no family history of this condition. Currently, I am taking Nexium to manage silent reflux, which I began in January, and Descovy for PrEP since June. Previously, I used Truvada for several months, but after my alkaline phosphatase (ALP) levels rose to the high-normal range, I stopped taking it for a period. My doctor later recommended switching to Descovy, and my ALP levels have stabilized since then. Two days ago, I noticed blood mixed in with my semen. It wasn't a significant amount, as it appeared more like a subtle discoloration rather than noticeable streaks. Interestingly, there was no blood present during my morning masturbation session, but it appeared in the evening. I have since engaged in three more sessions without any further blood present. There has been no pain during ejaculation or urination, and no additional symptoms have developed. I consulted with my primary care physician, who conducted a physical examination of my testicles. She found nothing alarming but recommended a testicular ultrasound due to my history of varicose veins and a previous bump near the junction of the scrotum and skin that a urologist had diagnosed as an inclusion cyst. Given my frequent shaving in that area, I hadn't been particularly anxious about it. An ultrasound and consultation with a urologist are scheduled for next week, but I am experiencing significant health-related anxiety, which is exacerbating my worries. I would appreciate insight into what typical evaluations look like for someone my age and advice on the potential causes of these symptoms. My concern often leans towards worst-case scenarios, especially considering my medical history with thyroid cancer. Any guidance would be immensely helpful. Thank you.