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What Causes Extreme Fatigue, Nausea And Blurred Vision When Diagnosed With Adrenal Insufficiency?
Question: I have rheumatoid arthritis, temporal arthritis, been on oral steroids 5 years, trying to reduce dose. Did get off them last year it began to feel terribly unwell. Rheumatologist did random cortisol test and after a result of just 28 I was diagnosed with adrenal insufficiency and went back onto prednisolone (hydrocortisone made me ill). Problem is now I have terrible oedema which doctors say is from steroids so put me on furosemide 40mg. This was not working so was recently upped to 60mg and since then I've been feeling more and more unwell - terrible fatigue, nausea, headache, unique challenges thirst, feeling hot, blurred vision - and I noticed on info leaflet that you should not take furosemide if you have Addison's. They don't know what's causing my adrenal insufficiency yet - they suspect steroid suppression, but I cannot get the prednisolone dose low enough for them to do the relevant tests. Do you think the furosemide could be causing these feelings of malaise? I'm sleeping about 18-19 hours a day right now which isn't normal for me. Normally I sleep badly because of pain. I feel like I'm just getting sicker and sicker and nobody cares.
Brief Answer:
Iatrogen cushings, tertiary adrenal insufficiency, needs slow taper
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. Glucocorticoids cause hypothalamic pituitary axis of hormones in supra physiological doses and its use for 5 years is very long and thus cause such adverse effect of adrenal insufficiency. The reason for that was leaving it cold turkey or not reducing the dose as it is. Slowly tapering of the dose, reducing it to only 5 mg every 2 to 3 weeks should be tried. Your symptoms of puffiness and edema all suggest iatrogenic cushing disease as well and is due to corticosteroids. Malaise and other symptoms you mentioned are all due to that. FUrosemide has adverse effects for sure . The treatment of this is slowly and gradually tapering of glucocorticoids and bringing it to the minimum possible dosage and then slowly discontinue. All your symptoms will subside . Let your doctor help you in slow tapering but i would suggest no more reduction than 5 mg in a month or 3 weeks times.
I hope it helps. Take good care of yourself and dont forget to close the discussion please.
Regards
Khan
Iatrogen cushings, tertiary adrenal insufficiency, needs slow taper
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. Glucocorticoids cause hypothalamic pituitary axis of hormones in supra physiological doses and its use for 5 years is very long and thus cause such adverse effect of adrenal insufficiency. The reason for that was leaving it cold turkey or not reducing the dose as it is. Slowly tapering of the dose, reducing it to only 5 mg every 2 to 3 weeks should be tried. Your symptoms of puffiness and edema all suggest iatrogenic cushing disease as well and is due to corticosteroids. Malaise and other symptoms you mentioned are all due to that. FUrosemide has adverse effects for sure . The treatment of this is slowly and gradually tapering of glucocorticoids and bringing it to the minimum possible dosage and then slowly discontinue. All your symptoms will subside . Let your doctor help you in slow tapering but i would suggest no more reduction than 5 mg in a month or 3 weeks times.
I hope it helps. Take good care of yourself and dont forget to close the discussion please.
Regards
Khan
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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