u/Complex_Trick_9906

I am currently under evaluation for adrenal insufficiency most likely caused by prednisone but I do have a substantial autoimmune family history so addisons is on the differential list.

I switched just over two weeks ago from prednisone 5 mg to hydrocortisone 15/5 mg. My endocrinologist doesn’t want to run any tests until I get to 10 mg for two weeks. I feel pretty awful now and mentally preparing myself to white knuckle it. Honestly I can manage the body aches, nausea, low appetite…but the mood changes are hard to live with. The worst is crying spells (worse in evening), but also struggling with feeling overwhelmed and agitated but there is substantial fluctuation.

I am seeing my pcp next week to talk about mental health…do antidepressants help? I am concerned that they won’t if the mood changes are inflammatory (I have RA) or adrenal insufficiency. Any advice on management? I do see a therapist and that helps. I have scaled back on exercise too as I feel intense activity worsens it and caused diarrhea which probably further worsens it. Ugh.

How often does adrenal insufficiency occur in rheumatology patients? I am finally getting RA under control and now under evaluation for AI with endocrinologist. Does this happen a lot? Any tips to get through it?

Recently had to be to work at 4:45 am and normally don’t wake up until 6 am. I did ok initially but after a few hours I was in so much pain…not specific joint but overall body ache, yucky flu like feelings. I have noticed this with staying up very late as well. Anyone else? Is this an RA thing or something else? I of course will ask my doctor when I see her. I have also been on prednisone for almost two years. I feel like my body does not handle stress well.

Does anyone else feel like their brain is connected to how their body is doing? When I don’t feel well I am more anxious, sad, fearful (emotionally sensitive in general). It isn’t enjoyable. But when I feel good I don’t have the depression and my emotional resilience is better.

I continue to be on the fence about antidepressants. I don’t want to feel flat or empty and I am unfortunately on steroids approaching two years and kind of want to get off them first to see where I am but that goal post keeps changing.

Does anyone else have damage to their wrists? I noticed this past week the ulnar styloid on my wrists are bony and prominent with one side notably larger than the other. I will mention it at my next rheumatologist appointment but reading online it sounds like this is a common location? Feeling discouraged.

I have had thorough GI workup and nothing found. It definitely comes with pain flares, so have wondered if systemic inflammation. Or is it something else not RA?

I have read that OT/PT was useful and asked PCP for referral. I am still working in optimizing medications with my rheumatologist but I would like to learn some skills to prevent injury and preserve functioning. I still function decently but my capacity fluctuates significantly. Just finished OT and sat in a room with geriatric patients and felt like the OT didn’t think I needed to be there (did learn some things.) She then wondered why I wanted PT. Am I crazy for thinking it might help or are they going to look at me and not be helpful because some days I function ok? (Joys of invisible disability in your 30s).