prednisone

I have had a few occasions when doctors want to give me steroids: prednisone or methylprednisolone. I have mild lupus, neck issues, lung issue at times etc.

The problem is, even with just 1mg (and starting dose for taper is 60mg!) I get palpitations and one time landed in an ambulance with afib, pulse 180+. I don't seem to be able to take beta blockers, due to low blood pressure. And not sure if they would help the situation either.

Is anyone else hypersensitive to steroids? I assume this means that at least some of my afib has an adrenal source.

I have asked three cardiologists if there is anything I can do to enable me to take steroids orally or by IV. They have no answer.


Thanks!

ps buying the Kardia was life changing, got a blood pressure cuff too. I have been drinking low sodium V8 and taking magesium for some time, thanks!

windyshores, I am a somewhat new member and poster here so take what I say with even a larger grain of salt. I wonder if corticosteroids (prednisone)
and noncorticosteroids (ibuprofen) are similar with respect to afib in that unless you have certain types of ablation procedures (not that I am suggesting them) use of these medications is generally not recommended or are in a use at your own risk category. Dammed if do, dammed if you don't. Like you, I have "inflammatory" issues and would like to take nsaids but am cautioned not to do so unless I have a procedure which will enable me to get off my prescribed blood thinner. Have you been diagnosed with afib or is your only episode the one you mention in your post which put you in afib? Are you taking any medications for afib? If you google "prednisone and afib" quite a few links appear that relate to your dilemma. I did not get any results when I typed "prednisone" into this forums search box. I'm sure others will have some better information or questions. Good luck, stay safe.

There was a Guy from Denver that used to post, and talked about extreme reactions to these Steroid Anti-Inflammatories (Corticosteroids).

It sounds like your too sensitive to take Corticosteroids at a therapeutic level. If you did take them, Hydrocortisone, which is 1/5th as potent as Prednisone may be an option. You are getting the reaction right as you are taking them right? and not afterwards? (you mentioned the Taper).

I also have mild Lupus, but I can tolerate Corticosteriods well, although I have to taper off very slowly, or it triggers AFIB.

Can you take NSAID anti-inflammatories? I have thought about taking Toradol for acute inflammation, but I am tentative to do so.



Edited 1 time(s). Last edit at 07/18/2020 06:59AM by The Anti-Fib.

Sorry I should have put in more detail.

I have paroxysmal afib. First episode was 2015, then 2018, then fall 2019 twice within 3 months. I figured out that GERD and pressure from eating was a trigger. I had one brief episode in March confirmed by Kardia but I changed my position quickly and this time it worked. I also seem to have an adrenal type trigger because a loud alarm triggered one episode. The first episode occurred after flying, dehydrated and stress because I flew out for a kid's medical crisis.

Anyway every time I have any afib, I end up in an ambulance and ER. Longest episode was 4 hours. I get very fast heart rate, 185+, sometimes low blood pressure and sometimes high. Chest pain going into my throat, Very short of breath etc.

I have diltiazem and propanolol prescribed. I will never take beta blocker (unless it would help with prednisone since both address adrenal issues). I avoid diltazem because it crashed my blood pressure (ambulance gave me when I said no, bp went to 60/30). But I bought a blood pressure cuff. The last ambulance call was after I took bp, it was okay, and I took 15mg diltiazem. It resolved without going to ER (they treated me at home with fluids, and checked stats, and I converted while in the truck).

I am not on blood thinners. There is a difference of opinion among my docs on this. They just removed the female part of the CHADS score so they are back to being optional (when I turned 65 I got pressure to take)>


So steroids give me palpitations. I have not taken more than 2mg for fear of afib being triggered but I don't know for sure. The palpitations are generally at the end of the day when I have taken them in the morning. This is in line with experiencin afib with relief or while coming down from a stimulant type med.

I also am afraid to take Tymlos. Forteo sped up my heart, as it does many, but last time I tried it was when I did not have afib. My bones are bad.

But my main concern is prednisone/methylprednisolone/dexamethasone. For lupus, for my neck, arthritis, pain, asthma etc. In fact, dexamethasone is being used for COVID! I had pneumonia last year and the urgent care doc was frustrated with me because he wanted me to do a Medrol pack starting at 60mg.There isn't much else in their tool box.

I thought maybe someone's doc used beta blockers to help with the cardiac effects of steroids.

Lately I have been taking ONE mg methylprednisolone and my heart flutters in the evening. Imagine 60!

Thanks to all for responding and sorry I wasn't clear.

windyshores, Don't be sorry. You done good. I don't know how many times in my life when I have encountered a problems that I said to myself: "Look you're not special and not the first person who has ever encountered this problem." So, I've learned to ask and more often than not you run into someone somewhere who is experiencing the same problem and can offer some helpful information, point you in the right direction, or maybe even offer a solution. Sometime it is just confirmation that what you are doing is the best that can be done. Happens all the time on forums such as these. Your dilemma is way above my pay grade but I still hope that someone on this forum may offer you more assistance than I can. If you read or have read in this forum you will soon see the name of Andrea Natale MD in Thousand Oaks, CA. mentioned. He is apparently regarded by many on this forum as one of the premier clinical cardiac electrophysiologists in this land of ours and also regarded by many as the go-to person with respect to ablations. I have no idea whether he would entertain a consultation with you regarding your situation but I'm thinking it's not an issue he has not come across or dealt with in at least a peripheral sense. I could be totally wrong and out of my element for even suggesting that or even if it'a doable but can't hurt to ask. Best of luck and stay safe.

The anti-fib, interesting that it is the taper that triggers afib. That aligns with my experience of having episodes 1) in the evening when it wears off and 2) during relief from a stress. In other words, it isn't the increase in steroid or adrenalin level that sets things off, it is the decrease. This gives me an idea for approaching a doc. But so far none of them have shown much interest and I tried to get my specialists to consult a cardiologist. I need to push more for that.

It's AFIB triggered at least in part by acute adrenal suppression (low cortisol) resultant from the Corticosteriod withdrawal . I believe this happens much more than the Medical establishment realizes. It is controversial about the the need to taper off of these Drugs, and obviously individuals are different in their physiology and reactions. However I firmly believe that both Doctors and Patients don't realize the cause and effect of having an AFIB episode several days or a week after they took Corticosteriods. I have done much research on this after my own experiences, with over 30 episodes occurring within 2-8 days after withdrawal. My Cardio Doctors first denied the possibility, and now only marginally accept the possibility of this.

Interesting,and I am sorry for your experience.

In my situation, so far, it is not a case of tapering or adrenal suppression, unless 1mg wearing off within 8 hours of taking it causes suppression!

I do think our experience may be related, and maybe mine can also inform yours. The waning of the stimulation of the heart by steroids may be a factor rather than adrenal suppression-?

My whole life I have noticed my heart is stable during times of stress. When the stress was over, I would get palpitations. So natural cortisol does the same thing.

The first afib that landed my in an ambulance on the streets of the city, came with relief of an immediate stressor.

YES....I was put on prednisone and my heart started getting many ectopic beats, I had to stop taking it...and they went right away.