Prednisone is a potent corticosteroid medication that is prescribed to treat numerous medical conditions including (but not limited to): adrenal insufficiency, cancer, hives, leukemia, lupus, lymphoma, rheumatoid arthritis, tumors and a variety of rare autoimmune disorders. The drug works primarily by mimicking the biological effect of cortisol, a hormone naturally produced within the human body by the adrenal glands. When ingested regularly at therapeutic doses, prednisone can help manage symptoms of debilitating medical conditions.
Although some individuals need to take prednisone for the rest of their lives, most prednisone users will take the drug for a set duration, and then discontinue treatment. Unfortunately, when prednisone is discontinued, most users will experience withdrawal symptoms. For many people, the withdrawal symptoms that emerge after prednisone treatment is over are extremely debilitating.
What causes prednisone withdrawal symptoms?
Prednisone withdrawal symptoms occur for a variety of reasons. However, the most common cause of prednisone withdrawal symptoms is decreased function of the hypothalamic pituitary adrenal axis (HPAA). When a person takes prednisone in large doses for a few days, or at regular doses for over 2 weeks, function of the body’s hypothalamic pituitary adrenal axis (HPAA) begins to change.
- Decreased hypothalamic-pituitary-adrenal-axis (HPAA) function
- Lower production of cortisol
- Lower production of neurotransmitters (dopamine and norepinephrine)
Specifically, the hypothalamic pituitary adrenal axis produces less cortisol within the body because of the prednisone. Why? Because there’s no need for the body to produce its own cortisol when it’s receiving a cortisol-like hormone in the form of prednisone. Unfortunately, when a person suddenly stops using prednisone, the body is still expecting to receive the cortisol-like effects from the drug.
It may take awhile before the body realizes that it needs to increase its hypothalamic-pituitary-adrenal axis (HPAA) function and make more cortisol. Until the body re-learns to secrete normal levels of cortisol after prednisone is stopped, withdrawal symptoms will probably occur. Moreover, because prednisone alters activity throughout the brain, it’s likely that neurotransmitter imbalances may cause withdrawal symptoms for a period of time as well.
Prednisone Withdrawal Symptoms
There are many withdrawal symptoms that might emerge when a person stops using prednisone. Understand that not all of the symptoms included in the list below are formally documented in published medical research. For years, symptoms of prednisone withdrawal weren’t even acknowledged in the medical community. Thankfully, medical professionals are now realizing that prednisone withdrawal can provoke severe symptoms. If you withdraw from prednisone, know that the symptoms that you experience may not be the same as someone else’s.
- Achiness: A very common symptom of prednisone withdrawal is achiness throughout the body. While body aches can sometimes be indicative of a returning medical condition such as rheumatoid arthritis, sometimes the aches are a byproduct of withdrawal. Some people report that warm baths, massages, and/or dietary supplements can help with the aching.
- Anxiety: Anxious thoughts may seem like they’re never going to end once you quit prednisone. The anxiety is likely related to temporary irregularities in hormone production, as well as changes of neurotransmitters within the brain. Sometimes doctors may prescribe anxiolytics to help patients cope with this symptom.
- Appetite changes: Prednisone is known to increase appetite of users, which commonly causes weight gain. After a person stops using prednisone, appetite may decrease for awhile before normalizing. If you experience a low appetite during withdrawal, it is important to ensure that you’re still getting enough calories and eating a balanced diet.
- Blood pressure changes: Do not be surprised if your blood pressure is abnormal during prednisone withdrawal. If your hormones and/or neurotransmitters are imbalanced, this increases likelihood of your blood pressure fluctuating during withdrawal. Anyone with blood pressure abnormalities should carefully monitor their blood pressure after quitting prednisone and report fluctuations to a doctor. If blood pressure drops too low, this could result in fainting.
- Blood sugar changes: During prednisone withdrawal, you may want to monitor your blood glucose levels. Some individuals report unpredictable fluctuations in blood sugar when they withdraw from prednisone such as hypoglycemia (low blood sugar). Any blood sugar fluctuations may be especially dangerous in diabetics.
- Depressed mood: Fluctuations in hormones and neurotransmitters after stopping prednisone can make people feel depressed. If you feel depressed, it is important to manage this depression with the help of your doctor and other professionals. In most cases, the depression will clear up as the hypothalamic-pituitary-adrenal axis begins secreting more cortisol.
- Diarrhea: Bowel movements may change temporarily when stopping prednisone. Some individuals might even experience diarrhea in the first few days or weeks after their last prednisone dose. Fortunately, the diarrhea usually can be managed with over-the-counter antidiarrheal medications.
- Dizziness: One of the top withdrawal symptoms associated with prednisone is dizziness. It may feel like you’ve lost your balance or that your head is constantly spinning. If you feel really dizzy, make sure that you report this symptom to your doctor. Most people report less dizziness after they’ve made it through the first 2 weeks of withdrawal.
- Fatigue: One of the absolute worst symptoms of prednisone withdrawal is fatigue. The fatigue is directly tied to lack of cortisol production during the early stages of withdrawal. As the body starts to produce more cortisol on its own (usually takes a couple weeks), energy levels will start to increase. Although you may want to fight against the fatigue, don’t overdo it – trying to do too much may exacerbate the fatigue.
- Fever (low grade): It’s possible to experience a low-grade fever when you stop taking prednisone – especially if you weren’t tapered off properly. To play it safe, anyone experiencing a fever should inform their doctor. A doctor may recommend standard over-the-counter anti-fever medication to help ease this symptom during withdrawal.
- Headache: Another of the most severe symptoms of prednisone withdrawal is headache. Some people actually take prednisone to get relief from certain types of headaches, and when they stop taking it, the headaches are even more frequent and severe than before treatment. While some headaches during withdrawal are probably inevitable, always ask your doctor if anything can be done to help with the pain.
- Joint & muscle pains: Your joints may feel more painful than ever or your muscles might throb with soreness during prednisone withdrawal. This could signify the return of an autoimmune condition that affects the joints, however, in many cases it’s simply just another withdrawal symptom. It is recommended to gently massage your joints and/or muscles during withdrawal and refrain from intense activity (this might increase pain).
- Nausea: Certain people might end up with nausea when they finish taking prednisone. The nausea can sometimes be managed with over-the-counter antiemetic medications. Talk to your doctor if you have any questions about dealing with the nausea.
- Skin rash: Somewhat of a rare withdrawal symptom that has been reported by some prednisone users is skin rash. Skin rashes are sometimes itchy and could be the sign that an autoimmune condition is returning, but they might also be directly tied to withdrawal. If you experience a rash during withdrawal – have it evaluated by your doctor.
- Sleep disturbances: Some people will experience bizarre dreams throughout the night when they first stop taking prednisone. In addition to weird dreams, you might experience insomnia (inability to fall or stay asleep) or hypersomnia (sleeping way too much). Your sleep patterns will hopefully begin to normalize within a few weeks of your last dose.
- Stomach aches: Your stomach may rumble and feel incredibly achy during prednisone withdrawal. The achiness may be somewhat related to diarrhea, nausea, and/or vomiting – if you experience any of those withdrawal symptoms. Aches in your stomach may also be related to appetite changes during withdrawal.
- Suicidal thinking: On some website forums, some prednisone users have mentioned that they feel suicidal while withdrawing from the drug. If you ever feel suicidal while stopping prednisone – tell your doctor immediately. This is a very serious symptom and should not be left untreated.
- Sweating: You might end up sweating more than usual during withdrawal. Some people report profuse sweating such that they soak their bed sheets each night. Know that the sweating should eventually subside. That said, make sure that all of the sweating isn’t causing dehydration.
- Relapse of condition: The medical condition for which you were taking prednisone may return during withdrawal. For example, if you were taking prednisone for an autoimmune condition – the condition might reemerge during withdrawal. Additionally, the condition may reemerge with greater severity than pre-prednisone treatment.
- Tremor: You might notice tremor or shaking when you discontinue prednisone. Parts of your body such as your hands or feet may uncontrollably shake or twitch. Usually the tremor will subside within a few weeks, however, you should report it to your doctor in case it’s the sign of a more extreme problem.
- Vomiting: If you tapered off of prednisone too quickly or stopped suddenly from a high dose, you may end up vomiting. During withdrawal, most people feel really nauseated before they actually vomit, so if you feel nauseous, realize that it might precede vomiting.
- Weakness: For some, the weakness that emerges during prednisone withdrawal can make it difficult to get out of bed in the morning. If you feel weak, take it easy for awhile and let your body recover. As your body’s hormone production normalizes, the weakness should gradually decline and your strength should return.
- Weight loss: Prednisone treatment can cause significant weight gain when used for a long-term. However, most people who stop taking prednisone will notice that their body returns to its pre-prednisone weight. Appetite decreases and most of the weight that was gained during treatment ends up lost during withdrawal.
Note: The above list of prednisone withdrawal symptoms may be partial or incomplete. If you happen to know of symptoms associated with prednisone withdrawal that weren’t mentioned, share them in a comment.
What determines Prednisone withdrawal symptom severity?
There are a multitude of variables that might affect the severity of Prednisone withdrawal symptoms that you experience.
- Length of prednisone treatment: The longer the duration you used prednisone, the more your HPA axis will be altered, possibly resulting in a longer recovery period.
- Speed of prednisone tapering: If you tapered very slowly, you’ll be less likely to experience withdrawal symptoms than someone who stopped suddenly.
- Other substances: Use of medications or supplements during withdrawal could make withdrawal symptoms easier to cope with.
- Lifestyle: Your diet, activity level, stress level, and sleep quality will influence prednisone withdrawal symptoms.
- Genetics: It is thought that people with certain genetic and/or epigenetic profiles may recover quicker from prednisone withdrawal symptoms than others.
How long does Prednisone withdrawal last?
The length of prednisone withdrawal is subject to significant variation among users. One person may experience a short withdrawal that only lasts a week or two, whereas another person may be strung out with withdrawal symptoms for months. The same variables mentioned above as influencing withdrawal symptom severity will likely also determine how long your symptoms last after your final dose. Perhaps the best advice for most people who stop prednisone is to be patient and re-evaluate symptoms after 2-3 months of your last dose – in most cases they will have significantly improved in comparison to the first week of withdrawal.
Best supplements to help with Prednisone withdrawal
There are many dietary supplements and over-the-counter medications that may help you manage prednisone withdrawal. Never use any supplement or medication without prior consent from a medical professional – the last thing you need during withdrawal is some adverse reaction because you didn’t confirm the safety of a supplement with your doctor.
Affiliate disclosure: The products below contain affiliate links which helps this website earn a small commission. That said, we only recommend products that we think are high-quality, reasonably-priced, and helpful to readers.
- Multivitamin: The last thing that you need during prednisone withdrawal is a vitamin deficiency – this will help cover your bases.
- Electrolytes: An electrolyte supplement may be useful if you’re sweating a lot during withdrawal.
- Magnesium: Magnesium can help with joint pain, muscle aches, and stress during withdrawal.
- Rhodiola rosea: This is an adaptogen that may help rebalance the HPA axis during withdrawal.
- Imodium: This can help with diarrhea and/or stomach issues during withdrawal from prednisone.
- Vitamin B-Complex: This supplement may help you deal with anxiety and/or muscle tension after quitting prednisone.
- Type-2 collagen: This is a great supplement for easing joint pain after stopping prednisone.
- Curcumin: This supplement can reduce post-prednisone inflammation, which might ease some aches and pains.
- Melatonin: If you aren’t getting quality sleep, you may want to try melatonin before bed.
What’s the best way to withdraw from Prednisone?
There’s not really a “best” or perfect way to stop taking prednisone, however, some recommendations may be helpful.
- Medical supervision: Only withdraw from prednisone under supervision of a medical professional.
- Taper slowly: Do not suddenly stop taking prednisone. It’s always best to taper the dosage gradually over an extended period.
- Healthy lifestyle: Make sure that you’re getting enough sleep, some low-level activity (e.g. walking), socializing with others, eating a balanced diet, and getting sunshine during withdrawal.
- Medications and supplements: Various medications and supplements can help ease withdrawal symptoms, but don’t use them without consent from your doctor.
Have you withdrawn from Prednisone?
If you stopped taking prednisone, leave a comment describing your experience. To help make the comments section as informative as possible, and to help others understand the full extent of your situation, we’ve created a list of questions that you can answer in your comment. You do not need to answer every question to leave a comment – these are just some ideas to get the conversation going.
- How long did you use prednisone before stopping?
- What dosage of prednisone did you use before withdrawal?
- How quickly did you taper off of prednisone?
- Why did you end up discontinuing prednisone treatment?
- What withdrawal symptoms did you experience?
- How long has your withdrawal lasted?
- Did any meds, supplements or lifestyle changes ease your withdrawal symptoms?