Is there anything I can do to help my body return to producing cortisol?

I was diagnosed with polymyalgia rheumatica two years ago and have been on steroids since. I’m slowly reducing my steroid intake and hope to come off them. Is there anything I can do to help my body return to producing cortisol? I am also taking tablets to protect from stomach bleeds and vitamin D and calcium to protect from osteoporosis.

Polymyalgia rheumatica (PMR) is a musculoskeletal condition. It has similar symptoms to fibromyalgia and rheumatoid arthritis, the main difference being that PMR usually responds well to treatment. PMR is characterised by severe pain and stiffness in the muscles and joints. However, it doesn’t cause progressive disability or deformity, unlike other arthritic conditions.

The corticosteroid Prednisone is the usual prescription for PMR and symptoms typically decrease rapidly. Most PMR patients require steroid medication for two years, with the condition being considered “in remission” once you have managed two to three months symptom-free after ceasing the medication.

Long-term use of steroid medication can lead to side effects such as osteoporosis, stomach ulcers, gastrointestinal bleeding, thinning of the skin, facial puffiness, high blood pressure, increased appetite and weight gain, decreased immune function, cataracts, raised blood sugar levels, and susceptibility to bruising.

Given that you’ve been on steroid treatment for two years, your risk of developing these side effects is considered to be relatively low. You have made a wise decision in taking measures to offset and minimise any potential damage in the meantime.

People with PMR often take the enzyme serrapeptase along with steroids. Serrapeptase supplements were formulated following research on a silkworm bacteria (Serratia marcescens) that enables the tough cocoon to be broken down easily. Serrapeptase helps to break down scar tissue without affecting healthy tissue while reducing inflammation.

You may need to look at supporting your adrenal glands for healthy cortisol levels. Gentle stretching exercises can help, along with eating a balanced wholefood diet without processed sugars and fats.

Herbs that help to strengthen adrenal function include liquorice root, tulsi (holy basil), ashwagandha (withania), rhodiola, Siberian ginseng, and maca.

Natural therapies such as acupuncture, homeopathy, osteopathy, and massage may also be beneficial in supporting your body to restore cortisol production levels.

Always inform your doctor of any therapies or supplements you intend to take alongside medication.

I’m just over covid. My symptoms were mild but I feel exhausted most of the time. What can I do to get my energy levels back?

Fatigue is the number one issue my patients struggle with after a bout of covid. To combat this, I prepare a remedy that includes traditional botanicals to support constitution and vitality.

The herbs I use are often used where chronic illness is an issue as well as for post-viral recovery.

Rehmannia root is a blood tonic; star anise is a powerful antioxidant with anti-inflammatory, antiviral, antifungal, and antibacterial properties; schisandra berries are adaptogenic, helping to boost stamina and energy levels; nigella sativa seeds are an impressive anti-inflammatory and are particularly useful in healing the respiratory system.

I also include the more commonly known herbals such as fennel seeds to help with digestion, respiratory health, viral infections, muscle cramping, and turmeric, which is currently being investigated as a complementary medicine to support covid recovery. You can also include foods in your diet that help to restore energy levels — choose richly coloured berries, plums, and beetroot, along with the healthy fats found in avocado, nuts, seeds, and coconut.

  • If you have a question for Megan Sheppard, please email it to feelgood@examiner.ie 
  • NOTE: The information contained in this column is not a substitute for medical advice. Always consult a doctor.

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