Shortness of breath, Polymyalgia Rheumatica and GCA, Patient, prednisone withdrawal breathing problems.

Shortness of breath

Posted 1 September 2014 at 18:22

I've felt quite short of breath since being on the prednisone.  I have always been a "fit" person and it worried me.  I read that prednisone can cause shortness of breath, palpitations, slow or fast heartbeats, etc.

What's the consensus:  are these symptoms danger signs — signs that the patient ought to stop taking the pred, or are these merely things we'll have to deal with?

23 Replies

Yes, I have had this on the higher doses of Pred, but it disappears as the dose reduces.  Additionally, with me Pred weight goes on round my midriff, sometimes this also causes problems with breathlessness on bending or exertion. 

I've never believed that it was anything worrying as it does disappear over time, but you can always ask the doctor when you see him next.

I was started on 15mgs of pred when diagnosed with pmr, and 19 months later i am down to 7mg but depending on the dose at the time i have experienced palpitations and shortness of breath my doctor said to me when i drop down further with the pred they will go and they did but they come and go with me i,m affraid. His only other offer was to put me on tramadol which i refused.But if in dought get checked out. Good luck   

Breathlessness can be a side-effect of pred yes. I also felt short of breath BEFORE pred, just because of the PMR. I would get to the top of the stairs and be gasping – definitely PMR not the pred as I had to wait 5 years to get pred.

Remember PMR makes your muscles intolerant of exercise – so that climbing the stairs is the equivalent of climbing a mountain! The muscles are short of oxygen, the signal goes out to breathe harder and get more oxygen. If you stop the pred you will be back where you were before taking it. And maybe – just a bit less enthusiastic exercise?

Darn – knew there was another comment: again, PMR as well as pred can lead to arrythmias. I developed atrial fibrillation but it started in the early days of PMR, although I didn't realise until something else triggered a very bad attack. Once that was diagnosed and treated I realised that I had had palpitations and tachycardia on occasions for several years but just hadn't recognised it. Get those sorts of feelings checked out, just in case.

I have the same thing. After about 4 weeks of Prednisone 15mg I suddenly became breathless, first on a hill then in a slight incline. I was very frightened by it. My GP was no help, she did not know that Prednisone could do this and ignored this possibility. Sent me for chest Xray and ecg. All normal, but time consuming and the breathlessness increasing. 

This is now 3 weeks later and I am at the stage of decreasing to 13.5mg and am hoping that the problem will decrease as the Prednisone goes down. 

I just pace myself, resting after any energy expenditure, but I am encouraged because my recovery time is shortening. It used to take about 2 hours, now after about 1/2 hour it has settled.

Its boring but better than having the pain.  

I hope this helps.

This seems to be the pattern. I started off on 20mg 10 months ago and am now down to 7mg. I have had shortness of breath and all the tests (ecg, etc) and am due to see a cardiologist sometime in the future. But, having read hundreds of letters with people suffering from polymyalgia we all seem to have the same symptoms, and yes, my GP told me that it would get better as the dose reduced – so I live in hope.

I had shortness of breath and palpitations with PMA and GCA so made it hard to exercise and breath and talk or breath and eat. The prednisone seems to have made this much worse– at 60mg now for 8 weeks. The difference is with  prednisone I feel so good and most of my pain is gone.  I can to move fast like my old self. but when run up the stairs or do any high movement activity my heart races even more and I'm so out of breath it looks like a panic or asthma attack. It's worrisome since it seems that can't be good for the heart and lungs? 

Not sure if this will improve as the prednisone is reduced? My Doc said a low dose of zanex may help with this side effects until the prednisone is reduced enough. Still figuring it out.

Your muscles have become intolerant of acute exercise due to the PMR – you will be able to get back a degree of fitness but you will have to "train" slowly. Your muscles now perceive something you used to do without thinking as high level exercise. Even with the pred which improves the blood flow to some extent, there is still a deficit that makes you feel totally unfit.

Not running up the stairs is also part of the management of PMR – pacing and resting appropriately.

And I forgot to mention that the autoimmune part of PMR can cause cardiovascular damage which shouldn't be dismissed. There are other reasons – and the PMR or the pred may have been the final straw to bring the symptoms to light. 

And that pred also causes breathlessness for some people which can be confused with cardiac problem – there was a study done in Holland I think. So that always must be borne in mind.

how very difficult to know. And impossible on a forum. Our garden has a 15 degree slope. I assumed the shortness of breath climbing up it was due to having become unfit over the course of a year. I changed diet to lose a bit of weight (not really overweight, just uncomfortable) and the pmr was at the point I could exercise a bit more.

But wait, there's more . slightly high cholesterol and reluctant to take statins for prevention gp convinced me to have a coronary calcium count. Stress echo test a disaster (though I decided finding something was success). End result a coronary stent for a thoroughly blocked artery. Just lucky I guess.

PS post coronary rehab I have no shortness of breath. Just started reducing pred again (now 4mg/day). I didn't change it during the rehab exercise as I figured change only one thing at a time.

I have had intermittent bouts of shortness of breath with my PMR & note a few of you also on this site have too.

​I am on a low dose of hydrocortisone now after 18+ months PMR (pred in NZ not enteric coated & ate into very sensitive gut).

​Just the slightest weight gain of a few pounds can make breathing hard as any fat goes on gut as mentioned.   I am slim, average weight.

​I was hospitalized April with suspected heart attack – alas no it was myocarditis & have mild changes to tricuspid & mitral valves.

​Can you or anyone offer any other suggestions as to how I can best improve my breathing other than the breathing exercises, I do plus mild exercise.

​Oh yes one other, my legs have been losing strength & now have tendon/ligament pain right thigh.

So many of these questions/replies seem to be almost a year old. I've been on Prednisone since March 2016 for GCA, trying to taper from 60 mg. Had a relapse after being all the way down to 15 mg and had to go back up to 60 mg.  I'm now down to 30 mg, but very short of breath. I haven't reported it to my doctor yet but will next week. How are the rest of you doing? 

anniversary stress test didn't pick up any abnormalities. Yeah. Next test 3 years.

Down to 2 1/2 mg/day but had a sort of smoulder rather than a flare so looking for new level around 3 3.5mg/day.

It generally takes more effort before I'm out of breath. A bit of exercise induced chest stiffness.

I have been on Prednisone since March 17 after being told I had sciatica before being sent to a Rhematologist who new immediately  I had PR, so was put in 20mg a day and now reducing bym1mg a month  from June. My problem is my weight gain of over a stone since March when I was a gold member at weight watchers. I have never had a middle before I feel very down about the weight gain. I go to the gym 3 to 4 days a week, watch what I eat and still not lose weight. I also,get shortness of breath when I am excersing, my heart rate goes upto 176.does anyone else have all of these symtoms. 

You watch what you eat – but what do you eat? Many of us have either lost weight while still on pred or avoided weight gain in the first place by cutting carbs drastically. Pred changes the way our bodies metabolises carbohydrate, reducing it as much as possble reduces the problem.

Thank you Eileen, I have cut out Bread potatoes, do not eat pasta. My main meal is chicken or fish with salad I do,have a spoon of low fat coleslaw. I have two boiled eggs and a small banana for breakfast. Lunch I have fruit and lean chicken,,may be I am not eating enough. I also drink 5 x 500c of water per day. Maybe someone out there can tell me where I am going wrong. 

If you are avoiding carbs you don't need to eat "low fat" anything – and low fat things tend to have a lot of added stuff, including sugar.

You may well find it is your fruit that is the problem. A low carb diet is less than 50g useable carb per day. You can get there just with an apple and a banana these days – they are so enormous! And while it is "healthy" sugar it is still sugar, is still carbohydrate – and it all adds up when you eat a banana, an apple, a few grapes, and then even lettuce has some carb in it – depending on what you eat in a salad that can come to 20g of carbs quite easily. That has been found to be a problem by others in the past.

But while on pred, no weight gain is also a good result. I struggle to lose weight, I would have to go to no carb I think, but I don't put any on. That will do if that's all I can achieve.

I'm getting all that and it's been 4 weeks since I stopped a 3 day dose of 70mg now I'm wondering how long does this thing finally take to eventually get out of your system that is once you stop taking this drug.  Can someone tell us?

Pred is out of your body within a very short time – if all you had was 3 days a month ago then it was gone long ago. 

The people on this forum have a chronic condition that means we need pred on an on-going basis for years usually so are in a very different position to someone like who needed it for an infection I assume? 

If you still have breathlessness now I think you need to check with your doctor unless there is another reason that might account for it.

I had considerable shortness of breath on the higher doses of Prednisone.  Now that I am down to 4 mg, it is much, much better. My symptoms also included palpitations, severe leg cramps, sweating, hunger, loss of sleep, etc.  All have disappeared except for the weight gain.  Even low carb isn't doing the trick.  Oh well.

I have been on prenisone for 30 days (15 mg)  On day 26 I got a shortness of breath after going up the stairs.  It only lasted a short time and went away.  I am very active doing all kinds of yard work,  do one mile on tread mill 3 times a week and never have any shortness of breath.  It goes way after a little while and some days it does not happen.  I also get just a little light head feeling at the same time.  That also goes a way at the same time.  I ask the question as you do.

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