Can prednisone make you tired?

In this article:

• Does prednisone make you sleepy?
• Why does prednisone make you tired?
• Managing prednisone fatigue
• When to see a healthcare provider 

In this article

• Does prednisone make you sleepy?
• Why does prednisone make you tired?
• Managing prednisone fatigue
• When to see a healthcare provider 

Prednisone is a corticosteroid medication that helps reduce inflammation. This versatile prescription drug is FDA-approved to treat autoimmune and inflammatory conditions such as arthritis, lupus, psoriasis, ulcerative colitis, multiple sclerosis, and endocrine disorders. It can also treat severe allergic reactions.

Like any medication, prednisone may cause side effects for some people. Though tiredness is not one of the most common side effects, it can occur in some cases—such as when taken at high doses for an extended period or following rapid withdrawal. Keep reading to learn what to watch for and how to manage prednisone fatigue.

Does prednisone make you sleepy?

Prednisone does not typically cause sleepiness. In fact, increased energy or difficulty falling asleep are more common when taking this medication. However, you may experience daytime tiredness if you have trouble sleeping through the night.

The risk of prednisone side effects increases with higher doses and long-term use. If you go off prednisone suddenly, you might experience withdrawal symptoms, including weakness and extreme tiredness. This is because your body may not be producing enough natural steroids to function. You can avoid prednisone withdrawal by tapering off the medication under the supervision of a healthcare provider.

Common side effects of prednisone include: 

• High blood sugar levels 
• Trouble sleeping 
• Increased appetite
• High blood pressure 
• Loss of bone density (osteoporosis)
• Swelling in parts of the body 
• Reduced adrenal gland function 
• Vision problems such as cataracts and glaucoma 
• Agitation
• Aggression
• Mood changes
• Shortness of breath
• Weight gain
• Slow healing of wounds

These side effects may become serious over time. Other serious side effects may include Cushing’s syndrome, stomach ulcers, an increased risk of infections, and stunted growth or development in children. This is not a complete list of possible prednisone side effects. Always notify your healthcare provider of any unusual symptoms.

Why does prednisone make you tired?

Prednisone can make you feel tired in several different ways.

• Increased energy: “Prednisone mimics the effects of cortisol, a hormone that regulates energy and metabolism,” says Shafaq Tarar, MD, internist and primary care provider with Medical Offices of Manhattan. For some people, this causes increased energy and difficulty sleeping. Insomnia can cause daytime sleepiness.
• Blood sugar fluctuations: “It can also cause fluctuations in blood sugar levels, leading to energy fluctuations and fatigue,” Dr. Tarar explains. A small 2019 study on nine young men performing high-intensity interval cycling performance after ingesting 20 mg of prednisone or placebo found that prednisone increased blood sugar levels and decreased the amount of work performed.
• Adrenal insufficiency: When you take prednisone for three weeks or longer, your adrenal gland may produce less cortisol. Stopping prednisone abruptly may also increase the risk of adrenal insufficiency. It can cause symptoms such as extreme tiredness and weakness because your body needs time to resume normal cortisol production when you are off the meds. One study found that one-third of patients who were taking low-dose 5 mg of prednisone daily for six months had adrenal insufficiency.
• Cushing’s syndrome: This rare but serious side effect of prednisone “causes significant weight gain and hyperglycemia [high blood sugar], both contributing to fatigue,” explains Harika Medi, MD, an internist with Houston Methodist in Richmond, Texas.

Managing prednisone fatigue

Dealing with medication-induced fatigue can be frustrating. The following tips can help you manage fatigue due to prednisone:

• Reach out to your healthcare provider. A simple dosage adjustment may make a difference. If fatigue becomes intolerable, your provider may recommend an alternative medication. Do not stop the medication or change the dosage without guidance from a healthcare professional.
• Do not stop taking prednisone abruptly—especially if you’ve taken it for a long period. This could cause adrenal insufficiency. Your healthcare provider can help you gradually reduce your dose of prednisone to give your adrenal system enough time to resume normal cortisol production. You may feel tired after your prednisone dose is reduced, but if it continues for more than seven days, check with your healthcare provider.
• Reduce intake of other substances that may contribute to drowsiness or fatigue. This includes alcohol and over-the-counter drugs that have drowsiness as a side effect.
• Take prednisone in the morning. Taking this medication when you first wake up can limit its impact on your sleep later in the day. Consult with a healthcare provider about the best schedule if you need to take multiple doses daily.
• Do some low-intensity exercise, such as walking, yoga, and light jogging. Research suggests that 20 minutes of low-intensity exercise may increase energy levels by 20% and decrease fatigue by 65%. Exercise triggers the release of energy-boosting hormones like dopamine, norepinephrine, and serotonin.
• Modify your diet. Eating an energy-boosting diet consisting of leafy green vegetables, fruits, whole grains, and healthy fats such as fish, nuts, and seeds may counter the effects of prednisone-induced tiredness.
• Stay hydrated. Dehydration may contribute to fatigue. Drinking enough water can provide many benefits, including increased energy, improved mood, better mental clarity, and overall improvement in normal physiologic body functions.
• Take supplements. Research suggests that consuming adequate amounts of vitamins (and minerals) like B12, B6, B9, C, iron, and magnesium can reduce mental and physical fatigue.
• See a therapist. Mental health problems, including mood swings and depression—which are both side effects of prednisone—may contribute to fatigue.
• Notify your healthcare provider of all other medications you’re taking or any medical condition you have. Your fatigue could be from a drug interaction or another health issue.

When to see a healthcare provider 

Seek medical advice from your healthcare provider if fatigue persists for longer than seven days after starting prednisone. They may reduce the dose, recommend an alternative medication, or recommend lifestyle changes.If you no longer need prednisone after using it for an extended period, seek guidance on how to wean off the medication to reduce the risk of side effects like adrenal insufficiency. Apart from extreme tiredness, other symptoms of adrenal insufficiency include body aches, loss of appetite, weight loss, mood changes, dizziness, nausea, and joint pain. Adrenal insufficiency can be life-threatening; visit the ER immediately for severe symptoms of adrenal crisis. They include loss of consciousness, weakness, confusion, vomiting and diarrhea, and severe pain in the lower back, abdomen, and leg.