During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex. Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation. Although it has been shown that there is considerably less adrenal suppression following a single morning dose of prednisolone (10 mg) as opposed to a quarter of that dose administered every six hours, there is evidence that some suppressive effect on adrenal activity may be carried over into the following day when pharmacologic doses are used. Further, it has been shown that a single dose of certain corticosteroids will produce adrenal cortical suppression for two or more days. Other corticoids, including methylprednisolone, hydrocortisone, prednisone, and prednisolone, are considered to be short acting (producing adrenal cortical suppression for 1¼ to 1½ days following a single dose) and thus are recommended for alternate day therapy.
Sixty steroid-treated patients with asthma were evaluated for the presence of muscle weakness by use of both manual muscle testing and the Cybex II isokinetic dynamometer. The patients were compared to age and sex-matched sedentary control subjects. Forty-eight percent of the patients (12/25) taking greater than or equal to 40 mg per day of prednisone had hip flexor strength greater than or equal to 2 SD below the mean of age and sex-matched control subjects by Cybex testing (CT). Sixty-four percent of the patients (16/25) taking greater than or equal to 40 mg per day of prednisone were found on manual muscle testing to have hip flexor weakness. Only one patient taking less than 30 mg per day of prednisone was found to have muscle weakness. Biochemical parameters, including CPK, aldolase, SGOT, LDH, and LDH isoenzymes were measured to assess the degree of steroid-induced muscle damage. They neither correlated with the degree of hip flexor weakness as measured by CT, nor did they discriminate between patients receiving small doses and large doses of steroids. Changes in urinary excretion of creatine did not help to confirm the diagnosis of steroid myopathy. Although CT provides an objective means of assessing muscle strength in these patients, at this time no definitive chemical test is available for the diagnosis of steroid myopathy.
I don't know if you'll fully recover or not. I'm not a Dr, just another person with steroid myopathy. I always think there is hope esp if your going down on the steroids. It seems to me the myopathy sets in after larger doses than what a person normally takes. I probably won't ever be able to get off of the steroids completely either. I asked my Dr about more weakness after exercise and he told me it was because I was weak to start with but he asked if my general trend was improvement......and it is. I was unable to walk at first and I too was really, really, scared but after I got with the right physical therapist, I started walking again but it was not easy. At first people had to pick me up to put me in the wheelchair, then I learned how to slide on a board and then I started to be able to stand. It took a months. Recovery is very very slow. It has helped me to keep a log of my progress. When I make an improvement, like going from the walker to using a cane, then going without the cane into the grocery store........I write it down. So I don't get discouraged and I can see my progress. You might want to try that too. Personally I think being able to walk with your dog for 30 minutes at a time is GREAT!!!! I wouldn't be able to do that yet. Keep working at it and try not to be scared, just know in your heart that you will do what it takes to get better and know it really takes a long, long time to recover and no one can give you how long that will be. I hope you find a good physical therapist. I do arm exercises too with light weights. I wish the best for you and know there are others out there that have been where we're at.