Can A Cortisone Shot Make You Tired? - Fatigue to Flourish - (2022)

If you are suffering extreme fatigue after a cortisone injection you aren’t alone.

Cortisone shots can make you tired.

When you scheduled your cortisone shot, you were probably looking for relief from a chronic injury. But I bet you didn’t consider that you might suffer fatigue after your cortisone injection.

You see, cortisone has a dark side. For all the pain-relieving benefits cortisone has, there’s a long list of potential side effects, including fatigue.

Before you book your next cortisone injection, read this post and educate yourself on the potential risks. Make an educated and informed decision. Because there are risks to cortisone injections.

Cortisol vs Cortisone

You’re probably more familiar with cortisol. Cortisone and cortisol are closely related. (1)

Cortisol is anti-inflammatory. Your body releases it in response to allergies or other inflammatory conditions.

Cortisone is a stronger anti-inflammatory due to the way it binds to receptor sites. This is incredibly helpful when dealing with an injury that never seems to heal.

But cortisone does more than act as an anti-inflammatory. Cortisone is a glucocorticoid, which is a steroid hormone. And that means it influences much more than inflammation.

The dark side of cortisone

Your blood sugar and cortisol are closely connected. So connected in fact that if your blood sugar isn’t balanced you may developadrenal fatigue.

The same relationship exists between cortisone and your blood sugar. When you receive a cortisone shot your blood sugar is going to increase – sometimes dramatically. For most people this is temporary. However, if you’re like most people in North America you may already be dealing with a blood sugar issue (find out if you are) – you just might not know it yet!

If you’re already struggling to regulate your blood sugar it’s very likely that you will experience fatigue after your cortisone injection.

(Video) When Being Tired Is More than Being Tired

How does blood sugar affect fatigue?

Regulating the quantity of sugar in your blood is extremely important. If you have too much sugar in your blood your tissues start to die. If you don’t have enough sugar in your blood you may end up in a coma close to death. To be healthy you need to control your blood sugar.

For most of you, your body runs on sugar (glucose), much like your car runs on gas. Without gas, your car won’t run. And without sugar, your body can’t create energy and you’ll feel fatigued.

Fatigue is your body protecting itself. By making you tired, your body conserves what little energy it has. Fatigue prevents you from doing activities that require energy output – which may be as simple as getting out of bed.

If your blood sugar is too high, too low, or fluctuating dramatically between highs and lows, you’ll also experience swings in your energy levels. When you are experiencing fatigue I can guarantee you have a blood sugar imbalance. I can show you how to achieve and maintain the perfect blood sugar.

A cortisone shot’s effect on blood sugar

A cortisone shot pulls sugar out of your cells and dumps it into your blood. As a result, your blood sugar levels go up. (2) In most people, this usually doesn’t last very long. But for some people, a cortisone shot could be enough to give you high blood sugar (hyperglycemia). And should this happen, it’s likely that you’ll experience fatigue.

If you don’t have diabetes, monitor your blood sugar levels before and after a cortisone injection.

You need to ensure your blood sugars return to normal within two weeks following the injection. They should. But that’s not a guarantee. If your sugars do not return to normal, you’re on the fast track towards fatigue.

To get them back on track you’ll need to alter your diet and lifestyle.

More ways cortisone shots make you tired

Your body uses something called the HPA axis to best handle the stresses of life. It is what controls the fight or flight and rest or digest responses.

Adrenal fatigue is a condition that occurs when your HPA axis is no longer resilient. Instead of adapting to a stressful event, your body crumbles. Adrenal fatigue often develops due to:

(Video) Ask The Expert -Truth About Adrenal Fatigue

  • Sleep disturbances
  • Hidden sources of inflammation
  • Blood sugar irregularities

And blood sugar irregularities can occur after a cortisone injection.

A cortisone shot floods your body with the hormone – and the larger the dose, the larger the response. This triggers a phenomenon known as feedback inhibition. The high levels of cortisone from the injection tell your body that there’s plenty of this hormone. Therefore, no need to make any more. When this occurs, your body slows its production of cortisol.

One cortisone injection dramatically lowers circulating levels of cortisol in the body. (3)

In a study conducted on 10 athletes given a cortisone shot (4), after two weeks three of the participants were suffering from adrenal fatigue. This was tied directly to the cortisone shot.

If a cortisone injection causes adrenal fatigue in healthy, fit athletes, what do you think it will do to you?

How to avoid fatigue after a cortisone injection

There are some things you can do to avoid extreme fatigue after a cortisone injection:

Step 1

Balance your blood sugar. You can do this all on your own with some simple dietary changes. A keto diet will have your blood sugar balanced in no time. If that seems too radical for you, check out my eCourse, Stop Feeding Fatigue. I’ll show you how to identify exactly which foods are wreaking havoc on your blood sugar so you can avoid them.

Step 2

Determine if your cortisol levels following the injection are high or low. Laboratory testing is your best option here. If lab testing is not an option, skip to the bottom of this section to learn what to do.

If you have high cortisol levels you need to lower them. You can do this with herbs like magnolia, cowhage, and eleuthero. GABA and phosphatidylserine can also help lower cortisol levels. I’ve also written a blog taking a deep dive into the best supplements for adrenal fatigue.

If you have low cortisol levels you need to increase them. I recommend using adrenal glandulars combined with licorice root. Other herbs/supplements that can help increase cortisol include ginseng and cordyceps.

(Video) Chronic Fatigue Syndrome and Persistent Fatigue

Do not take supplements if you don’t know whether your cortisol is high or low. They are only to be used when you actually know your cortisol levels. If lab testing is not an option, you’re going to want to use adaptogenic herbs. These herbs have a balancing effect on your cortisol; raising it when it’s low and lowering it when it’s high.

My recommendations for adaptogenic herbs include Rhodiola, Schisandra, and Ashwagandha. Opt for a combination of these three and you won’t make your fatigue worse.

Take the supplements until your fatigue improves. Just remember that you’re going to have to ensure your blood sugar remains balanced! Otherwise, none of these supplements are going to work.

Cortisone injections – more risks than feeling tired

Fatigue is not the only adverse effect of cortisone shots. You can also experience:

  • Pain and swelling
  • Skin discoloration
  • Fat atrophy
  • Tendon injuries
  • Cartilage loss
  • Allergic reaction
  • Irregular menstruation

Pain and swelling

After an injection, cortisone can crystalize inside your body. This will intensify your pain signals – big time. Fortunately, this will typically last just a few days. Should it happen to you, grab an ice pack and sit on the couch!

Skin discoloration

Months after your cortisone injection, you may notice that the skin surrounding the injection site is a different shade than your surrounding skin. This is called hypopigmentation and can occur after cortisone injections. (5)

While not harmful or painful, the condition can be permanent. The darker your skin tone the more likely hypopigmentation is to occur. Rough estimates suggest this to occur in 1-4% of patients. (6)

Fat atrophy

If you noticed depression or divot surrounding the injection site, that’s due to fat cell atrophy. If the fat cells underneath your skin disappear, the skin and tissue will appear to fall in on themselves. The cells will regenerate but it can take upwards of 2-3 years. (7)

Tendon injuries

Be absolutely certain your physician is not injecting cortisone into your tendons. Cortisone weakens tendons making them more prone to tearing. (8) Ideally, cortisone should not be injected anywhere near tendons.

Should your injection need to take place in close proximity to a tendon, ensure you rest the affected joint for a few days following the procedure. No heavy lifting or exercise are recommended.

(Video) What Is Chronic Fatigue Syndrome?

Cartilage loss

Cortisone is a catabolic hormone which means it breaks down tissues. This includes cartilage. One study found that cortisone injections in the knee caused more than 0.1cm of cartilage loss (that’s a lot!). (9)

FYI, cartilage loss is what occurs in osteoarthritis. Meaning continued cortisone injections into joint spaces will cause long-term, irreversible, degenerative changes. No bueno.

Allergic reactions

You won’t have an allergic reaction to cortisone itself. But allergic reactions can occur in response to the local analgesic used before a cortisone injection. If you’ve reacted to anesthetics before, make sure your doctor knows about it!

Irregular menstruation

To be clear, sex-related side effects are rare and tend to only occur in women. Sex-related side effects include irregular menstruation, disturbances in lactation, and excess hair growth. (10)

Can cortisone injections make you tired? – final thoughts

Cortisone shots can be a ridiculously fast and effective means to relieve chronic pain. I’m not at all against the use of cortisone. But I take a strong stand against the uninformed use of cortisone – and any hormone.

Cortisone injections can have adverse side effects:

  • Extreme fatigue
  • Imbalanced blood sugar
  • Tissue atrophy at the injection site

While these effects may be relatively rare, heed the following:

Check your cortisol levels before scheduling your injection

    • I recommend acortisol test that involves testing at four different times throughout the day.
    • At the very least, opt for an AM cortisol reading with your family doc.
    • If your levels are either low or high, postpone that injection!

Monitor your blood sugar

    • High blood sugar and low blood sugar readings are both indicative that your body is struggling to balance its sugars.
    • If your blood sugars are irregular, avoid getting a cortisone shot until they’re properly balanced. I can show you how to balance your blood sugars.

If the cortisone injection didn’t work the first or second time, don’t keep scheduling appointments.

    • Cortisone breaks your tissue down. You don’t want this to happen.
    • The more injections you get, the higher your risk for cartilage loss and tendon injuries.
    • Cortisone shots should not be a regular occurrence.

Ask your family members about adverse reactions.

    • If your mom, dad, brother, or sister had an allergic reaction to cortisone, you’re more likely to experience a similar reaction.
    • Talk to your doctor about alternatives to cortisone
    • There’s plenty of injectable therapies that won’t trigger fatigue yet still offer pain relief.
    • Protein-rich plasma (PRP), hyaluronic acid, and prolotherapy are three alternatives to help improve your joint pain while not affecting your hormones.

Ok, now you know all the risks associated with a cortisone injection. If you experienced extreme fatigue after a cortisone injection, be sure to check your cortisol levels! You’re likely dealing with adrenal fatigue.

It’s time for me to hear from you!

How did cortisone affect your energy?

(Video) Signs and symptoms of lymphoma - Mayo Clinic

What steps did you take to improve your energy after the injection?

Leave your answers in the comments section below!

FAQs

Can cortisone injections cause fatigue? ›

According to the National Institutes of Health, the side effects from cortisone shots include: Dizziness or headaches. Skin issues, including dryness, thinness, acne, dry skin, and red or purple blotches. Fatigue and trouble sleeping.

How long does cortisone fatigue last? ›

We call this reaction a cortisone flare. Usually, a cortisone flare starts after 6 hours and lasts up to 5 days. One study suggested that a cortisone flare can last up to 4 days. If you develop a cortisone flare, we recommend rest from activities, including sports, until the pain settles.

How long does cortisone stay in your body after an injection? ›

Cortisone shots commonly cause a temporary flare in pain and inflammation for up to 48 hours after the injection. After that, your pain and inflammation of the affected joint should decrease, and can last up to several months.

Can injections make you tired? ›

It's normal to feel slightly drowsy or sleepy in the hours after a vaccination, especially if it was a stressful event for you or your child. It might help to take a bit of time to rest and recover.

Does a cortisone shot affect the whole body? ›

Cortisone shots are used to treat a wide variety of inflammatory conditions affecting your joints or other parts of your musculoskeletal system. They're generally safe, but they can cause side effects that either affect the treated area or your whole body.

What is causing tiredness? ›

Most of the time fatigue can be traced to one or more of your habits or routines, particularly lack of exercise. It's also commonly related to depression. On occasion, fatigue is a symptom of other underlying conditions that require medical treatment.

Can a cortisone shot affect your heart? ›

Forty years later, Maxwell et al11 raised the possibility that systemic corticosteroids also increase coronary heart disease. Corticosteroid treatment has been previously associated with risk factors for cardiovascular disease such as hypertension, hyperlipidaemia, and hyperglycaemia.

Do you need to rest after a cortisone injection? ›

Common side effects

You may also get some bruising where the injection was given. This should go away after a few days. It helps to rest the joint for 24 hours after the injection and avoid heavy exercise. It's safe to take everyday painkillers such as paracetamol or ibuprofen.

What are the disadvantages and side effects of cortisone injections? ›

Cortisone Shot Disadvantages and Side Effects

Infection. Bleeding from broken blood vessels in the skin or muscle. Soreness where you get the shot. Aggravation of inflammation in the area injected because of reactions to the medication (post-injection flare)

What is the next step if a cortisone shot doesn't work? ›

If the first injection doesn't provide pain relief, your doctor may try a second injection four to six weeks later. If there's no improvement after the second injection, a third injection is not recommended.

How many cortisone injections can you have in a lifetime? ›

You can only have three cortisone injections in a lifetime

Generally, if the first injection doesn't work, the second and third probably won't either. Moreover, you should limit yourself to 2-3 injections in one area over 3-6 months.

Can a cortisone shot wear off in a week? ›

After you begin to feel relief, it should last for between four and six weeks. Some types of acute injuries may heal in that time, and your pain will be gone, and stay gone, once the cortisone wears off.

How long does anxiety last after steroid injection? ›

This is usually minor and self limiting. The cortisone may result in palpitations, hot flushes, insomnia, and mild mood disturbance. This usually resolves within 24 hours and no treatment is necessary.

What is the best injection for arthritis? ›

Studies show hyaluronic acid injections may work better than painkillers for some people with OA. Other studies have shown they also may work as well as corticosteroid knee injections. Hyaluronic acid injections seem to work better in some people than others.

Can a cortisone shot cause sleeplessness? ›

Side effects of injections given into the blood tend to be similar to side effects of steroid tablets, such as increased appetite, mood changes and difficulty sleeping.

What is an alternative to a cortisone shot? ›

Enter – PRP, or platelet-rich plasma. PRP injections offer a viable alternative to corticosteroid injections, without all of the nasty side effects.

Are cortisone shots safe for elderly? ›

Epidural steroid injections (ESI) using CT-guidance may be safely administered to elderly patients, according to a study published in Pain Physician. An estimated 30% of patients in the United States with back pain are over age 65.

Why am I always tired sleepy and have no energy? ›

Many possible factors cause chronic fatigue, such as underlying medical conditions, nutrient deficiencies, sleep disturbances, caffeine intake, and chronic stress. If you're experiencing unexplained fatigue, it's important to talk with your doctor to find the cause.

Why am I always tired and have no energy or motivation? ›

The following factors can contribute to fatigue, either alone or in combination: Psychological and psychosocial – stress, anxiety, and depression. Physical – anemia, diabetes, glandular fever, and cancer. Physiological – pregnancy, breast-feeding, inadequate sleep, and excessive exercise.

What can you do for extreme fatigue? ›

Self-help tips to fight tiredness
  1. Eat often to beat tiredness. ...
  2. Get moving. ...
  3. Lose weight to gain energy. ...
  4. Sleep well. ...
  5. Reduce stress to boost energy. ...
  6. Talking therapy beats fatigue. ...
  7. Cut out caffeine. ...
  8. Drink less alcohol.

Can a cortisone shot cause a stroke? ›

Steroid injections into the spine can cause partial or total paralysis, brain damage, stroke, and even death.

Can a steroid shot cause your heart to race? ›

Prednisone may cause what is known as tachycardia, or a rapid heart rate over 100 beats per minute. In clinical studies, other possible adverse cardiovascular effects reported were: Cardiac arrhythmias. Bradycardia (slowed heart rate)

Do cortisone shots affect your kidneys? ›

Corticosteroid increases the risk of cyclosporine toxicities by increasing drug levels: kidney dysfunction, gall bladder disease, tingling sensations, high blood pressure, edema (swelling), fluid/electrolyte disturbances, and hyperglycemia (high blood sugar).

How much does a cortisone injection cost? ›

Cortisone injections - a shot containing a corticosteroid - can cost anywhere from $25-$300, depending on your health insurance status, the injection site, and what the injection is being used to treat.

How long will blood pressure stay elevated after cortisone shot? ›

Similarly a transient increase in blood pressure can also occur after a cortisone injection although again this typically goes away within 5-7 days after the injection.

Does cortisone affect the immune system? ›

Corticosteroids also suppress your immune system, which can help control conditions in which your immune system mistakenly attacks its own tissues.

Does cortisone cause weight gain? ›

Steroids affect your metabolism and how your body deposits fat. This can increase your appetite, leading to weight gain, and in particular lead to extra deposits of fat in your abdomen.

What is the best injection for hip arthritis? ›

Hyaluronic Acid Injection

To address the changes in the synovial fluid of hips affected by osteoarthritis, doctors at NYU Langone inject into the joint space a hyaluronic acid product. The injection is designed to make the fluid more substantial and to improve the joint's gliding motion.

Can you feel sick after a cortisone injection? ›

Stomach Upset – Cortisone injections can cause stomach upset for a few days. Some people also experience hiccups. Tendon Rupture - Cortisone can also cause weakening of tendons even tendon rupture. This is one reason your doctor may limit the number of cortisone injections administered.

How many cortisone shots are safe in a year? ›

Typically, corticosteroid injections are not given more often than every six weeks, and usually not more than three or four times a year.

Can a cortisone shot take 2 weeks to work? ›

It can take up to 7 days for a cortisone injection to begin working in the body. The effects of the injection usually last up to 2 months, but sometimes longer. Cortisone can reduce inflammation that damages joints.

What is the best shot for knee pain? ›

Cortisone and hyaluronic injections are commonly used for fast, temporary relief from knee osteoarthritis pain. Cortisone injections may begin working within 24 hours of the injection, and the effects of a cortisone injection typically last between 6 weeks to 6 months.

Why can't you use heat after a cortisone shot? ›

Heat loosens up your muscles for stretching and exercises. Note that heat therapy is not recommended for treating inflammation, which is characterized by redness and throbbing pain. Inflammation typically does not respond well to heat, even though it may seem to provide short-term relief.

What is a cortisone flare? ›

A cortisone flare is the most common immediate side effect of a cortisone injection. Some people may notice a flare-up of pain in the joint for the first 24 hours after receiving the injection, although this is rare. The discomfort can often be managed by taking over-the-counter painkillers.

Can cortisone shots affect your brain? ›

The use of corticosteroids is strongly associated to the development of psychiatric/neurological side effects. These effects are due to the wide expression of GR in the brain, and their long-term modulation can lead to functional and anatomical alterations, which might be responsible for the observed side-effects.

Why does cortisone cause anxiety? ›

Excessive amounts of corticosteroids can lead to mood fluctuations and depression. Norepinephrine regulates emotions, alertness, sleeping, and dreaming. An excessive amount of norepinephrine can lead to overstimulation of the sympathetic nervous system, causing an increase in heart rate and BP, trembling, and anxiety.

Can cortisone make you anxious? ›

They treat conditions like asthma, allergies, arthritis, and bronchitis. Doctors aren't sure why, but these medicines can make some people irritable and anxious. You may have symptoms of anxiety if you're taking: Cortisone (Cortone)

What is the newest treatment for osteoarthritis? ›

ACI has been shown to improve the symptoms of osteoarthritis, including pain and mobility. It can also slow or stop osteoarthritis developing, delaying or preventing the need for joint replacement surgery. This makes it particularly useful for younger people with early-stage osteoarthritis.

What is the new drug for osteoarthritis? ›

A drug called tanezumab reduced pain and improved physical function in patients with osteoarthritis of the knee or hip, according to the results of a large clinical trial published in JAMA.

Does rest help arthritis? ›

Sometimes rest is appropriate

If you are experiencing an arthritis flare-up, it can be helpful to take a break for a day or two while you focus on reducing pain and inflammation. In the meantime, focus on rest, ice or heat therapy, and anti-inflammatory pain medications.

Can cortisone injection affect cortisol levels? ›

In addition, cortisone administration could also lead to a dampening of pituitary ACTH secretion, leading to lower production of cortisol by the adrenal glands.

Do you need to rest after a cortisone injection? ›

Common side effects

You may also get some bruising where the injection was given. This should go away after a few days. It helps to rest the joint for 24 hours after the injection and avoid heavy exercise. It's safe to take everyday painkillers such as paracetamol or ibuprofen.

What are the disadvantages and side effects of cortisone injections? ›

Cortisone Shot Disadvantages and Side Effects

Infection. Bleeding from broken blood vessels in the skin or muscle. Soreness where you get the shot. Aggravation of inflammation in the area injected because of reactions to the medication (post-injection flare)

What are the side effects of steroid injections? ›

Steroid Injection Side Effects
  • Infection.
  • Allergic reactions.
  • Bleeding.
  • Ruptured tendon.
  • Changes in skin color.
  • Fatigue.
  • Mood changes.
6 Jun 2022

Can cortisone make you feel unwell? ›

increased sweating; headache, dizziness, spinning sensation; stomach pain, bloating; or. slow wound healing.

Can a cortisone shot affect your heart? ›

Forty years later, Maxwell et al11 raised the possibility that systemic corticosteroids also increase coronary heart disease. Corticosteroid treatment has been previously associated with risk factors for cardiovascular disease such as hypertension, hyperlipidaemia, and hyperglycaemia.

What is the next step if a cortisone shot doesn't work? ›

If the first injection doesn't provide pain relief, your doctor may try a second injection four to six weeks later. If there's no improvement after the second injection, a third injection is not recommended.

What is the next step if steroid injection does not work? ›

When one (or several) injections fail to fix your problem, often the next recommended step is surgery. The majority of the people we work with are seeking pain relief for their back, knee, neck or shoulder WITHOUT the need for surgery and other procedures.

What is the best injection for arthritis? ›

Studies show hyaluronic acid injections may work better than painkillers for some people with OA. Other studies have shown they also may work as well as corticosteroid knee injections. Hyaluronic acid injections seem to work better in some people than others.

What is an alternative to a cortisone shot? ›

Enter – PRP, or platelet-rich plasma. PRP injections offer a viable alternative to corticosteroid injections, without all of the nasty side effects.

Are cortisone shots safe for elderly? ›

Epidural steroid injections (ESI) using CT-guidance may be safely administered to elderly patients, according to a study published in Pain Physician. An estimated 30% of patients in the United States with back pain are over age 65.

How many cortisone shots can a person have? ›

Typically, corticosteroid injections are not given more often than every six weeks, and usually not more than three or four times a year.

Can steroids cause fatigue? ›

However, steroid-induced adverse effects including depression, myopathy, and hyperglycemia may contribute to fatigue. We report our experiences with aggravation of fatigue with steroid use in three cases.

Does cortisone shot affect kidneys? ›

Corticosteroid increases the risk of cyclosporine toxicities by increasing drug levels: kidney dysfunction, gall bladder disease, tingling sensations, high blood pressure, edema (swelling), fluid/electrolyte disturbances, and hyperglycemia (high blood sugar).

How long does a steroid shot last for inflammation? ›

The effects of the injection usually last up to 2 months, but sometimes longer. Cortisone can reduce inflammation that damages joints.

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