reaction to reducing prednisolone

[Jackie_boy]

I’ve been a steroid taker for some years now as a result of an autoimmune blood problem and more recently, ie 2-3yrs ago, polymyalgia. This latter diagnosis took me up to 15mg of prednisolone and over the last couple of years I’ve managed to get down to 7mg which is a dose I have stayed at for over a year and have been feeling mostly very good on it. I’ve had one or two tries at reducing but the shoulder aches etc have always returned so back up to 7mg. This summer I have tried again and am now at 6mg which has taken several months of slow reducing. I generally feel ok apart from a feeling of heaviness and stiffness I my limbs as well as breathlessness when going uphill on my daily walks ( which at 7mg I could do easily). Is this a reaction to the boost that steroids give us or is it a sign that my body won’t accept the lower dose and that the polymyalgia is returning?

Any opinions welcome, I would love to reduce more but am concerned that it will trigger a flare up.

Thanks!

[PMRpro Ambassador]

It is difficult to say - but you do also have the problem of returning adrenal function at this level and lower. Above about this dose, it suppresses the production of cortisol by the adrenal glands. As you reduce the pred dose, the body must start to produce a top-up amount so the body can function well. This doesn't happen suddenly, it takes some time. Until it is settled, you are likely to feel the difference. The effects vary from person to person but stiffness and heaviness are possible effects.

[Jackie_boy in reply to PMRpro]

Thank you for your reply, as you’ll see from my reply to Dorset Lady, I hadn’t thought about adrenals waking up. I’ll see now how I get on and perhaps give the current steroid dose a decent length of time to settle before trying any more reduction.

[DorsetLady PMRGCAuk volunteer]

As per PMRpro comments re adrenals gave a look at this -

healthunlocked.com/pmrgcauk...

[Jackie_boy in reply to DorsetLady]

thank you for the reminder about the adrenals, it’s something I had not taken into account so am grateful for that link. I certainly have several of the listed symptoms and also interestingly had tried taking some painkillers to see if that would help with the overall body aches. I felt a lot better as a result and would I be right that polymyalgia pain doesn’t react to painkillers?

[DorsetLady PMRGCAuk volunteer in reply to Jackie_boy]

Painkillers usually do zilch for PMR itself….

[Horses1234]

Have been on steroids for PMR now for 9yrs only taking 3mg for about 5yrs ,but going up a slope or hill or steps l really struggle now and also get breathless ,but also have AF which doesn’t help ,

[PMRpro Ambassador in reply to Horses1234]

That happens to a lot of people - pain in the neck!!