Cushings? Moonface returned

[Caro12line]

Have GCA. started 60mg Prednisolone in Jan 2015. Tapered, flared. Since May 2015 have been on slow taper. Experienced all the usual side effects of Pred, mood swings, weight gain, moonface (as well as some others that are irrelevant to my question) .. Have recently tapered to 9mg ... With CRP 6 (I understand this is not a an exact marker, but it works for me) .. After 10 days on 9mg I feel absolutely fine but in the last 3 or four days my moonface has reappeared with avengence... my question is.... Has my normal Adrenal cortisol kicked in and I am topping up with 9mg (making 16mg) .. Why has my moonface returned (my husband says more noticeable than before) I thank him for his honesty!! I take my Pred at 8am ... But I am an early bird.. So majority of days up at 5am... So my theory is..... My adrenals have kicked in...produce 7.5mg of cortisol at my normal waking time.. Then I am just topping it up at 8am... Thoughts please

[PMRpro Ambassador]

I don't think it usually works quite like that - while you are taking more than 10mg your adrenal glands are told not to make cortisol because there's plenty of corticosteroid around. That usually happens after a few weeks at high doses. When the adrenals start to make cortisol again it is generally in small amounts to make up the amount, although it may swing about a bit at first. Could it be fluid retention?

If you are up at 5am - why not take your pred then? The earlier in the morning you take it the better effect it has and you may find you can get to an even lower dose.

[Celtic PMRGCAuk volunteer in reply to PMRpro]

Like PMRpro, I'm inclined to put the onus on fluid retention. You could try including plenty of known diuretic-type foods in your diet for a week or two to see if it makes a difference, for instance, asparagus, celery, garlic, melon and fennel.

[Caro12line in reply to Celtic]

Thank you PMRPro and Celtic. I thought the magic time to take Pred was 8am regardless of the time you get up. But thinking about it it does make sense to take it earlier, as soon as you get up. And yes it could be fluid retention, I will work on that. Many thanks for your help X