Hi, My Mum has just been diagnosed with Polymyalgia and has been prescribed the above dosage for just one week. She has not taken anything yet as she is having a colonoscopy on saturday. I have just read many of your comments regarding this new tablet which we did not realise were steroids. The Doctor never inspires me with confidence which is why I always research tablets.
I feel very concerned that firstly the dose seems incredibly high and secondly that it is just one week of tablets when you're all saying that with such a high dose, you should gradually come off these. Mum is also partially sighted with dry macular degeneration and unless i've misunderstood, if Mum goes on these and then comes off them, she could go completely blind, which we're already battling against...
Does anyone have any advice please?
Thanks.
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kys690
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I assume that the doctor is giving your mother steroids just for a week to see if it works. If it does not work it is probably not Polymyalgia and she can stop taking them immediately. 15mg is not a particularly high dosage, it is a usual starting dose for Polymyalgia, some people are given 20mg. There is something called GCA which can cause blindness and for that people take much larger doses of steroids around 60mg.
Sorry to hear about your Mum. If she has been diagnosed with PMR do you know why she has only been given a week’s worth of tablets. To me that would indicate the doctor is not sure. What tests did he do to come to that conclusion?
So long as you do not take the tablets for more than 2-3 weeks it is quite safe to come off them again. Many people have them for a short period and are okay - asthma is one example. The problems only start if you have been on them long enough for you own adrenal glands to stop working, and that usually takes about 3 weeks.
With PMR your mother is very unlikely to go blind, it’s the bigger sister illness - GCA that can cause blindness. So unless she has head symptoms she should be fine.
I assume after a week on steroids she has another appointment and then it will be decided whether she has PMR or not, if so then she will need to be on them for at least 2 years maybe longer.
Actually the dose is not incredibly high, and is at the lower end of the range for PMR.
You are understandably concerned, particularly with your Mum ‘s deteriorating sight, but have a read of attached it may help you understand PMR a little better and the difference between that and GCA.
Many thanks for your comprehensive reply Dorset Lady, it has really helped. Mum has lost a lot of weight recently and has had a hazy and sore scalp as well as the other symptoms. I will look at your link to try and gain a greater understanding. Thank you once again.
Actually a one week trial of 15 mg per day (a single dose with food in the morning) is standard in diagnosing PMR. It is considered a moderate dose, by no means high. A good response to this dose, usually at least 70% relief of symptoms within a few days, is one of the tools the doctors use to diagnose the disease. BUT if she does have the good response and the doctor feels this confirms the diagnosis, it is very important that she stay at this level for about a month to six weeks. This will make sure the inflammation is properly cleared out. Then a slow taper is begun where one works to find the lowest possible dose which will manage the symptoms to the same level, or close to, the initial relief. The thing we all have to be careful of is not to reduce too quickly. Lots of discussion about this on this forum!
If she doesn't respond adequately to the pred then the possible diagnosis needs to be reconsidered, although some people do seem to need a little more. If it's decided she does not have PMR and is not responding to the pred it is perfectly safe to stop taking the pills immediately. It is those of us who have been on long term treatment, more than a month or so, who have to be careful to taper.
Prednisone does have some side effects but they can mostly be managed quite well and reduce as the dosage is reduced. She will have to expect to stay on the pred for some time, two years is considered a standard length of time, but many of us have found it takes longer and two years is not realistic. I've been on pred for about two and a half years (and had the disease undiagnosed for over a year before that) but for more than thirty of those months my dose has been below 5 mg, for some time considerably lower. Prednisone can really feel like a miracle drug when used for PMR!
As for the vision concerns, if your mother has the symptoms of GCA or temporal arteritis she will need a much higher dose of pred in order to preserve her eyesight. It is not the starting and stopping of prednisone that would damage her eyesight. It would be if she has GCA and is not treated properly with a high dose. There will be others along to explain more about that. But I do want to reassure you that prednisone is not as scary as some of the doctors seem to believe.
Heron HS, I thought I'd replied to you yesterday, but it cannot have submitted properly. Thank you so much for your comprehensive reply and advice, it really helped clarify my understanding of PMR and how Prednisone could help. Very reassuring - thank you.
My grandma had GCA, then called temporal arthritis . She had double vision and was on high dose prednisone until she died only 76. My mum has had pmr for many years, now 84 yrs old, and now me at 57.
Prednisone gives dramatic improvement for PMR, in an hour I felt a big change. Encourage her to start as soon as possible. Quality of life changes. The stiffness and having to haul yourself around goes. If she has jaw pain, tightness in the neck and scalp and spikey, stabbing headaches get back to the doctor ASAP as her sight may well be at risk with GCA.
PMR is very easily diagnosed by the good reaction to 15mg prednisone. I’m on that dose at present with a long term commitment supported by regular checks, vitamin D, calcium, alendronic acid and a protector against ulcers.
My best wishes to your mum. Read up all you can to understand it all.
Thank you Hevaj for your reply, encouragement and good wishes. The information about GCA is particularly interesting/alarming as she has complained of sharp pains going through her head for the last two weeks and the tightness has gone up to her back of her head. Mum has an appointment at the hospital first thing tomorrow for an Ultrasound scan, but I will take her to the Doctor straight after. Thank you once again for your advice, it's much appreciated.
15mg a day is classed a moderate dose - 20mg and above is high, 10mg and below is low. It is the usual starting dose for PMR - and some doctors use it for a week as a test for PMR: the symptoms should improve during the week and then return in the same time scale when it is stopped. The concept is described here:
After just a week it is fine to stop suddenly - it is not until after a couple of months at this sort of dose you must be careful stopping and as already mentioned, stopping pred when you have GCA is a risky business.
However your other post mentioned hazy (vision I assume?) and a sore scalp and that does concern me as those are typical GCA symptoms, as is weight loss for no apparent reason. Does she have any other symptoms? Headache or jaw pain when chewing for example?
If she has any of those I think your GP needs to be rather more proactive and contact the local rheumatology department as an emergency - the same as he would for a suspected heart attack or stroke, particulalry in view of her existing visual problems. In fact, her eye specialist would be a good place to start as they also may be involved in care of GCA. It may not be the case - but far better to be safe than sorry.
Thank you so much for your comprehensive reply and advice PR Pro. I will contact the Doctor tomorrow as Mum has displayed some of these symptoms (sharp pains in the head) over the past couple of weeks, only about 4 or 5 times though on isolated occasions. The base of Mum's head feels like a hazy headache and she feels like her head does not belong to her body. I particularly remember the jaw ache as I joked that she'd been talking too much... thinking it was probably related to an abcess Mum had in March. I did reply to you earlier but as my reply hasn't shown I think it cannot have posted properly. Anyway, thank you once again.
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Advice before doctors appointment - Monday
The Chronicles of Ozzy and his mum with PMR. Part 2
PREDNISOLONE? 
