Slow reducing Prednisone Plan

[Pieater67]

Please can some one give me the website address for the slow pred reducing plan,I seem to have misplaced it.Thank you.

[Rose54]

Is this the one

1 day new dose, 6 days old dose

1 day new dose, 5 days old dose

1 day new dose, 4 days old dose

1 day new dose, 3 days old dose

1 day new dose, 2 days old dose

1 day new dose, 1 day old dose

1 day old dose, 2 days new dose

1 day old dose, 3 days new dose

1 day old dose, 4 days new dose

1 day old dose, 5 days new dose

1 day old dose, 6 days new dose

[PMRpro Ambassador]

This is the full version of the one Rose mentions:

healthunlocked.com/pmrgcauk...

There are others.

[DorsetLady PMRGCAuk volunteer]

healthunlocked.com/pmrgcauk...

[sharonnorfolk]

My rheumy gave me a list for reducing the pred. the 2 years I am on it (hopefully only 2 years). I started on 60 in February and am now down to 25. I have symptoms/side effects all the time. Have no choice as to whether we take them though. So just battle on. Keep your chin up.

[bluemoon70 in reply to sharonnorfolk]

Dear sharonnorfolk,

This is the problem all of us face; prednisone gives people with PMR/and or GCA wonderful relief quickly. There seems to be an idea in the medical community that PMR resolves in approximately 2 years; I was told the same thing by a rheumatologist in the US.

We know from the experience of others that it does not go away in 2 years for everyone and that tapering to a certain point will bring return of symptoms. It seems that doctors are terrified of damage to the bones caused by prednisone and are desperate to taper too soon and too fast.

I consider myself a youthful 71 years old; I exercised with aerobics, free weight lifting, yoga and/or pilates; 50 m. classes 3-4 times a week. I always exercised here and there, but became consistent at ages 40-62 or so. It did a lot of good and I think the results of it are still with me. I stopped going regularly when I started living out of country, but always walked, swam and did physical housework; never shyed away from physical tasks.

But now, I can't imagine driving to the gym, and I need the motivation of a class, music , instructor, and others around me or I will not do it.

My last DEXA scan in 2017 by the FRAX method ="mild osteopenia" with 0% chance of fracture in next 10 years." So I am thinking, what harm could be done by going up on my Prednisone to a point where I feel well and can be fully functional again and go back to exercising.

I think my new rheumatologist is of that mindset, but waiting for bloods to come back; I see him in 1.5 weeks. He also thinks weekly 15mg methotrex, given to be steroid-sparing, may be making me sicker (I feel sicker than I did when I first sought care 18 months ago. From my point of view, the Methotrex, now on 14 weeks does nothing ,but give me unpleasant diarrhea 4 days a week.

What say you all? Thanks.

An Aside: I did have severe osteoporosis all the years I exercised; in 2012, I discovered that I had a bad PARA thyroid gland ( not thyroid) which robs bones, brain, and other vital organs of calcium and dumps it in the blood stream. I went to Tampa, Florida where Dr. Douglas Norman has a practice solely for parathyroid surgery and a hospital wing at Tampa General just for his group's patients. Dr. Norman holds the patent on a minimally invasive technique via nuclear medicine surgery to locate the 1of 4 tiny glands that has run amuk , overproducing parathyroid hormone and thereby putting the other glands into hibernation. I had my relevant medical records reviewed by one of their surgeons and within 3 days, I got a phone call to come on down if I wished to use them. I did; stayed over 1 night, and flew home the next day with an incision of less than 1 inch.

This diagnosis is also very rare, parathyroid blood testing is rarely done routinely and again, doctors rarely see it. I had 2 clues and Dr. Norman's excellent website told me what else I needed to know. If you are an adult over 30 and your blood calcium levels are CONSISTENTLY higher than 9.9, you likely have a parathyroid tumor. It's not cancer, but unremoved, it lowers life expectancy by 7 years with a lot of symptoms along the way, including feeling crazy which I did. This is another problem with lab result parameters which include the normals for babies, ,growing children and adolescents mixed in with adults. This is an endocrine disease which can happen at any age.

Sorry to get off point, but prednisone to osteoporosis to reversal of osteporosis, thereby raising question of why force tapering of steroids in the older population??

[bluemoon70]

Hi Pieater67,

The reducing plans listed by Rose and PMR Pro make good sense; a Professor at John's Hopkins recommended reduction of 2mg. and hold 3 weeks; and so on. I was doing OK with that until 8 mg when I had a several minute loss of vision left eye. The vision switched back on after a few minutes; it was traced by duplex color doppler of the orbits to the central vein of L retina being occluded, presumably damage from GCA.

I took it upon myself to go back to my original dose; thought going to ER would be a waste of time since the vision returned before I could have gotten there.

Have since tapered back to 8 mg. from 16. Do be on the look out for any new symptom during tapering or extreme return of prior symptoms and contact your physician right away.

Good luck and let us know how it goes.