optimum dose

[gtate1914]

I'm still trying to find my optimum dose. This is day 10 at 50mg. The symptoms of brief, light headaches, sensitive spot on head, seem to be lessening. My symptoms have never been severe or very painful. Does it sound reasonable to stay at 50 for awhile longer or perhaps increase slightly the dosage to see if it will take away ALL symptoms, however light or brief they may be? I do not want to taper until all symptoms are gone.

I am sure some of the discomfort I feel at times is due to tension from stress and I feel it in my eyes and forehead. Thanks for any suggestions!

[SheffieldJane]

It is a tough call. Some people only ever get 70% relief. What is your doctor’s view?

50 mgs is still a moderate dose for GCA, others have gone much higher for relief. All the best, this is an anxious time for you.

[Primarose]

Hi gtate1914

How long to do the head pains last? I've just consulted my 2017 diary, while on 50mgs of pred I had no head pain, mainly the side effects of pred. I actually stayed on 50mg for 14 days and was feeling fine for five days before I tapered.

I don't think that there an actual optimum dose, it depends of the individual really.

[gtate1914 in reply to Primarose]

Head pains light and brief, usually less than 5, 6 seconds. Sometimes a sensitive spot on head which also is brief. My blood labs are low, 0.4, although I know symptoms trump markers. I'm thinking give it a few more days then ask rheumy about upping dosage a little to see if that takes care of all symptoms.

[Primarose in reply to gtate1914]

Good idea, give it a few more days @ 50mgs. Forgot to ask you, are the pains like "shooting pains"? I did occasionally get that especially after the TAB.

[gtate1914 in reply to Primarose]

Not shooting or stabbing, just an ache.

[Primarose in reply to gtate1914]

I see, similar to what I had, only I called it shooting pains. Give it a few more days and hopefully it will improve.

I learnt to my detriment, on the advice of rheumatology that reducing too quickly did not help.

As I said, we are all different and GCA presents it's nasty self in different ways.

[PMRpro Ambassador]

Some people are never totally pain free, especially at the start, but you should be stable and feeling better. Fleeting pains are probably not a concern but I would have thought that 3 to 4 weeks at 50mg wasn't much to worry about in the context of GCA. And I'd also think that upping the dose at this stage and with this level of symptoms isn't really necessary. But I'm not your rheumy.

[gtate1914 in reply to PMRpro]

I started on 60mg Feb 28, 2018, lowest I've gotten to is 45 and had to go back up. Have never been totally symptom free, even when beginning to taper. Usually around day 8 or 9 symptoms would increase and become more painful and up I would go again. Today at day 10 feeling not bad, but have had a couple of fleeting aches in my head. Am so hoping it will all go away in a few days. Trying not to stress!! Will see rheumy in few days.

[PMRpro Ambassador in reply to gtate1914]

If you got into a yoyoing situation then that will have set you back a long way. If it is OK at present I'd think sticking at 50mg for up to a month was preferable - just for stability's sake.