Is 4mg prednisolone enugh to keep PMR/GCA inflammation under control?

[marigolds]

I have just reduced to 4mg prednisolone and think it might be a good idea to stay on this dose rather than risk problems. I am aged 85.

[DorsetLady PMRGCAuk volunteer]

The question is how do you feel on 4mg?

Looking at your profile and posts not sure whether you actually have GCA or just PMR.

But whatever you seem to have reduced very quickly - have you had any problems along the way.

The only sure fire way you will know if 4mg is enough is if no symptoms return. At such a low dose there’s no rush to do any more tapering anyway. If you’re happy at 4mg then stay at 4mg, but do keep doctor informed.

[marigolds in reply to DorsetLady]

Thanks, I have had problems but they seem to have been caused by reducing the pred. So am trying to get off it. Will let you know how I get on.

[DorsetLady PMRGCAuk volunteer in reply to marigolds]

So do you think it was steroid withdrawal rather than not enough Pred?

I would say your PMR is still very much with you, so by continuing to reduce you may actually be doing the wrong thing. You may need more Pred rather than less.

The medication doesn’t get rid of the PMR - only the inflammation caused by it - so if it’s still there- you need the correct dose to control your pain.

[marigolds in reply to DorsetLady]

Thank you, the pred has caused havoc in my body!

[Jan_Noack in reply to marigolds]

well looks like you've answered your statement yourself here.. IF you feel like your adrenals are kicking in , It's ALWAYS better if you can to let your body use its own adrenals (they produce far more than pred, so its better NOt to suppress them in the long run if you can) AND the pred has caused havoc with yur body. . So just stay there for a while (at least a month), and then gradually reduce.. say 1/4 of a 1mg tablet every month or even every two months(but no more than a half a mg a month!)..take it gradual. You don't need to get worse osteoporosis(says me who has it bad) than you need to . I know a lady at 93 tell me its not a fall or trip that got her like they try to tell you, she was just washing up at the sink and her body just dissolved and get kind of just crumbled..from osteoporosis (hips went)- heard a few others that say the same, so you don't need to make that worse than you have to. I know people living by themselves age 95 and 100 :)..I'm 62 and not sure how long I'll make it ..feeling sorry for myself at the moment!

[marigolds in reply to Jan_Noack]

Thanks That's what I will do. I am having cataracts done 1 to go, so far so good. I'm sure that the pred has got me that done.

[Jan_Noack in reply to marigolds]

thanks for the reply marigolds. to me. You seem to be amazing in how you're coping with all of this. I've been stuck myself on 4mg to 3mg for over 4 mths now... I also feel like my adrenals are kicking in. I also have bad osteoporosis, just working away at doing more and reducing

[SheffieldJane]

I think it is quite sensible to have a rest for a few weeks at certain doses. Particularly if you feel symptoms threatening. From your “ enviable” dose I would only reduce by half a tablet, at a time, using a pill cutter ( terrible faff I know). Has your doctor discussed your Adrenal function with you? It is possible at your stage to have a Synacthen Test to ensure that your Adrenals can work on their own. Good luck!

[marigolds in reply to SheffieldJane]

I am hoping to stay fairly well. Got to sort my bowel problem (which was made worse re my muscle problem) seeing specialist on 2nd April. I feel as if my adrenals are kicking in.

[SheffieldJane in reply to marigolds]

It does sound like you are doing very well. Good luck with the bowell problem. X

[PMRpro Ambassador]

If it is enough to keep your PMR symptoms under control - it's enough. EVeryone is different,

How has the pred caused havoc? Most of the side effects of pred can be managed or minimised when you know how.

[marigolds in reply to PMRpro]

I am not blaming the pred, I couldn't have done without it. I think it was a combination of my age and vertebrae fractures, the pred was only trying to help.

[Christophene47]

Hello Marigolds,

If 4mg of Prednisone keeps you comfortable, stay with it. 4 mg. cannot hurt you; I am also just holding my dose at 4 mg. It was a struggle to get here from 16 mg. I am stubborn and do not want to raise my dose now that I have reached 4 mg. I don't always think it completely controls my symptoms, but I push through.

I agree with the other comments, stay with it. If you have a return of symptoms, you should consult with your doctor about raising your dose. My doctor says that the correct dose is the lowest dose at which you feel relatively well.

What havoc has the prednisone caused you before?

[marigolds]

Have just woke up I was diagnosed last May started on 40mg pred Dr told me to reduce too and caused me to have terrible weard muscle problems in my lower and upper body which made me so weak I hadn't any support in my back. As a result I am seeing a bowel consultant tomorrow

[Hidden in reply to marigolds]

I missed your original post but would like to wish you Good Luck tomorrow & please let us know how you get on.

Kind Regards

MrsN

[marigolds in reply to Hidden]

Thanks I will let you know how I get on. Beryl.

[marigolds]

Thanks for replies. I have just read something that I think applies to me but will the specialist consider it? Steroid Induced Myopathy.

[Jan_Noack in reply to marigolds]

wow never heard of that one..steroid induced myopathy, but too tired to google it now

[PMRpro Ambassador in reply to Jan_Noack]

It is discussed quite often on the forum.

[marigolds]

I have just googled it and it fits me to a T. Affects women mostly.