New diagnosis

[Summertimegolf]

Diagnosed with PMR 6 weeks ago. Started on 20 mgm Prednisone which resolved all pain within 48 hrs. After one month I am on 15 mgms for 2 weeks and then down to 10 for two weeks . Will see my Primary then and will repeat blood work. I’m having pulsatile tinnitus the last few days. Any thoughts?

[Marlenec]

Hi

Welcome to the site. Have a look on the pinned posts and second one down, "Information for new patients". Lot of info. 🌻

[PMRpro Ambassador]

That is a very speedy reduction with very large steps down - top experts in tapering say not more than 10% of the current dose each step.

This isn't a case of taking pred to get rid of the symptoms and inflammation and then tapering relentlessly to zero to get off pred. You are always looking for the lowest dose that manages the symptoms as well as the starting dose did, it provides your guide. In the early days you are likely to need more than later and it isn't unusual to need 15mg for a few months. One thing you really should try to avoid is going to far too soon and letting a flare happen - for some reason it seems to make getting things under control again more difficult and anyway you have to go back to a higher dose and reduce again so all the perceived advantage of getting to a lower dose has been chucked out of the window.

However, your complaint of pulsatile tinnitis concerns me a bit. Pred can cause tinnitus but unfortunately so can GCA. Do please keep a weather eye out and if it gets worse or any other symptoms of GCA appear and you feel worse rather than better as time goes on, please go back to your doctor immediately. You are not enough pred to manage GCA entirely (some doctors will try to tell you any pred protects you, no it doesn't) so it is possible you could be developing it. About 1 in 6 patients with PMR go on to develop GCA at some point - it may be the PMR is a symptom of the GCA at the start or it may happen much later as a flare of the illness.