Fatigue at 4.5mg Prednisolone Adrenal advice please

[Bamber99]

Hi I cannot find the earlier posts about the adrenals kicking in at under 5mg

I’ve been at 4.5 for the past week and am feeling more fatigued and sleeping VERY well, too well. Otherwise I’m feeling ok.

My rheumatologist is happy for me to go at my own pace.

I’d like pacing recommendations at this level.

I’ve successfully gone from 40 to 5 at my own slightly random pace since August last year.

[SheffieldJane]

If you look to the right of your post you will see a column of relevant posts, including DL’s taper. I am at your level of Prednisalone, perhaps more negatively impacted. Your journey sounds lovely and smooth. I had my Adrenal function tested via a Synacthen Test and was found to be mildly deficient. I am no further forward with the result though and I intend to reduce by 0.5 of a mg at my own pace to zero. I loved the deep, deep, sleep after the exhausting insomnia of the last 3 years. If I were you, with my Rheumie’s blessing, I would carry on with a gradual taper of half mgs, stopping only if symptoms persistently reappear. Good luck!

[Bamber99 in reply to SheffieldJane]

Jane, the good thing is the moon face has gone!

[DorsetLady PMRGCAuk volunteer]

Hi,

This is a post I put up a couple of years ago. It’s not about GCA nor PMR but another illness that’s helped by steroids, and how to try and get the adrenal glands to start working again. The level they need to kick in again varies from 10mg- 5mg depending on individual - so average is around 7.5mg which is what we often quote. For me it was 6mg! Doctors won’t usually consider testing to see if they can, until you reach the lower level - 5mg.

The only thing you can do is taper slowly and in small amounts - 0.5mg a time to give them a nudge! They will spark eventually - mine seemed to take about 9 months.

healthunlocked.com/pmrgcauk...

[Bamber99 in reply to DorsetLady]

Thanks. I was anticipating 3 months max! Just have to wait and see 😻

[DorsetLady PMRGCAuk volunteer in reply to Bamber99]

It is a matter of waiting and see. Plus I think it may depends on the amount of Pred you’ve taken and the length of time.

Me- start dose 80mg and 2&half years to get to 6mg - considerably more than someone with PMR!

[PMRpro Ambassador]

If you have got from 40 to 5mg in 9 months at your own pace I don't think you have much to learn about pacing!! That is a really good rate! If it were me I would stick at 5mg for a few months - one UK top PMR rheumy likes his patients at 5mg for up to 9 months - and then the subsequent taper seems to go better as the adrenal glands are already starting to wake up at that level and adjust better.