About to drop to 7.5

[Rosina1871]

My doc said I could drop to 7mg following successful drop to 8. Decided to go for 7.5. I’ve read on here that some people struggle with this dose. Is this the point where my adrenals may try to wake up or is this very dependent on the individual. Thanks for listening

[DorsetLady PMRGCAuk volunteer]

Hi,

It is very individual - normal production of cortisol can vary anywhere between 5mg-10mg for patients, so 7. 5mg is always quoted as an average figure. Certainly most patients seem to struggle around this figure which is why we always recommend reducing as slow as you can - then it gives the adrenals a chance to wake up and start working again.

This link was written by patients who had been on higher doses of Pred, not for PMR, but does contain some useful info -

healthunlocked.com/pmrgcauk...

[Rosina1871 in reply to DorsetLady]

Does

it make a difference that I had one kidney removed in 2015 but they left my adrenal gland

[DorsetLady PMRGCAuk volunteer in reply to Rosina1871]

I don’t really know. Sorry

[Rosbud in reply to Rosina1871]

This is my problem but they took my right kidney and adrenal gland so I really don't know what will happen when I get down to 7/8 mg pre!

[Rosina1871 in reply to Rosbud]

Good luck Rosebud

[Rosina1871 in reply to DorsetLady]

Thanks for your swift response x

[PMRpro Ambassador]

Really does depend on the individual but it does seem a difficult area. I don;t think the loss of one adrenal gland will make much difference here - if it was working fine before

[Rosina1871 in reply to PMRpro]

Thank you. I’m sure the surgeon said he had left it

[PMRpro Ambassador in reply to Rosina1871]

If you haven't been on replacement therapy with hydrocortisone I;m sure he did. You would have known by now!

[Rosina1871 in reply to PMRpro]

Thank you

[Rosbud in reply to PMRpro]

This reassures me somewhat as I understood they'd taken my adrenal gland but as I'm not on replacement therapy and I'm 17 years down the line maybe they left it xx

[Rosina1871 in reply to Rosbud]

I’m sure it would be in your hospital fe orcs somewhere but it sounds as though they left it

[Rosina1871 in reply to Rosina1871]

Records sorry for typo

[PMRpro Ambassador in reply to Rosbud]

There are two - one on each kidney.

[Rosina1871 in reply to PMRpro]

Yes I knew that but wasn’t sure if it would affect the efficiency of the adrenals if a kidney was removed, even though the gland remained.

[PMRpro Ambassador in reply to Rosina1871]

As long as one gland is there you probably have enough function - but the surgeons would have assessed that at the time. I hope!

[Rosina1871 in reply to PMRpro]

Thank you

[HeronNS]

If you aren't already using a slow taper method this is the time you should start. That is to say don't drop to 7.5 overnight, but phase it in over a few weeks. I'm using a really annoying tablet but I know someone else can provide the link to the dead slow method.

[PMRpro Ambassador in reply to HeronNS]

healthunlocked.com/pmrgcauk...

[Rosina1871 in reply to HeronNS]

Thanks heron. Yes I’m already using dead slow method. Just get nervous each time I drop. I’m fortunate I haven’t had a flare yet. Proceeding with caution

[SheffieldJane]

Yes it is but it is by no means inevitable. Press on with caution and don’t fall at the first fence. If at first you don’t succeed try, try again. I finally got to 5 mgs/ 4.5 mgs after several attempts.

[Rosina1871 in reply to SheffieldJane]

Thank you sheffield jane

[composition]

I just saw the rheumatologist this week and she wants me to go from 20 to 15.......is that too much of a drop? I tried it 2 mos ago with a significant relapse in pain. Right now, feeling GOOD! Maybe down to 17? I am also on the DMARD Leflunomide in an effort to go completely off of the prednisone. I sure hate to mess with the current "success" but ... So how did you get all the way down to 8? Did it take long and in what increments? Good luck and good wishes and definitely good prayers for you.

[PMRpro Ambassador in reply to composition]

Some people manage it, some people have pain immediately they reduce - that is steroid withdrawal rheumatism - but it improves in the following few days.

But I would go via 17.5mg.