How do I know when my own immune system kicks in?

[Cairocat]

I have tapered from 30 mg prednisone (August 2018) to 4.5 mg and would like to know when my own immune system “wakes up”. How will I know? I have been really tired but aches and pains are not a major issue, although I can still root through the cupboards for carbs..... Right now I am reducing .5 mg every 5 or so weeks. I did have a bounce around in July where I needed to go up to7 then back to 6 for a week then down to 5 for a month before alternating between 4.5 and 5.

[SnazzyD]

Hello, do you mean the adrenal system? That’s the bit we tell about “kicking in”, especially at your stage.

[DorsetLady PMRGCAuk volunteer]

If you means adrenals as SnazzyD says- then if you are still suffering from fatigue that’s a sign they are not working at full steam as yet. Just keep to the slow tapering, and they will eventually.

But don’t just concentrate on them, your PMR may also have some time to run, so keep your mind on that as well - the episode in July proves it's still active.

[Hidden]

Your immune system is running all the time the pred just suppresses it to control inflammation. As snazzyd and DL say.... adrenal is the one we have to wait to kick in and they can be tested at around 3mg.

[PMRpro Ambassador]

You are aiming to suppress the activity of your immune system - it is causing the symptoms we call PMR. Do you not mean adrenal function?

[Cairocat in reply to PMRpro]

Duh!!!! Of course I meant adrenal function...not immune. I wrote this post just before I slipped away to noddy land. Sorry for the confusion...

[PMRpro Ambassador in reply to Cairocat]

In that case - everyone would like to know when their adrenal function wakes up! Everyone is different but as long as you can reduce in small steps that don't leave you totally flat with fatigue you can be fairly sure all is well. At below 5mg, preferably 3mg, it is a good idea to ask for a synacthen test to see if they can work - doesn't mean they are though but at least you know one factor. But it is believed by experts that it can take as long as a year after stopping pred altogether for adrenal function to get fully up and running.