Help at 2 mg Prednisone.

[Ronswife]

My bloodwork no longer shows inflammation for Pmr and my RA says any pain left is osteoarthritis but I feel bad most every where and cannot think clearly , am exhausted and cannot reduce under 2 mg even .25 at a time. I've worked at this for months. Do I need an adrenal function rest or does this sound like I am just sick still with pmr. It has been 3.5 years.

[PMRpro Ambassador]

I would say you need an adrenal function test - all the normal blood markers means is that the 2mg is enough to manage any inflammation and 2mg is a very low dose that isn't doing any harm so that is fine. But if you are that unwell and have remained so over a long period you need expert endocrinology advice. Soon.

[Mary63]

Your blood work should not show inflammation if your PMR is being treated. That doesn’t mean your PMR journey is over yet.

BUT i even wonder if you are on a high enough dose. Adrenal problems may explain the ‘exhausted’, ‘cannot think clearly’ symptoms. It might for that reason be a good idea to request a synacthen test, and maybe some intervention from an endocrinologist. Re ‘ feeling bad almost everywhere’, is that similar to the PMR symptoms you had a at diagnosis? If so your dose is too low to deal with the inflammation. In your shoes I would want to go back to the last dose which dealt with symptoms as well as the starting dose did. What was that?

And even if you cannot get any lower than 2mg at the moment, it does not mean you won’t be able to get lower in a month or three.

When you mention your RA do you mean a rheumatologist ? I believe you have some rheumatoid arthritis as well as PMR from looking through your previous posts. It may be worth you updating your profile so people can more easily advise you knowing your history a little better.

If I were you I would try to find another opinion, and consider at what dose you were as pain free as you were on the highest dose of prednisolone.

Good luck!

[SheffieldJane]

Yes definitely, it is time for the Adrenal function test. What was the last dose of Pred that gave you relief? That’s where I would want to pause. I have OA, but it doesn’t consume me like PMR pain and is very effected by the weather and lack of activity.

[Ronswife]

Thank you for responding. I have called this am for the test to be scheduled. I have upped my Prednisone a tiny bit and will not try again until I know more. We have had bad weather so it was hard to judge osteoarthritis from pmr but now I know it is the pmr and/or adrenal function and will sort this out. I shouldn't feel so bad in my head I cannot function

I appreciate your concern and prompt advice. You are just the best resource.