Just a quick question. A couple months ago I made the mistake of reducing from 2mg prednisone to 1.5mg, with no alternating doses. Adrenal problems developed, and after some playing around I ended up back at 4.5mg. For 7 weeks I've been at the higher dose, the first couple weeks trying 4mg and 5mg then settling at 4.5mg. I've been doing well. What I'm wondering about now is how the taper should go from here. About the same as before, or easier? I was doing great at 2mg., which caused me to have the bad judgment to listen to my GP and drop straight to 1.5mg, thinking I was basically over PMR.
Advice much appreciated!
Written by
Heidi_SF
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As you are less than 2 year since diagnosis, very doubtful you are “over PMR”.
As from now a slow taper (0.5mg a step) such as below would be sensible, both in terms of PMR and waking up the adrenals. You may well have a lot longer on this journey than you think -
I think it is a "who knows"!! You obviously struggled with 4mg - and 1/2mg can make a big difference. Slowly does it - and you are at a low enough dose not to worry too much.
The main reason I don't want to stay where I am is because the weight is piling back on! It was so nice to see it going in the other direction. I kind of figured "who knows" was the answer.
It is " who knows" , it seems to be 50/50 of people who get down at the same rate and people who find it takes longer to reach the same point again.
The most important thing is not to push it , because that is when you are more likely to Yoyo back up again , no matter how tempting it is to try because if its effect on your weight.
Listen to your body , and use the extra time on your doses to slowly increase your strengthening exercises and activities and build up your Nutrition , and this will help when you get back to those trickier tapering doses again .
I appreciate that but there are other ways to deal with the weight gain and believe me, if you allow a flare in by forcing to a lower dose you will be miserable, probably eat more and be unable to exercise...
I would want a Synacthen Test to ensure that my Adrenal Glands we’re capable of producing Cortisol, before reducing below 3 mgs. This was advice I received from my Endocrinologist.
As to your weight gain, are you careful in monitoring your intake of calories? I am tapering, have got to 4mg for past 5 days. I make sure I eat nutricious food, but monitor amount so as not to overdo out of emotional eating etc. Also I try to keep my activity at a level that will burn excess calories. Of course it is not always easy, but I keep trying and so far it is working for me.
I'm really not stressing too much about the weight. Also it went up so quickly that I think it's at least partially caused by water retention, a common pred side effect. My appetite has increased somewhat so I'm needing more self-discipline. However the other day I passed a bakery and before I knew it I was walking home with an apple pie. I'll take a different route next time!
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