Flair of underlying disease or adrenal problems?

[krillemy]

Dear all. I am back for a quick question. I still have no diagnosis yet, but are trying to taper off pred., How do I know if symptoms, like fatigue and headache in the morning, light pain in arms and legs and weakness in joints are due to tapering pred. or flair of the underlying disease (could still be PMR) ? All symptoms feel exactly like before I started taking pred. but in a very light version. It seems to start

3-5 days after I start the lower does. I have need on 15 mg since august 2019, and with a few ups and down I am down to 11,25 mg in the evening.

[SnazzyD]

Mine started anywhere from day 1 to day 4 and lasted for up to a week. This wasn’t the same at all dose levels which is why I’ve stated a range. It has been said that if these symptoms occur a week or more after the reduction it is more likely to be a flare because it takes a bit of time for the inflammation to build up. This question is a perennial and of course there are variations which makes it all the more tricky to guess. In time I noticed a pattern.

[krillemy in reply to SnazzyD]

Thanks - I will try to stay on 11,125 mg (I am getting the number wrong). Not concentration too well :-D. Have been here for 5 days.

[PMRpro Ambassador]

But do they then improve again afterwards? Really, after only 4 or 5 months and starting at 15mg you shouldn't have too much trouble with reducing and adrenal problems shouldn't become a factor until below 10mg.

[krillemy in reply to PMRpro]

I have not waited long enough to see, but gone up again and then down. But I will try to stay on 11,5 and take a little extra at bad days where I need to be better. I am definitely not as good as on 15 mg but I need to taper. I am happy to hear that the adrenal issue may not be the cause, the faster I get off pred. the better they can set a diagnosis. thanks

[PMRpro Ambassador in reply to krillemy]

You will just make it worse if you start to yoyo the dose - that is expressly warned against by experts.

[krillemy in reply to PMRpro]

ok, so I stay on a fixed does?

[PMRpro Ambassador in reply to krillemy]

Well no - your doctor wants you off pred altogether doesn't he? What I'm saying is don't go down and then up and then down again. Stick at the new lower dose for a few weeks and see what happens. If it gets worse then you have to discuss it with your doctor if you can't find one who thinks you DO have PMR.

[krillemy in reply to PMRpro]

Ups - the dose is 11,125 mg. We only have 5 mg tablets.

[DorsetLady PMRGCAuk volunteer in reply to krillemy]

That’s not very good....you’ll need smaller ones once you get below 10mg - or invest in a number of pill cutters.