Possibly having a flare so increased to 10mg from 4.5mg today. Had planned to stay on 10mg for few days or a week.
Been reading some latest posts and comments re 10mg cancels adrenals !!!
Suffered badly with fatigue when tapering to 5mg. I was starting to feel reasonably ok so adrenals were hopefully starting to wake up.
Will staying on 10mg for a week cause them to give up again. ???
No, it shouldn't. They take a long time to wake up but they don't give up again within a few days. Up to 7-10 days as a short term measure is the same as using pred in an acute situation when you are't on pred, it is just the baseline is higher. Obviously the shorter the time at the higher dose the better - often just a few days will sort out the accumulation of inflammation so you can go back to your previous OK dose. I assume you are going to go back to 5mg, not 4.5mg?
If I remember the context of the thread you are referring to, the individual was asking whether increasing the dose would be a good idea to handle a stressful situation. Pretty much universally everyone said only increase the dose if dealing with increase of PMR symptoms. So it was a different situation from yours. You may not need to stay at the increased dose for as long as a week, play it by ear and how you feel, but you almost certainly will need to be at some increased level for up to a week, and it can be longer, and probably should only go back down to 5 mg for a while, doing a normal taper back to 4.5 from there when you are ready. As for adrenals, you have to remember the PMR is what you are treating. In my case, when I stated I thought my adrenals had never really recovered from the way I handled my flare, remember, I had been fiddling around with gradually increasing doses and not coming out swinging with a decent increase right at the beginning, so I went about it the wrong way. What you are planning to do is exactly what we would recommend.
You inadvertently helped me as I’ve had an increase in symptoms while tapering and was wondering the same as you. How long is an increase good for etc etc. Thanks for raising it - we really are all sisters under the skin! Good luck! 😀👍
Glad to be of help 😊
FYI I am exactly in the same place as you. Was at 4.5 mg and started to get the 1st flare that I was convinced of being the real thing. Went to 10 mg for 1 week and the spent 1 week tapering back down to 5 mg. Will hang there for 3-weeks before trying to go down again. Like you, I was wondering the impact it might have on the adrenal function. 5 mg seems to be a real barrier for many of us.
I hate the thought of an increase. Took ages to drop to 5mg . Started at 60mg Dec 2017 . I plan a straight drop to 5 from 10 after a few days. Hope that works !! My rheumatologist said stick at 5mg as long as I feel a need it. Apparently a fairly safe low dose. That was back before Christmas. Haven’t seen him since due to pandemic!
My Dr. also said to take 5 mg of pred for awhile (3 wks to a month before I dip down). I also started at 60 mg, Dec 2018 due to GCA symptoms. My "canary" symptom was the shoulders getting very reduced range of motion; alleviated overnight with 10 mg of pred.
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