It has been a week taking my 6/7 mg of predisone at 2am...SO FAR, I have been pleased with the results. I am less stiff in am and lots more energy....only drawback, I have a tendency to overdo...will wait to see.. My RHM said to go for it if it works.
Anyone try HRT for bone protection rather than the much pushed RX.that we are bombparded constantly? THX. Georgedog USA
You might find this interesting:
theros.org.uk/information-a....
It too has downsides and there are situations where it shouldn't be used.
Good to hear you're doing well. You may want to think about changing the time of your dose once you get down to 5mg and below. As your PMR begins to subside and what I mean by that is your body produces less inflammation which is why the lower doses of pred still control your symptoms, you now need to give your adrenals and HPA axis a helping hand. We naturally produce cortisol early in the morning and the peak occurs at around 8 to 9 am. If you have too much synthetic cortisol, that's pred, in your blood stream at the time your adrenal cortex should be releasing cortisol, the pred will inhibit this process. All this is theory and it works for me and I now take my 4.5mg at 9am. Sadly hardly any papers have been written about this aspect of the perils of long term steroid use and the difficulties associated with getting off steroids. If you flare you may have to resume 2 to 3 am dosing to squash down the IL 6 release.
It's midnight that is the witching hour! It is having the naturally lowest level of cortisol at midnight that triggers the whole system into producing cortisol at the time you wake up. So you can take pred at 2am without any problem - it is at its peak at 4am and that doesn't have any effect on the normal adrenal function.
Hi Pro, I've been continuing to take my coated Pred at bedtime- sleep so much better. But now at 4.5/4mg I am wondering if this is optimum for encouraging adrenals?
If you are taking coated pred at bedtime it shouldn't be a problem: coated pred is unlikely to enter the system before at least 1-2am - it must pass through the stomach and get lower down the GI tract before the coating is broken down by different pH conditions before it can be absorbed. The cortisol/corticosteroid level at midnight is still going to be very low and that is what triggers the release of cortisol in the morning.
So does that mean I should continue to take mine at 2am? Sometimes it varies slightly, is later than 2am better than earlier? I’m down to 5mgs ... no pain but a bit of shoulder stiffness. This might be due to light weights. Your advice is always appreciated.
If that suits you it shouldn't be a problem - whatever time after midnight works best for you next day.
Thanks. I’ll stick with my routine.
Excellent, thanks 😊
Timing of Pred - mornings
Moving time of Pred dose. 
Timing of PPI and Pred
Low dose pred timing 
