What is the best way to reduce prednisone after 3 and a half years and now at 4 mg daily.

[nousdeux]

I would like to learn more about women with pmr in their seventies.

[DorsetLady PMRGCAuk volunteer]

Hi,

Slowly - 0.5mg per month providing no return of symptoms - if necessary using a slow taper - if you don’t already - this is just one - there are others -

healthunlocked.com/pmrgcauk...

[PMRpro Ambassador]

Slowly, providing there is no return of symptoms. You have to bear in mind that the median duration of management of PMR is just under 6 years. It really is early days yet. And in your mid-late 70s the other limiting factor is a return of adrenal function. That tends to fade with age anyway - add in long term treatment with corticosteroids and that may become an important factor.

[Hidden in reply to PMRpro]

Would you elaborate on return of adrenal function fading with age? Rhuemy has not mentioned. Maybe give me something to broach to her in the future. Thx. 🤗

[PMRpro Ambassador in reply to Hidden]

Like everything else, adrenal function doesn't remain as good as it is in youth, it reduces as we age. So if you then add long term steroid use on top of natural aging that adds to the problem. In fact, one of the things pred is accused of is making things age faster

Nothing in our bodies repairs/returns to function as well as we get older, however fit we may think we are the "bits" have been in use for a long time and some don't regenerate so they wear out or take longer to recover after illness or accidental damage. That's why we get the label of "elderly patient" and the ED/A&E worries about us more when we arrive.

[Hidden in reply to PMRpro]

Makes perfect sense. ie., how long vertebral fracture recovery has been for my “ elderly self”. Since GP has sent me to nephrologist for low sodium, am going to ask him about adrenals. Have read that also can be a sign of adrenal insufficiency. My dose is currently 8.5 mg. but I could be one of those ( as SnazzyD pointed out) who doesn’t absorb well. Age just adds insult to injury. 😒

[PMRpro Ambassador in reply to Hidden]

Low sodium is a common effect of poor adrenal function - and unless they had you on rather more than 8mg post surgery your adrenal function is going to have been stretched.

[FRnina]

I'm about where you are (coming up 4 years and mid seventies). I'm doing a very slow taper now just going down from 1mg to 0.5mg (with my trusty pill cutter). However I'm also on Tocilizumab weekly injections which for me is helping the process of reduction (doesn't work for everybody as I've read on this site). So far so good. Feeling well and not fatigued. I think the main thing is as both DorsetLady and PMRpro advise: go SLOW.

[Looseloafers]

Hi I am doing 6/5 alternate days for 2 weeks then 5/4 etc seems to be working ok so far 😊

[PMRpro Ambassador in reply to Looseloafers]

But beware - that is quite fast at this stage. The closer you get to the lower doses, the slower you should go about it.

[Looseloafers in reply to PMRpro]

Yes you’re right! Got to 6/5 but felt so ill I had to go back to 7 feel heaps better so will stay here for a while 🥴🥴

[Lafontainepam1]

I am 71 and have been on Prednisone for8 years. I had been down to 7 mg until last October had severe back surgery and went up to 15. Now at 12 1/2 and will continue to reduce. I have type 2 diabetes caused by using prednisone! It is horrible being a diabetic! My back is finally feeling better, now I have to tackle trying to reduce. My bones are ok, but need to get it down before that happens!