Steroids advise.

[Choosepink]

I have been taking steroids for a number of years trying to lower the dose at the moment I take 4mg prednisolone ,a week ago I had a fall and fractured my arm didn't need an op just a sling it has been very painfull not able to lie down so getting very little sleep ,my question is should I up my steroids for a short time would it be a good idea ?

[PMRpro Ambassador]

How do you feel? Theoretically the answer is that you are at risk of a flare - any sign of that? And your adrenal function might not be up to dealing with the stress of the accident itself and that would come under "Sick day rules" for steroid dose. So -how do you feel? If all is going well you may be fine. If it isn't, that's another matter.

[Choosepink in reply to PMRpro]

It has been 8 days now and just feeling really unwell not sure if this do to the fall or it could be a flare , due to go back to hospital next week ,just wanted some advise

[Pollyanna16 in reply to Choosepink]

I think if you are feeling so unwell, as I did for a week after falling off my bike & no serious injury, I would double my dose but how long for I’m not sure. Then come down slowly to 4mg again. You’ve had a shock. I’ve also been on pred since 2011 & my adrenals don’t work well so I suspect we might be in the same scenario. Obviously a good idea to run it passed your GP & you may need extra pred in prescription. I find the body doesn’t like these nasty shocks these days!

[Choosepink in reply to Pollyanna16]

Thank you I found that very useful ,as you say after being on preds for so many years I think the adrenalin glands don't seem to work as they should any more

[Choosepink in reply to PMRpro]

Sorry I take 4mg a day not a week I have been taking steroids for PMR for the last 10 years and try as I might seem unable to get off them completely I am 75 years old

[PMRpro Ambassador in reply to Choosepink]

It is probably worth trying a bit more pred - just feeling generally unwell is very possibly a lack of adrenal function. The doctor is really the person to ask - but maybe try 8mg tomorrow and see if it helps. Do you have a fracture clinic follow-up?

[Choosepink in reply to PMRpro]

Thank you for your reply I very grateful I am due back at fracture clinic on Wednesday ,I think I will take 8 today and give it a try how long do you think I should take the 8 mg for ,thank you ?thank you for your help

[PMRpro Ambassador in reply to Choosepink]

Try it for 2 or 3 days and see if it helps then discuss whether they think it is needed at fracture clinic - remember to tell them you have been on long term corticosteroids and how unwell you were feeling.

[Choosepink in reply to PMRpro]

Thank you so much I will do that

[Dappa]

Hi Choosepink,

I am on 3 mgs at the moment. I did get off them for 4 weeks and then became quite ill and went back on 5mgs to see if this helped me. It didn't. Then found out after blood tests my B9 Folic acid was on low side. So taking Folic acid tabs now twice a week. Feel tons better. So I have been coming down 1mg each week and have been fine. If I was you I would take 5 mgs see if this helps you and then come down. No need to take months to come back down to 4 mgs. I feel fine how i did this. All the best. Hope your better soon xx