5mg Pred

[piggylovesgolf]

Hi everybody,

I'm new to this post and happily in good health!!!! However, hubby not so.

3 years ago developed PMR --started on 20mg--got down to 7 in a year then relapsed. Went back up to 10 and tapered down for another year. So pred for 2 years and nothing since. However, symptoms' still there but obviously nothing like original but he's a tough old bird and soldiers on and fights the aches and pains. A recent flare up caused doc to order blood tests which showed elevated markers and suggested he return to Pred at 15mg which he is very reluctant to do as he is on other meds and feels he takes enough pills and is wary because of covid. Doc did say it was up to him and he will call him back in 2 weeks to discuss further

History over. My question is that a friend did a load of research and came up with conclusion that 5mg of Pred has no side effects and can safely be taken indefinitely. Has anyone an opinion on this please. I'm sure he would take 5mg despite his reluctance to return to steroids.

Many thanks for any comments. I am sure this site is a great comfort to sufferers of this horrible illness and I did laugh at Dorest Lady's recent post!!!

[jinasc]

Is your Husband aware that left untreated its big sister, GCA, can come along and that is not what you want at all.

You both must watch out for any signs, ie vision problems however small, jaw ache etc.

Read GCA Symptoms in the Pinned Posts.

[DorsetLady PMRGCAuk volunteer]

Thank you!

Actually he needs to get the built up inflammation back under control...and would say his PMR has never really gone away. Some do manage within 2 years, but many do not...and as it’s a self limiting disease one never know how long it will be.

He may be able to get away with 10mg, even 5mg, but as GP suggested, and you know, 15mg is the usual starting dose...it really depends how much inflammation there is to clear out...but it might be worth discussing.

Although 5mg is a easy dose, it may not be enough initially, and hopefully won’t need to be taken indefinitely- as I said PMR is normally self limiting - although not always.

As for Covid & vaccine - this from versusarthritis site -

Can I have the vaccine if I am taking steroids?

It’s fine for you to have the vaccine while you’re taking steroids. There’s no reason to delay the vaccine if you’re taking steroids, or have recently had a steroid injection or finished a course of steroid treatment.

Taking steroids as tablets, liquids, injections or drips might mean that your immune system doesn’t respond as well to the vaccine as someone who isn’t taking these drugs. This means that you may be advised to follow advice on shielding and social distancing guidance after you have had it. Steroid creams or eye drops should not affect your immune system or response to the vaccine.

[piggylovesgolf in reply to DorsetLady]

Many thanks to you both for the posts. Hubby had covid vaccine last week but previously following blood tests (I think) doc did say if he could manage without the steroids to do so as if he caught covid, due to suppressed immune system I assume, it would be very difficult.

[piggylovesgolf in reply to piggylovesgolf]

Sorry I should have added in agreement to DL that hubby does not think the PMR ever really went away but it is infinitley better than it was and he feels mostly that its under control. Doctors seem to want you off steroids asap. Hubbys main problem, and it is a problem, is that he is absolutely tired out and has very little strength. We have both always been keen golfers but he has lost all strength in arms and cannot hit the ball any distance now. Currently incredibly lethargic.

[123-go in reply to piggylovesgolf]

Hi there. No strength in arms and fatigue are indications that PMR is alive and kicking and not under control. Your husband should consider the consequences of allowing inflammation to build up. He needs the help that Prednisolone offers in managing the disease. I hope he gives this serious consideration. It must be hard for you, too.

[PMRpro Ambassador]

All well and good - providing 5mg is enough to manage the symptoms. But unless it is, there is no advantage: unless you take enough pred to manage the daily dose of new inflammation created each morning. If it isn't enough then eventually it will mount up and you will be back where you were - like a dripping tap will eventually fill a bucket and it overflows.

Untreated PMR is thought to be more likely to progress to GCA - and that can happen at any time, not just the first time round. Since he got to zero before it does suggest that he probably only needs a low dose ongoing - anything under 7mg is taken by doctors to be a safe dose for longer term use. But before he can establish that he needs to start with enough to clear out the build up of inflammation that is currently causing the pain and disability. Some of the fatigue may well be due to his adrenal function struggling having tapered off altogether and maybe a bit quickly. If it were me I'd start at 10mg and see if that is enough and then taper slowly to find his ideal dose. It may well be 5mg or less - but you can't assume that. Yu have to find out.