Prednisolone Taper

[headgirl]

Hi, I have been taking Pred for 9 years due to PMR & GCA & thanks to the slow tapering method I have been able to reduce to 7.5 mg without the re-occurrence of any disease symptoms. However, what I have found is that I feel very light headed most of the time and extremely tired. Has anyone else experienced this? any thoughts would be much appreciated. Thank you.

[DorsetLady PMRGCAuk volunteer]

You are now at the level when your adrenals need to start working again....and that can take some time, especially if you’ve been on high dose and long term Pred as you have.

They have been “resting” for the last 9 years while Pred has been supplying “artificial” cortisol above the level your body would normally produce - so need gentle nudging to get them to work again.

What you are feeling is typical of not quite enough cortisol in your body. Your adrenals will start to work, but the best thing you can do is to continue reducing slowly....as you are. I found it took about 8-9 months to get through this stage - reducing from 6mg to 3mg.

Obviously if you feel really grotty then discuss with doctor, but generally it’s just a matter of time- and patience on your behalf.

[headgirl in reply to DorsetLady]

Thank you, I had wondered if that might be the case. I'm determined to keep going!

[SnazzyD]

Hello, at 7.5mg you could well be coming into the dosing zone where the Pred dose may not be up to doing all day for your normal needs but your adrenal function that has been switched off all this time, hasn’t quite caught up. Until the adrenal function kicks in, one can feel pretty washed out, achey, weak, dizzy, emotional to name a few. Some people are fine but this dose is often when people write in to say they feel bad. The only way to get past this seems to be by keeping going until the adrenal system finally keeps up and my Endocrinologist doc was certainly keen on this. If you go back up in dose the adrenal glands just switch off again and you’re back to square one. So, providing your disease activity isn’t showing up, reducing slowly gets there in the end but you need to do it slowly enough so as not to have an adrenal crisis. I found 0.5mg drops introduced over 6-8 weeks worked for me but I didn’t feel I had much bounce until 3mg. It is worth reading up on this because it can creep up on you. Under 5mg some docs like to send the patient for a Synacthen test to see if the adrenal glands respond to an artificial hormone signal, as if the brain had just told them to work. Some just do a morning cortisol level first.

pituitary.org/knowledge-bas...

[headgirl in reply to SnazzyD]

Thank you, that's helpful. I'll keep going & get there in the end!

[PMRpro Ambassador]

I agree with DL and Snazzy ...

[piglette]

At around 6mg I started to have extreme fatigue and light headedness, I assumed it was my adrenal glands.

[Dudley316]

Heard girlDid you have to buy at pharmacy or is a long term requirement free via NHS.

( I know not free as we pay NI, but I didn’t know what phrase to use!)

Thanks

Dudley316