Covid 19 Vaccination

[AMDRunning]

I had my vaccination (AZ) 9 days ago. Within the last few days I’ve been feeling really achy & fatigued. I reduced to 4mg a few weeks ago so I don’t it can be that? How is everyone else feeling?

[Rache]

I had no significant after effects with the AZ jab but everyone is different. It could be the jab or It could be the fact you’re on such a low dose of pred. It sometimes takes a while for the adrenals to wake up. They will have been sleeping while pred supplied the cortisol. I am trying to reduce to 5.5mg at the moment and suffering from nausea and fatigue which can be due to adrenal insufficiency I believe.

[PMRpro Ambassador]

Could be either - the new lower 4mg dose might be very slightly too low and then it can take a while before the inflammation builds up enough to cause symptoms. Or it is possible that the vaccine has prodded the immune system and woken it up a bit. And as Rache says, the lower dose may be struggling to replace the body's needs for corticosteroid and the body is just catching up with the lack.

And it really IS impossible to work out which really. If it is a flare of the PMR for either reason, then it will probably get worse in the next days - and the answer is to go back to the previous dose, wait a bit and then try to taper again. Did you reduce from 5 or 4.5 to 4mg?

[AMDRunning in reply to PMRpro]

I reduced from 5mg to 4mg about 4 weeks ago

[Rache in reply to AMDRunning]

At that stage it’s advisable to reduce by only .5mg each time. The overall rule is no more than 10% reduction for each drop. At the lower levels this is even more important.

[PMRpro Ambassador in reply to AMDRunning]

That is a big change, relatively speaking. Top experts recommend drops should not be more than 10% of the current dose - so not more than 1/2mg at this stage. And using a slowed taper also helps.