Hi, I'm new to the site. Would like to say thank you for the huge wealth of knowledge and advice given. Every time I go to ask a question or make a comment- it's already been asked or made. However, I cannot find the answer to this one. I eventually started on 20 mg of prednisolone on 09/03/21 after months of pain and immobility. 2 days later I was mobile and 'relatively' pain free and flying. GP reduced the dose to 15 mg on 30/03/21 - had a couple of fatigued/dizzy days but nothing major. However for the last 3 days the pain in my hip and leg just on the left side has returned after being blissfully absent for a month. The co-codamol helped the pain yesterday but this morning it's still there. As yet there has been no return of pain/immobility in other hip, leg, shoulders, arms or neck. Am looking for any advice or thoughts on what course of action to take before ringing the GP. Did try to update my profile a little this morning but will not accept the changes. Any advice will be gratefully taken. After reading this forum every morning I appreciate the experience of the many contributors here. Thank you in advance.
Could reducing pred cause symptoms 2 weeks later - PMRGCAuk
Could reducing pred cause symptoms 2 weeks later
Hi and welcome,I've been on pred for two years and discovered with each drop in dose.... particularly from higher doses....any returning symptoms (new or otherwise) would tend to be side effects of withdrawal from the previous dose IF they emerged within first one to two weeks of the change of dose. If this happened after three to four weeks though, this has usually been because I've dropped too low and not now taking enough steroid to mop up what would be the current level of inflammation in my body......hence the polymyalgia has revealed itself again.
If you drop by too big a dose too quickly, it can take several weeks in some people for the body to manifest this. That's why the experts here usually recommend when tapering you stay on any new dose for up to at least four weeks.....to ensure you're stable on it. Your drop from 20mg to 15mg seems a little fast...just under 3wks!... but more knowledgeable people will be able to comment on that if necessary.
The above is my experience and others may experience different I'm sure.
You're current pain maybe because you've dropped just below the minimum amount you currently require to keep things under control or it may be completely unrelated.
I hope you manage to get things back on track and wish you well.
You're in the right place for help and support.
If it is a flare (return of symptoms ) it can take anything up to 2 weeks to materialise....In your case would say the 20mg was plenty, so that cleared all the pre existing inflammation, but after a couple of weeks of being on 15mg that dose was not enough, and has allowed the daily inflammation to build up again.
PMRpro always equates it to a tap dripping into a bucket.....the drops of water will be contained for quite a while, but eventually the bucket is full and the water spills over the top.
Would suggest a return to 20mg for a few days (5-7) - although if you catch it quickly 17.5mg may be enough to mop up built up inflammation.
If you need 20mg, once stabilised, drop to 17.5mg - which is a more recognised taper. Stay at17.5mg for 3-4 weeks then start taper proper.
17.5-15-12.5-10mg is recommended , but not always achievable, if not you may need to reduce by 1mg a time (every 3-4weeks).
Thank you so much ladies - they were my thoughts but needed some expert advice before approaching my GP. Thanks again
They took the words out of my mouth, you needed every mg of that 20 mgs, your doctor was too quick off the mark to advise you to begin a taper. I would actually return to 20 mgs and stay there for at least 4 weeks and when you feel settled enough to taper, do a slow taper of not more than % of your dose. I might even begin the subsequent taper with 1 mg drops. The body can be quite unforgiving of this kind of thing with steroid treatment. Good luck!
It often does take a couple of weeks for the inflammation that is left on a slightly too low dose to build up. That drop from 20 to 15 might be OK in other things pred is used for - but it won't work for PMR at this stage (or any other stage come to that!). You are not reducing pred with a view to getting off it, you are tapering the dose to find the lowest dose that works to control the inflammation and that will still be more now than it will be later. No step down should be more than 10% of the current dose, that was 25%!
It might be you need 16mg at the moment - or it might still be 20mg. But by reducing in such an enormous step you don't know. They are always in such a hurry - and it ends up making life more difficult for the patient because they don't know where they are and how much they need,
Thanks so much. Have just walked to the shops and am now hobbling. Can't get consultation with GP until tomorrow but feel bad enough right now to jump straight back to 20 mg tomorrow and with your invaluable help and advice will be more confident in 'liaising' my taper with the GP. Thanks again
I've just walked to the village shop and back - essential supplies: milk! - and I'm knackered!! Blaming the vaccine for that.
We went out for a celebration ride, 14 days after final vaccine. Stopped to get Asparagus and potatoes at a local farm (had masks on of course).
Lovely feeling of 'freedom'??? though.
Oh yum! Been on the spargel for a few weeks her but not really as good as I remember on Bavaria. The relatively local wonder-stuff costs and arm and several legs though ...
€14.50 per kilo here! It gets cheaper as time goes by. Fresh (daily) Asparagus until 22nd June now.
Not sure what Terlan spargel costs - but it is miles away, other side of Bozen. Though I did see an offer to deliver locally - the supermarket does me.
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