Pred dose ... do I go up or stay the same?

[Tayzee]

I’ve just had my esr back and it’s gone from 39 to 33 so it’s going down so that’s good. My question is... I’m on 10mg and still having leg pains at night sometimes and achy legs in the daytime... not severe just niggly ..... my gp says I can stay on 10 if the pain is manageable, or increase by 1mg to 11mg... not sure what to do as I feel that just ‘managing on 10mg’ is sort of defeating the object? I thought the aim was to get the esr down and feel fab (like I did when it went down to 12) and then gradually decrease the dose monthly until the symptoms are still under control at the lowest possible dose? Any thoughts on this would be much appreciated 😁 thanks

[PMRpro Ambassador]

If it were me I'd go back to 11mg since that should get the ESR down faster - the fact it is still well above normal suggests there is a bit of built up inflammation still there. What was your ESR at 12mg?

[Tayzee in reply to PMRpro]

The gp didn’t test my esr from 15mg he just told me to reduce to 12.5 then 10 (every 2 weeks..)... so I never really knew I suppose what the level was between 15-10mg 🙄

[PMRpro Ambassador in reply to Tayzee]

Numpty - you test regularly at the start especially otherwise you have no idea if the dose is enough!!! Or where it stops falling. The ideal is to stay at the starting dose until the level is well down and preferably stable - though that often takes more than a month and they get itchy to reduce the dose. But 15 to 10 in 4 weeks is far too fast, especially without testing.

[Tayzee in reply to PMRpro]

Yes I think I’ll try 11mg ...

[piglette]

I have discovered that if you start having aches and pains with PMR and you try and sit it out you will never succeed, PMR always wins, so I would increase a bit and ensure that you feel comfortable, when you do you can start to reduce again. Just take it easily and slowly.

[Tayzee in reply to piglette]

Thank you that’s what I’m thinking... makes sense I think 🧐

[HeronNS]

Could the leg pains be relieved by taking magnesium as that can lead to that sort of symptom? I know my leg pains were actually relieved when I discovered I had (and dealt with) a salt deficiency!

[Tayzee in reply to HeronNS]

That’s a thought 🧐