Can you become resistant to prednisolone over a period of time?

[Pr0jection]

As a matter of interest, and because I've been feeling very good up until recently, I wonder if you can become resistant to a particular dosage of prednisolone over a period of time? I'm currently on 7.5mg (since October 2020) and have been feeling pretty good, back to my former active self, until the last week or so. I've started to experience some aches and pains in my shoulders and hips - nothing major, but it's prompted me to ask the question - does your body become used to the level of pred you're on and start demanding more? Thank you and enjoy your day....

[DorsetLady PMRGCAuk volunteer]

At the dose you are at, it may be that your adrenals are re awakening…..and that can make a big difference to some…your body needs to produce its own cortisol to “top up” to the physiological dose that your dose of Pred previously exceeded…. Have a read of this explanation- healthunlocked.com/pmrgcauk...

Plus your comment “and have been feeling pretty good, back to my former active self, until the last week or so” may give you the answer…….so not so much as resistant to Pred, but trying to be too active for your current dose..

[jinasc in reply to DorsetLady]

Snap the first thing that came to my mind as I read

“and have been feeling pretty good, back to my former active self, until the last week or so”

may give you the answer……"

Trying to be too active for your current dose.."

[SnazzyD]

Hello, you are only 8 months in on a journey that usually takes at least 2 years. So 7.5mg isn’t bad and it may be you are at the border your lowest effective dose.

In addition this dose level is about when the adrenal glands need to start working to make up for the lack of Pred which teetering on the level we normally make for ourselves. For some around 7.5mg is not enough for the body to function and cope with demands but still too much for the sleepy feedback system to realise it needs to set up shop again. It can make one feel pretty rough. The only way to get through this is by slowly reducing until the body realises it has to fend for itself a bit. Usually 0.5mg drops are easier and I did around every 6 weeks. BUT, you need to be sure your PMR isn’t flaring up and the two can feel similar. Poor adrenal function gives general aches and pains for example. It can be disappointing when one is expecting an easy slide down the dosing later but debatably this part be the hardest and slowest of all. Once again, patience. Do have a read of this, written by the volunteers.

healthunlocked.com/pmrgcauk...

[PMRpro Ambassador]

There are doctors who say that - but if you have been more active recently, I'd look there first! Plus it is perfectly possible to have a flare in the disease activity - doesn't have to be in response to reducing the dose. My flares have all been at a dose I've been stable at for some time and have required a return to a higher dose.

[Pr0jection]

Thanks to you all. I'll read up on the information and will consider all your advice. I've put my tapering plans on hold for the time being as there's no hurry. It's sunny and warm here in Cyprus so it's a perfect afternoon to put my feet up and relax!

[PMRpro Ambassador in reply to Pr0jection]

Probably about the same as the south of England!!!

[HeronNS]

Just want to clarify - have you been on 7.5 mg since last October? Or did you start pred at a higher dose then? Looking quickly at you profile it looks like you started a couple of months earlier at 15 and then were dropped quickly to 7.5 and have been there since?

[Pr0jection in reply to HeronNS]

Hi HeronNS, yes I've been on 7.5mg since last October. I was diagnosed in August 2020 and put on 15mg for 3 weeks, then 10mg for 4 weeks and since then I've been on 7.5mg. I've been feeling pretty good all the way through until just recently so I wondered if the effect of the prednisolone does wear off slightly as time goes on. Of course, it could just be old age! I'm almost 78 and I suppose I have to face the fact that things are wearing out.