Is this a flare or asteroid withdrawal symptoms?

[LBM1953]

HI All. I have been tapering since mid-July and last Saturday (2nd October) tapered down from 17.5 mgs to 15 mgs (starting dose was 30 mg). Sunday commenced with twinges in muscles around neck and arms, deltoids mainly but also traps, lats and triceps to a lesser extent. I have a full range of movement and I’m not in any real pain as such, just twinges when I use them in certain motions. It has been the same all week really (may have gotten a tiny bit worse yesterday but it’s difficult to quantify). Also been generally knackered for the last couple of days which hasn’t really happened with my previous reductions. My last CRP from 1st September was 2 mg/l (this was 1 mg/l the month before). Next blood tests scheduled for beginning of December. Considering where I was in mid-June with a CRP of 106 mg/l (and incapacitated) I think I am fortunate to be where I am at the moment. I don’t really want to increase the Pred unless absolutely necessary and feel a bit of a fraud for posting this question when I am (relatively) OK and reading the significant problems that others have to endure. Question. Any opinions as to whether this is a flare or steroid withdrawal and any suggestions as to what I should do? My natural reaction is to carry on as I am and see how it goes but does anyone think otherwise? Thanks in advance. LBM1953

[SnazzyD]

Firstly, try to assess accurately if it’s your gut that says stick or your head saying keep going. When you’ve done that , tell us how you did it. The fact that it started soon after reduction suggests withdrawal. I often had to go to bed for a few days as I felt flu like and sometimes it lasted a week. I also had to make sure I didn’t do anything active in reduction week which wasn’t a lot to start with, or I’d pay. Perhaps you do have a virus. As you go down it is common to find reductions more noticeable especially if you don’t change the proportion of the old dose. So if I’ve got the maths right a 2.5mg drop from 17mg is more than 10%, the usual advised (by those playing this game) drop at any one time. 2.5mg was too much for me. Even if you want to keep to the same rate you can always drop by smaller doses but more frequently to smooth it out. Just because previous reductions have been ok, doesn’t mean the body doesn’t notice forever.

[DorsetLady PMRGCAuk volunteer]

Its a bit difficult to tell, but from this link - healthunlocked.com/pmrgcauk... - and based on my experience I found steroid withdrawal only lasted for3-4 days at most... and as yours started straight away it would suggest SW... but by day 5 or 6 it should be receding.

As SnazzyD suggests it could be something else...or too big a reduction...although 2.5mg is recognised at the levels you are on, it doesn't always work...for a variety of reasons.

If you feel no better by the weekend, then maybe you need to return to 17.5mg, and then rethink how to reduce next time... or follow advice in link.

[PMRpro Ambassador]

Difficult to say really - if it were steroid withdrawal I'd expect it to be improving a bit but if it that the dose is too low then I'd think it would have gotten worse. But the speed with which it appeared suggest the former.

I'd go back and try a 1mg step down. And make sure I cleared the decks and rested for that crucial first week

[cycli]

I rather like the concept of an Aseroid withdrawal. Very topical since NASA are going to zap one in November to see if they can shift its course safely. Maybe they have some suggestions. Otherwise the most experienced on here seem to think it's a suck it and see issue as we are all so different in our responses. Don't feel a fraud posting. How you feel is important and we all have issues trying to decide what is causing what. I have just shifted the dose at early morning to increase and the midday to decrease so I'll watch it for a few days to see what effects it is having before the next reduction.