Steriods

[Harrigan]

steriod, Iam confused, told to reduce steriods by 1mg per month, got down to 2mg but doctor said i had to go back to 4mgs, fine, but the pain at 4mg or 2mg is no different, so how do i know when to reduce, is it the pain that you go by, or what,

[DorsetLady PMRGCAuk volunteer]

Couple of things - Your illness has not gone just because you are on Pred, the medication only addresses the inflammation caused by the underlying illness... and

You are not reducing relentlessly to zero, you are trying to find the lowest dose that controls your symptoms....taper too quickly, particularly at lower figures and you go below that dose.

We often suggest at lower doses you reduce by 0.5mg a month rather than 1mg - that way you have more change of avoiding a flare, or at least catching it before it gets too bad.

Your GP was correct in telling you to increase, but if you have no relief, then obviously the extra was not enough...usual recommendation is to add 5mg to the dose you last felt okay for anything between 7-10 days to get inflammation back under control. Once that is done, you can then drop back down to just ABOVE the level that caused the issue.

This post explains how to treat a flare - adjust the doses in the example given to your own circumstances -

healthunlocked.com/pmrgcauk...

..and yes you do need to go by symptoms, or rather lack of them to decide when to reduce... follow your plan by all means (the clue is in the name - not set in stone, can be amended), but don't stick rigidly to it if you have pain....listen to your body.

You might also find a slower plan more advantageous at lower doses - very little spare Pred to mop up and inflammation, and many people find the last leg the most difficult.

here's a couple to look at -

healthunlocked.com/pmrgcauk...

healthunlocked.com/pmrgcauk...

Maybe also read through the link I gave you at last post about your illness.

[SheffieldJane]

Was your CRP raised in your latest blood test? That can happen even with the sniffles. I would ask my doctor to explain the reasoning. I’d be a bit reluctant - people really struggle to get from 4 to 2mgs.

[PMRpro Ambassador]

Whatever relief you managed to achieve at the starting dose is your guide. Then you taper to find the lowest dose that gives the same result as the starting dose did. You taper to a dose where the symptoms start to return and then go back to the last dose where you were good.

Why did the GP tell you to go back to 4mg? If it was because you were OK at 4mg but are not now, then maybe you need a week at a bit more to clear out the built up inflammation before going back to 4mg

[piglette]

Had you complained about pain to your doctor? If so it might have been why they suggested you increase. I find 5mg for a week or so works well in that case.