Best time

[Hops1865]

What is the best meal to take pred with? For breakfast I just have a fresh fruit protein shake, would that be classed a meal?

[piglette]

I just have a piece of hard cheese. I normally have Comte or Ementhal.

[PMRpro Ambassador]

Probably enough - a glass or milk or some yoghurt is helpful perhaps.

It is more what time is best to take your pred for the PMR symptoms. The ideal time is 2am in the morning - determined by a study - so that allows the pred to be at its peak in the blood by 4am which is shortly before the inflammatory substances are released in the body and they set off to create inflammation throughout the body. By doing that the inflammation never gets to take hold and you need less pred to manage it. Doctors say to take the pred all as one dose in the early morning, preferably with a meal, but a glass of milk or a few spoons of yoghurt is enough for many people.

For some people the antiinflammatory effect doesn't last a full 24 hours - and so they split the dose, taking about 2/3 in the morning and the rest sometime later enough to extend the effect overnight to the next morning dose. That often also allows a bit of adjustment of when you take the bulk of the dose to be more convenient and yet still allowing a comfortable morning to get going without stiffness and pain.

[Caloo650 in reply to PMRpro]

I have just tried splitting the dose. 2mg at around 6pm and 2.5 at 6am. 4 days in and only minor stiffness. I tried 2am whole dose and found I was very stiff from 8pm through till 2am and then couldn't get back to sleep.However I am grateful for your suggestions and I'm hoping the new routine will allow me to taper abt more very slowly as rheumie has given me a script for leflunomide and I'm not keen to start it after reading the data sheet

[PMRpro Ambassador in reply to Caloo650]

The problem with simply shifting the time for the whole dose is that if the effect doesn't last 24 hours - you will STILL have a period of symptom return. Just at a different time. A small number of people don't have a problem because activity helps them a lot and taking the dose just before bed so it is effective by early morning combines with that effect. But they are few and far between,

[Caloo650 in reply to PMRpro]

I hope to have sorted it with the split.

[HeronNS in reply to Caloo650]

Let us know how it works for you . It all adds to the amazing pool of information we share on this forum.

[Caloo650 in reply to HeronNS]

I will so far so good

[Kendrew]

I don't know what the medical professionals would say is the best meal to take pred with. I would think though that our own individual circumstances will determine the optimum time for each one of us.

I personally take my pred each morning after a substantial & healthy breakfast. This seems to work well for me but the differing needs of others may mean it wouldn't work well for them.

[HeronNS in reply to Kendrew]

And things can change over time as well. I used to take pred in the middle of breakfast, but now find any time between 11 pm and 2 am works better. Tried to return to morning, after missing several doses for cortisol test, but the difference was apparent within a couple of days.

[Sharitone]

If you have any trouble sleeping with pred, then it helps to take it with the earliest food possible. I don't know what effect it has on sleeping if you take it in the small hours - I was unable to do this because mere yogurt or cheese wasn't enough to stop the pred hurting my stomach. So as Kendrew says, it can be quite an individual thing.

[HeronNS in reply to Sharitone]

I've been able to do this, but because of various muscle and bone issues I now sleep with my upper body slightly elevated which may help with any potential gut problems. Did not have any trouble getting back to sleep and staying asleep. I did have everything set out and ready and only ambient light. And @Hops1865 , Caloo650

[Bcol]

Morning. I take mine very early in the morning with some Greek Yogurt and a Banana, and so far no problems.

[Daffodilia]

I had large bowl of porridge on higher doses

[Theziggy]

I'm from Ireland (North) where porridge is regarded as the perfect breakfast. I have tried to like it, because I also think it is a very good slow release carb, but ................. it still tastes like what I imagine wallpaper tastes like.

[PMRpro Ambassador in reply to Theziggy]

Not enough salt!!!!!

[DorsetLady PMRGCAuk volunteer in reply to Theziggy]

Add fruit to it! Or honey (just a little) - if you don’t like PMRpro’s version!

[HeronNS in reply to DorsetLady]

In Scotland many years ago at our B&B was asked what I wanted on my oatmeal. Surprise when I said just salt. I noticed I was actually watched from a distance because they didn't believe me, thought I was some show off tourist and I would sneak sweetener anyway. When they saw me tuck in they stopped watching. I may have been eating low-salt, but never with oats or rice!Originally as a child was given Lyles Golden Syrup! Out of the strong comes forth sweetness.

🤣