Steriod reduction

[Harrigan]

Hi every one, i got down to 2mg steriod, but then doctor said go to 4mg after blood test but just for 2 weeks, then reduce, so after 2 weeks do i go back to 2mg, or do i have to reduce slowly from 4mg again, very confusing x

[SheffieldJane]

I think the key thing is how you feel symptom-wise. Your doctor needs to explain the thinking behind the increase in dose. It can be tricky to taper at these small doses. Due to the Adrenal Function having to recover, the advice is always a slow taper of perhaps half a 1 mg tablet.

[PMRpro Ambassador]

Since we don't know WHY they said to go back up, I think you need to ask the GP. If the 2mg isn't enough there isn't any point dropping back to 2mg is there?

[Harrigan in reply to PMRpro]

blood test , he said go back up to 4mg for 2weeks , fine but what after that, i was on 2mg so do i go back to 2mg, or 3 mg and reduce from there. why don't they explain

[PMRpro Ambassador in reply to Harrigan]

I'd be inclined to assume it was because the 2mg was allowing the blood markers to rise so you need more than 2mg. I would now taper VERY slowly from 4 in 1/2mg steps. This already a very good low dose - no hurry and best to to spoil it now by letting the inflammation get the upper hand.

[Harrigan]

i have been reading loads of comments, am i supposed to be pain free before reduceing as i never have been since the beginning, which was 18months ago, Doctor told me to reduce by 1mg every month which i did, got down to 2mg then had to go up to 4mg, but have never been pain free, not sure about this one, mmmmmmmmx

[PMRpro Ambassador in reply to Harrigan]

Whatever level of freedom from pain you achieved with the starting dose is your guide - you shouldn't feel worse at the end of a taper step than you did at the start. And increasing PMR-type pain is a sign to go back to the previous dose. Below about 5mg it pays to spend a couple of months at each nw dose and only go 1/2mg at a time.