How to Tell Between Steroid Withdrawal and a Flare?

[Louisa1840]

Hello All,

I recently dropped to 3 and a half mgs pred and very excited to be there! It didn't last long though as horrible PMR symptoms re-appeared within two or three days. I braved it out for a few days and then, reluctantly, went back up to 8 mgs to knock the inflammation on the head. I felt much better almost immediately though yesterday I had sharp stabbing pains in the side of the head which made me worry I was developing GCA. I still have a few head pains today but I do feel much better.

Should I have stuck it out for a few more days? Was this steroid withdrawal or a flare - I really don't know? Is it too easy to grab at a higher dose to make the pain go away?

I anticipate and am grateful for all you lovely people and your wise responses.

[DorsetLady PMRGCAuk volunteer]

Have a look at this post - explains difference (hopefully) for you.

healthunlocked.com/pmrgcauk...

You don’t say how many days at 8mg, but you can stay for up to 2 weeks before dropping back down……without jeopardising your taper.

[PMRpro Ambassador]

The fact you say you "were excited to be there" and "braved it out" for a few days suggests to me it didn't start immediately and t was worsening - certainly not getting less? Steroid withdrawal will hit immediately the dose is changed but then improve slowly over a week or two. A flare because the dose is now too low, usually takes a day or two, or more, to manifest and then progressively gets worse.

I'd give it a month or so and try again - but not stick it out too long if it doesn't work. It may take a few attempts but you will get there sooner or later. And are you using a slowed taper or just going directly from every day one dose to every day the new dose?

[piglette]

Never try and stick it out, PMR always wins!

[Louisa1840 in reply to piglette]

So true Piglette I must remember your wise words!!