Update after visit to Dr re Hydrocortisone.

[IdasMum]

I'd been imagining that my Dr would be pleased with my taper to 5mg Pred but he was pretty shocked and said it was too quick.

We discussed swollen ankles, disturbed sleep, hunger, irritability and anger. He says none of them are side effects of Hydro. My low level anxiety has dissipated so I didn't discuss it.

He believes that my symptoms are down to my fast taper from 8mg to 5mg and wanted me to go back up to 7mg! 😱. I am inclined to agree that the fast taper could well have been the catalyst for the symptoms I experienced. We had a long discussion, I told him I'd prefer to stay where I am and see how the side effects pan out. He was reluctant to agree but was persuaded.

In the longer term he wants me to stay on the same dose of Hydro (30mg in divided doses) and see how my CRP levels are over next 6 months and then reduce my Pred again (actually he said I could just stop it! ). I think that will be another discussion nearer the time.

So for now I will stay where I am.

[PMRpro Ambassador]

Sorry to disagree again but others have had similar symptoms when trying HC . And he seems blissfully unaware that he has put you on a much HIGHER dose of corticosteroid than you were.

[IdasMum in reply to PMRpro]

My hands are tied. I will continue tom monitor my symptoms and adjust accordingly.

[PMRpro Ambassador in reply to IdasMum]

I know - all the best.

[Bennijax in reply to PMRpro]

How is HC used with or withour Preds for PMR? I hadn't heard of this. If you can explain, that would be helpful for those of us who don't know.

[PMRpro Ambassador in reply to Bennijax]

It isn't really - although one lady on the forum has been on HC because she can't tolerate pred.

It is usually used to help regain adrenal function - it is shed from the body faster than pred so is more likely to allow triggering of the HPA axis to produce cortisol..

I don't for the life of me understand what this doctor is trying to do by ADDING HC to pred without reducing the pred in the equivalent amount. They are both corticosteroids, both affect the adrenal function. The idea is usually to replace the pred with the equivalent dose of HC and go from there. HC isn't as effective an antiinflammatory so there are often problems.

[Bennijax in reply to PMRpro]

something I didn’t know. I have a rare appt to see my Rheumy next month, and I’m stuck at 8mg since the flare I had after the very high July heat wave.

[Bennijax in reply to PMRpro]

and thank you.

[Tiredofpmr555]

It is my understanding that both medications are basically the same thing so that's a lot of steroids that you are taking.

[IdasMum]

This dose is doing my head in. I am obviously feeling well, moving well and quickly which is great but don't feel I have made progress in terms of steroid levels. So tempted to come down another 1mg of Pred.

[PMRpro Ambassador in reply to IdasMum]

"don't feel I have made progress in terms of steroid levels" - well you haven't, he added a LOT of steroid to the dose of pred. He seems to think they are different things - only in the sense a spaniel isn't a labrador - they are both still dogs! Pred isn't hydrocortisone - but they are both steroids with the same sort of effect on the adrenal glands.

[IdasMum]

I'm gonna have to sit it out until mid October (after our trip away) and then go back to him. Or, I could drop to 4mg Pred (again after our trip) and make an appt with my rheumy whose last letter some years back said she would see me again at 4mg. I do think though I need to liaise with him before I do that.

🙄