confused new to pmr etc

[Sueloobyloo]

I would like to thank you, for the advice from you, it has given me peace of mind knowing that some of you take pred at night and that I am going to revert back to taking the pred at night, for which I feel more comfortable with, I thank you all again 🥰

[SnazzyD]

This may have been said already but the time where not taking it at night is sensible is under 5mg or debatably a bit before. This is because when one is trying to educate the adrenal glands to work again, the stimulus to produce more cortisol for the morning is thought to be from a low in the night. If you take it at night, that natural low isn’t allowed to happen. I was already on 4mg before the endocrinologist told me this. On higher doses it doesn’t matter because the adrenal glands are switched off anyway.

[Sueloobyloo in reply to SnazzyD]

Well I was on 15mg pred but I am now on 12.5 so I assume I am alright to take my preds at night? I also thank you for your advice 😊

[PMRpro Ambassador in reply to Sueloobyloo]

It also depends a bit how late at night you take it - even at low doses, if you don't take the pred unti about midnight, it isn;t in the system at the time that is the trigger for adrenal production of cortisol.

[Sueloobyloo in reply to PMRpro]

I usually take my pred between 6 and 7pm as I go to bed to read about 8pm, I hope this is ok, and thank you 😊

[PMRpro Ambassador in reply to Sueloobyloo]

If it works for you - that is what matters.

[SnazzyD in reply to Sueloobyloo]

It’s when you get a bit under 10mg that it becomes more critical

[SheffieldJane in reply to SnazzyD]

That clarifies the firm instruction from my endocrinologist to switch to taking my 6 mg Pred dose to 7/8 am. I usually take Entric coated Pred at around 11pm. The transition cost me an entire night’s sleep.

[PMRpro Ambassador in reply to SheffieldJane]

If I were on enteric coated, taking it at 11am I would ignore the endo. Plain pred at 11pm is a bit so-so, enteric coated at 11pm isn't anywhere near into your system until at least 2-3am so play no role

[singingloud]

I split my dose. 4.5 or 4 at 11:30pm and 5 at about 8am. Everyone is a bit different according to what works for them. I’m working my way to 9mg of prednisone.

How do you feel in the morning? Are you splitting your dose so you have some in your system through the day?

[Sueloobyloo in reply to singingloud]

No I’m not, but that sounds like a good idea and I will try that and thank you 😊

[singingloud]

Many of us split the dosage. Hope it helps.