Flare or Adrenals

[Carathedog]

Hi,

I’ve been on 6 mg for a bout three months now, didn’t want to reduce over the holidays.

I have pain in my shoulders and hips when I get up, this gets much easier as the day goes on, in fact by late morning it’s sometimes gone. I’m also very tired, usually sleep in the afternoon.

What should I do, how can I tell if it’s a flare or adrenals, should I consider reducing to 5.5

Many Thanks

[DorsetLady PMRGCAuk volunteer]

I would say a mixture of both, the morning stiffness which eases sounds like too low a dose (flare) - and the fatigue sounds like adrenals struggling.

Think I would be staying at 6mg a bit longer and see if the mornings improve - but obviously don’t let them get worse. Or even consider splitting dose - 1/3rd in evening to help with the early mornings; 2/3rd usual time…some find that helps.

The adrenals are just a matter of time, very slow tapering, and patience.

[Carathedog in reply to DorsetLady]

Thanks for your helpful advice

[PMRpro Ambassador]

How to tell the difference? Hard - but at a stable dose, if the symptoms get worse, i.e. mornings are stiffer and it lasts longer, then I would suspect a flare, If they are stable or improve, then adrenals.

You are very much at the borderline - if you could cope with slightly less it might poke the adrenal function a bit harder and it do a bit more. And as DL says - possibly splitting the dose without taking the second part of the dose too late in the day (which might lull the adrenals a bit too much) may improve early morning. Ideal might be trying the whole dose at 2-3am - improves mornings no end!

[Carathedog in reply to PMRpro]

Thank you, will just stay where I am at the moment

[piglette]

I found the tiredness was due to my adrenals. Mine were really bad around 5mg so I just hung on for several months. I am always rather loathe to reduce if I don’t feel pretty OK.

[Carathedog in reply to piglette]

Thanks, yes, I’ll have to be patient

[piglette]

It is worth it just to stay comfortable.