What next, ?Flare or Adrenals

[Carathedog]

Hi,

I was on 6mg for about a month, gradually began to feel worse with severe leg pains during the night. Took your advice and increased by 5mg daily, now on day seven. Things have improved, a bit sore for the first hour of the day, then pretty much ok.

What’s happening please, and what next.

Thank you

[DorsetLady PMRGCAuk volunteer]

You might need to give it a few more days -you can stay another seven without impacting on future reductions.

If you feel better after extra days, you can then reduce to just above the dose that caused the issue - so 7mg rather than 6mg. Stay there for a month before restarting taper.

If it doesn’t improve by continuing at increased dose for another week, then you need to seek medical advice.

[Carathedog in reply to DorsetLady]

Thank you

[PMRpro Ambassador]

What had happened?

You had overshot the target dose: the lowest effective dose, the lowest dose that gives the same symptom relief as the starting dose did. 6mg was marginally too low, it allowed a bit of left-over inflammation to build up day by day until there was enough to cause symptoms. Pred cured nothing - it is a management strategy to clear out the effects of the daily batch of inflammatory substances shed in the body every early morning. You have just spring cleaned, now it will be back to daily dusting to stop it building up again.

This is what you were aiming for, not a relentless progression to zero. It doesn't mean you won't get lower, just not yet. And possibly, from here on, trying 1/2mg at a time might get you lower. But nothing, however slow, will get you past that lowest effective dose.

[Carathedog in reply to PMRpro]

Thanks, so should I stay at 11 for a few days more, then go back to 7

[PMRpro Ambassador in reply to Carathedog]

Probably not a bad idea - DL thinks so too

[SnazzyD]

My experience of low adrenal function pain was a fluey all over aches, not bad pain in specific areas. Yes, if I overdid an activity I wasn’t used to I was in pain in whatever area was upset but not severe pain that crops up at night. I know I am just one example but based on that I’d point to a flare.

[Carathedog in reply to SnazzyD]

Thanks, appreciate your input