I think I'm having a bit of a flare up and have increased my dosage of predisenole. I've still not recovered fully from hospitalisation 20 months ago but have been feeling a lot better and stronger. The last couple of weeks I feel like taken several steps back. Feel really low and run down. Everything aches again and mobility deteriorated. So tired all the time with headaches and general flu like symptoms. Spoken to GP and upped preds slightly. Am I always going to feel like this?Maybe it's not PMR flare but ME as suffer with all the symptoms of it?
What's my way forward?
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Everett19
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Sorry to hear you feel so rough, but it’s a bit difficult for us to tell.
Could be mixture of all your other illnesses, but did notice that in your last post you said you were at 6mg…so some of what you describe could be down to adrenal stuttering - especially as you have been on Pred for a long time. This explains in more detail -
The only way to deal with that is a very slow taper, plenty of rest and patience…an increase won’t necessarily help them.
But the flu like symptoms, headaches, loss of mobility sound like something else…so think you need to be seen by GP - maybe it is a virus, and I trust you’ve tested yourself for covid….
If it’s a flare of PMR then usual advice is up by 5mg…so I doubt that an increase of 2mg will have helped significantly - this link contains info on treating a flare - if that is what it is but tbh not 100% sure it is totally that -
It probably won't ALWAYS be like this but it does take patience. The autoimmune part of active PMR does cause similar symptoms to ME and so does the adrenal insufficiency stage of reducing the pred dose and the adrenals starting to produce their own cortisol again. It is important to know your body and your PMR well enough to distinguish between the two.
The only way adrenal function returns is to weather being at a slightly low dose of pred until it wakes up - but you can feel pretty ropey, very ME really. Going back to a higher dose of pred is not really an answer for that as it delays the natural response. On the other hand, if it is the PMR waking up you are at too low a dose and you NEED more. As DL says just adding a couple of mg is probably not enough to make a noticeable difference straight away until any accumulated inflammation is cleared out again.
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PMR or something else
Flare/adrenals or something else
thoughts - is this a flare or something else? 
PMR or Something Else?
