reducing steriods

[Eternity6]

I have been put up to 10mg pred from 1mg after catching covid, it has affected my liver ( autoimmune hepatitis) so my liver levels very raised , my consultant told me I’d have to go straight to 10mg to help my body, my urine was very orange, I’m still feeling weak but urine has now changed to normal colour it’s my last day of 10mg, I’m waiting to hear from my specialist to see which mg I go to from tomorrow, having the most awful nightmares on 10mg been on steriods for 17 years and never ever had nightmares, has anyone ever reduced their 10mg back straight away to 1mg . As I’m thinking surely you would have to taper down in maybe reducing 1mg at time for couple weeks each time. I am due blood tests in four days time

[PMRpro Ambassador]

If it is less than 7-10 days (max 14 days) since the dose was raised it is fine to just drop back to the previous dose. From about 10-14 days it is possibly a good idea to go in 2 steps, via 5mg for a few days.

When I first started pred it was on a taper of 2 weeks each of 15/10/5 and stop which is a common way to use pred acutely - you are in a similar situation so it is entirely dependent on how long you have been at the higher dose to affect adrenal function.

[Eternity6 in reply to PMRpro]

thank you, I didn’t realise you could go from 10mg straight to 1Mg .before I got covid three weeks ago I was on 1mg and due to finish the 1mg and come off altogether( well that was the plan but still take 50 mg azathrioprine now this has happened🙄 I’m wondering if my specialist will want me to carry on longer on the 1mg,

[PMRpro Ambassador in reply to Eternity6]

Sorry - not clear what you mean. How long have you been on azathioprine? It can cause acute liver toxicity too so are they sure it is the Covid?

We would all say to take this last 1mg step very slowly - even 1/2mg can be plenty to keep PMR inflammation under wraps and many doctors think 1mg is doing nothing and tell patients to just stop. A few months later the inflammation has built up enough to cause symptoms again.

[Eternity6]

I’ve got autoimmune hepatitis I’ve been on azathrioprine for years and years along with the prednisolone I was tested for covid at hosp after I passed out at home, the hosp dr said as my blood was checked lots of blood tests one being liver inflammation that obv covid could well have put the liver levels up as before I became poorly with covid my liver inflammation was satisfactory

[Eternity6 in reply to Eternity6]

I’ve just realised I’m posting on pmr site I don’t have pmr

[PMRpro Ambassador in reply to Eternity6]

Never mind! But if you've been on pred a long time - that last 1mg is still tricky to get off!!!!

[DorsetLady PMRGCAuk volunteer in reply to Eternity6]

Never mind, you've still had answers...

[Eternity6 in reply to DorsetLady]

for which I’m really great fun

[Eternity6 in reply to DorsetLady]

grateful not fun🙄

[DorsetLady PMRGCAuk volunteer in reply to Eternity6]

dashed computers thinking for themselves... but you are allowed fun as well😉

[Eternity6 in reply to DorsetLady]

and I can’t wait to have some Dorset lady be nice to just feel well enough to go outside but I’m keeping positive

[Eternity6]

yes I’ve been on pred well over ten years thank you for your help

[Smithie49]

Hi Eternity6. Even though you're not in steroids for PMR I was interested about you having to increase your dose post covid. I was slowly tapering from 6mg to 5mg prior to Christmas. Stayed on 6 over the hols as it was lovely but somewhat stressful, then picked up Covid. Since then my stiffness had got really bad so upped to 10mg 3 days ago. Today, I feel almost back to normal so plan to give it a couple more days then drop back. PMRPro and Dorset Lady, and all you other wonderful, experienced folk, should I drop back to 6 or go to 7mg for a few days before restarting my tapering? Many thanks as usual

[DorsetLady PMRGCAuk volunteer in reply to Smithie49]

I’d be I inclined to go to 7mg or 6.5mg even though you caught it quickly, 6 mg was showing signs of being on the borderline of being enough/not quite enough.

And don’t be in too much of a hurry to restart taper….after effects of Covid may still be hanging around, and always best to ease up in tapering during winter months - body is under more stress anyway.

[Smithie49 in reply to DorsetLady]

Very many thanks . That is hugely helpful. I'll go to 7 for a while then start reducing again. X