Prednisolone not working as well?

[Bayleaf1]

I have gradually been reducing from 15mg down to 7mg and my symptoms have been kept at bay but yesterday I woke up feeling I had a cold and my knees were aching. I was wondering if the fact that I have a cold would have lessened the effectiveness of the Prednisolone to suppress my symptoms. When I was diagnosed last September I had constant acheing in my thighs and knees and found it difficult to walk. I don’t want to increase my dosage if I don’t need to and am due to reduce again in 7days time. I would welcome any thoughts on this. Thank you.

[DorsetLady PMRGCAuk volunteer]

Would say you could be on the cusp regarding the level that your PMR requires… it’s not a matter of reducing ‘come what may’ to reach zero…it’s tapering to find the lowest dose that continues to give you the same relief as did the original dose.

It seems that at the moment you may have gone below your dose - doesn’t mean you won’t get lower- just not now.

If you haven’t seen this - it might help explain how PMR/Pred and your experience with both work -

healthunlocked.com/pmrgcauk...

Of course. It may just be a cold - so maybe try paracetamol and see if that helps… but I would suggest no tapering until you feel better. And then maybe 0.5mg a time - you are getting into the realms of adrenals needing to re-awaken - which can be troublesome in its own way.

[Bayleaf1 in reply to DorsetLady]

I was beginning to think along those lines from reading experiences of others with tapering. I will stay where I am then until I feel better then reduce by 0.5mg and see how I am. Thank you.

[PMRpro Ambassador]

You are not reducing relentlessly to zerom you are titrating the dose to find the lowest effective dose, the lowest dose that gives the same level of relief of symptoms as the starting dose did. The pred cures nothing, it is a management strategy and like all management strategies must be properly implemented to work. That means in this case ENOUGH pred.

It could well be the cold as well, even rather than, but I definitely wouldn't reduce the dose any further until the cold is gone and you can tell whether this is really one or the other causing the symptoms. But be prepared that MAYBE you have reached your dose for now - you will get lower, just not yet.

[Bayleaf1 in reply to PMRpro]

It’s all very well for the rheumatologist who I saw last month to say, “oh yes, you are doing very well. Just continue reducing by 1mg a month to nothing.” I knew it wouldn’t be as simple as that from reading all the comments on here plus I have a friend who has had PMR for four years and has been told that she will probably need to take 5mg for the rest of her life. She is 80.

[PMRpro Ambassador in reply to Bayleaf1]

Her problem is very possibly related to the return of adrenal function at her age. Adrenals get less effective with age anyway, the pred MAY have finished them off. You are relatively young and no reason why you won;t get off pred, But at the moment - PMR rules. And really, when it comes down to it, PMR rules until it goes on holiday - if it is there, it can poke its head above the parapet!