Question re side effects of Prednisone at different levels

[musclesinflamed]

I'm tapering slowly and at 14mg Prednisone now. A couple days ago I received blood work results which showed a marked increase of A1C, LDLs and Glucose. I'm a careful eater and I exercise. Therefore I believe this is the fault of the Pred. So, I have 2 questions:

Question 1: At what point will Prednisone not continue these negative side effects? (I've heard 10mg and 7mg.)

Question 2: How fast can I reasonably get down to a less damaging levels without having flares?

[piglette]

Things should improve as you reduce the steroids.

[SheffieldJane]

I got my first normal blood glucose at 5 mgs. I am going down by half a mg every 4 weeks 🤞

[DorsetLady PMRGCAuk volunteer]

I’m afraid those are the life long questions ‘how long is a piece of string’ ..

Q1. The side effects will reduce as you reduce your Pred level…and regarding the 10mg or 7mg I think you might be referring to adrenals glands needing to re-awaken - which is a slightly different matter albeit it marginally connected.

Q2. That depends on your illness and your activity levels and any other health issues you may have - you are not reducing relentlessly to zero - you are trying to find the lowest dose that on a daily basis give you the same relief the initial dose did. That varies from person to person.

[SnazzyD]

When you say careful with your diet, have you tried very low carb diet? This is often necessary with Pred as normal healthy eating doesn’t prevent the increase in blood sugar with Pred. I found I needed to observe this all the to low doses of Pred in order to keep my HbA1c and weight steady. My cholesterol was always ok from 60mg down.

[Exflex]

At 5mg or under the risk of permanent damage is minimal.

If you taper sensibly by not more than 10% over a period of 4 weeks on average patients don’t yo-yo, so get there quicker in the end. I don’t think there’s a shortcut unfortunately.

[Koalajane]

even at 5mg I find that pred spikes my blood glucose. I have discovered when it spikes so don’t eat in that window. I eat low carb and my hba1c is in the normal range.

[PMRpro Ambassador]

It is a very individual thing - I have been on pred at above 10mg for years and my Hba1c remains at about 37. I usually eat low carb - I wouldn't like to see my figures after this weekend but things will go back to normal once I'm not eating as much carbohydrate!