The ups and downs of timings

[Pangolin43]

Good morning everyone.

On Thursday 13th I forgot to take my enteric coated Pred at 11pm as I normally do. I think I was so distracted by my son’s lovely dog who is staying with me that I went to bed exhausted 💤 I

I felt fine the next morning but from 1pm began to feel rather unwell. That’s when I checked my dosette box!!! I took my Pred immediately. I think I read somewhere on this site that to help restart the adrenals then it’s better to take Pred am regardless of it being plain or coated when you get to lower levels. 5mg in my case. So I changed my timing to 7am. However I have felt pretty ropey for the last 3days and aches and pains show me that my PMR is alive and kicking. I’m wonder wether to pursue this course of action ask for uncoated Pred or just go back to taking my EC Pred at 11pm and give it a chance to be in my system by morning. I have a rheumatologist appointment at the end of May and I’m concerned she may ask me to swap to morning doses anyway. Dog going home today. So I’ll get more rest. 😀

What do people think?

[PMRpro Ambassador]

If you are taking coated pred at 11pm, it is not into your system until about 3am at the very earliest, it must pass all the way through the stomach before it is broken down. The requirement for restarting the adrenal glands is that the lowest level of pred is at about midnight - so the earlier you take the pred in the 24 hours the better, especially with enteric coated pred.

Not taking it until 7am means it won't get to a peak until about lunchtime so can't do much about the inflammation until then plus there will be more left at midnight than when you took it 8 hours earlier at 11pm. The natural peak of cortisol happens about an hour after you wake up, starting to rise before you wake to prepare the body for the day ahead - no wonder your mornings have been rubbish! Providing you take the pred slightly before midnight - you are fine on all counts.

[Pangolin43 in reply to PMRpro]

Perfect. Thank you PMRpro for responding so quickly. I’m going to take my Pred at around midnight tonight. Hopefully I can return to my previous self and I haven’t done any lasting damage such as a flare 🤔

[piglette]

Go back to your normal time and you will be much happier, with or without your son’s lovely dog. Tell your doctor you felt better taking the steroids at 11pm if they ask!

[Pangolin43 in reply to piglette]

Thank you piglette 😀

[sferios]

I'm so sorry this happened. Looks like you're getting back on track. Personally, I have been so scared of missing my pred that I even had a nightmare about it once. I take mine in the morning and I do it with my breakfast routine. I find that if I am strict in my morning routine, I don't forget. At night I am sleepy and worry that I might forget.