Reduce or not ? Thoughts please

[Jigsawlass]

I'm reducing 0.5mg every calendar month which seems to be OK. I'm due to go from 5 to 4.5 on Monday . I've had shocking fatigue this week, and I'm not sure if it's adrenal glands waking up or as a result of doing more in terms of walking whilst on a recent holiday . Should I reduce or stay put for a couple more weeks ? I had got to 5mg in November and flares etc meant I increased and then reduced slowly down to 5 in April. Any advice welcome x

[DorsetLady PMRGCAuk volunteer]

I would be inclined to stay at 5mg for another month….at least

Could be adrenals, so a prolong period at 5mg will give them chance to catch up, but as you flared at 5mg a few months ago, perhaps that’s a message that 5mg is the level your illness actually needs at the moment…. and as you were diagnosed about 16/17 months ago, quite likely.

When you do restart tapering stick to the 0.5mg, but maybe add in a slower tapering regime -helpful for your PMR and adrenals… and listen to your body rather than watch the calendar [your PMR doesn’t 🤨].

[PMRpro Ambassador]

I'd wait - this isn't a race, a few weeks is nothing in the great scheme of things and it might make it clearer what is causing the fatigue.

[SnazzyD]

Don’t rush it because the symptoms are telling you you are not producing enough cortisol for your needs, rather than it being a sign they are. Working glands gives you no symptoms and you go about life without thinking about it. Have a think if there has been anything mentally or physically that have been extra recently. If so that may have needed the adrenals to work more than they were able. If not you need to slow down your reduction schedule until you catch up a bit. 0.5mg per month was too fast for me, especially under 7mg.

[piglette]

I would say shocking fatigue equates to deathly fatigue caused by your adrenal glands making a fuss at being woken up.

[Jigsawlass]

Thanks for your advice everyone, much appreciated. I will stay put for a while as suggested. In the meantime I will rest even more than normal!