Here we go again!

[Pangolin43]

Good morning,

I have reduced my EC Prednisolone down to 4.5mg per day. This is the first time I have got this far, having tried twice in the past. However I feel dreadful in the morning with stiff legs, achy shoulders, arms and wrists. I feel very weak too. My question is, ‘ should I stay at 4.5mg for a while and see if I improve or go back to 5mg where I felt comfortable. The discomfort is relieved by late morning ( sometimes helped along with paracetamol) and I wonder if this is something I just have to live with or am I risking a flare?

I have a telephone appointment with my rheumatologist this coming Wednesday and I suspect she will be surprised to learn that I have not reduced further. (1mg in almost 4months). I am already preparing my speech!! I had bloods taken yesterday so I guess my inflammatory markers may tell the story for me :-(. What do you lovely people think?

[PMRpro Ambassador]

When do you take the e/c pred? It does sound as if you are absolutely at the tipping point between enough and not quite enough so the effect isn't lasting the full 24 hours. But the morning problem could be improved by taking the costed pred shortly before midnight - it takes 4 hours to get into the system so won't interfere with the low level at midnight required to poke adrenal function into life, but will be there for the morning dose of inflammatory substances so they don't take hold and give you a miserable morning.

Me? I'd go back to 5mg and give it another month and try again - you weren't heading relentlessly for zero but the lowest effective dose - sound like you are there!

[Pangolin43 in reply to PMRpro]

Helll PMRpro. Thank you for your response. I agree with you. I’d be happy to return to 5mg for a month or so and then try to drop again. I take the ec pred at around 11pm. Not sure what my rheumatologist will say but it’s worth a go 😀

[ImC_]

I don't think you should feel bad about reducing by 1mg in 4 months! I took 4 months to taper 0.5 from 5 to 4.5mg. I did the 5 week slow taper but repeated some weeks multiple times at the slightest inclination . . . something coming up that I wanted to be my best for . . . something coming up that I didn't want to provoke the delicate stage of things . . . go your own pace. Got to 4.5 without any PMR symptoms, just the awful fatigue some days. Hope you find again that comfortable spot you recognised, one way or another.