Reducing Prednisolone

[Thiago1396]

what is it with PMR that allows your body to reduce your steroid dose, without pain?

[SnazzyD]

If you are you reducing to a dose that still covers the inflammation made by your level of autoimmune activity you don’t get PMR pain. If the dose is too low at the time to cover your inflammation you get pain.

The Pred isn’t stopping the PMR, it stopping the inflammation from PMR. Sometimes the inflammation takes a while to build up again though so it isn’t always instant. Is this what you mean?

But, pain that comes on quickly like in the next day or few can be withdrawal pain and not PMR. This is the body’s reaction to having less Pred in the system. Why exactly, I don’t know. That should go in a few days.

[Thiago1396 in reply to SnazzyD]

at 15mg of pred I get some small degree of pain in my shoulders occasionally most days. I think my dose should possibly be 20mg pred daily to get my inflammation under control. Then after around 4 to 6 weeks, with no pain, start reducing slowly.

[PMRpro Ambassador]

You usually start on a dose that is higher than you need - so then you taper down to the correct dose for YOU. Eventually the underlying autoimmune disease activity also falls and then there is less inflammation for the pred to combat,

[Thiago1396 in reply to PMRpro]

at 15mg of pred I get some small degree of pain in my shoulders occasionally most days. I think my dose should possibly be 20mg pred daily to get my inflammation under control. Then after around 4 to 6 weeks, with no pain, start reducing slowly.

[Mayadill in reply to PMRpro]

Pin the tail on the donkey, blind man's bluff. So tapering or for that matter increasing is an accurate gauge of disease activity and much of the rest is mad nonsense, what you're looking to find out when you reduce is whether your disease activity has fallen since you last reduced, and if it clearly hasn't, you don't reduce, which is exactly what kept me cheerfully jogging along on 10 mg for most of a year, after which life was simplicity itself because the PMR had hugely abated, 9, 8, 7, 6, 5. I think it would have gone if I hadn't had the Moderna jab to wake it up, but I did, so here I am a year later. is there any leeway for what certain members of the medical profession appear to think happens, that being that a lower dose cons the body into thinking it needs less to do the same job - or as you say they omitted to ask the PMR? An element of wishful thinking - just lower your dose and we're sure your disease activity must be falling so it'll be all right?

[PMRpro Ambassador in reply to Mayadill]

Exactly, PMR does what it does - and no-one can influence it with pred, or anything else as yet

[Mayadill in reply to PMRpro]

Freaking petrifying, the - what shall I call it, the meme, that tapering in itself achieves something.

[Africschoice]

absolutely no idea I’m reducing and an rattling with pain killers 🤕