Been Stupid follow-up

[Pusph]

Hi, just to recap I had been on 8mg Prednisolone for about 5 to 6 weeks and thought I was having a flare after pushing friend around garden in a wheelchair so increased to 10mg. Your general concensus was that it was more likely DOMS, which hopefully it was. I'm keen to get back to where I was so am thinking of staying on the 10mg for one week then reducing to 9mg for one week and then hopefully back to 8mg. Does this sound sensible/feasible or what would you suggest? Thanks for any advice.

[PMRpro Ambassador]

Up to about 10 days you can drop straight back to the previous dose, no need to have the step down unless you want to.

[brook2138]

My experience suggests that PMRpro, as usual, is exactly right,

[AmberAliona]

I’m down to 5mgs Pred now, after 5 years. My Rheumy has discharged me from his clinic with an open appointment if I need it. His advice( which I follow) is if I have a flare, increase to 10 for a few days. It works for me.

[Rozzyt]

I am on 4mgs. Eight weeks since 5mgs and seem to be managing so far. I will be on 3mgs by end if August but been told to do 4mgs one and 3mgs the next until 8 weeks. Too much exercise makes things worse. Little and often but keep walking, don't sit down too long, I keep getting up to walk about my house, stops my hips and groin getting sore. When u do go back to 5mgs try for 8 weeks. And go straight from 10mgs when u get relief back to 5mgs or alternate 5 and 6mgs each day. Hope this helps.

[Nosmell]

At the moment I’m hovering between 3 and 5mg as symptoms are reappearing - my rheumatologist suggests dropping by half a tablet every 6 weeks or so - maybe after another 2 weeks, I’ll go to four and a half - I think gradually is best. I was trying dropping one mg each month! Polymyalgia seems to lurk and “kick in” at a certain level of Prednisolone. I don’t know if this is any help. Best wishes. 🤞❤️

[PMRpro Ambassador in reply to Nosmell]

If you are getting to a lower dose and symptoms are reappearing you have almost certainly gone too low. You are never reducing relentlessly to zero - you are looking for the lowest effective dose, the lowest dose that gives the same result as the starting dose did. Pred cures nothing, it is a management strategy to mop up the inflammation created by the underlying autoimmune disease process. When you get to a dose and symptoms reappear, you stop reducing the dose, maybe even go back to the last dose that was good. The PMR doesn't go away, it is continuously active in the background, and when you go too low, ther is left over inflammation and it mounts up until the is enough to cause symptoms.

It doesn't mean you won't get lower, just not yet.

[Nosmell in reply to PMRpro]

Thanks so much - I may need to increase to 6mg - very painful in morning. Take care.xx

[Abbeynan82]

Hi. I have been asked to reply by the group as having experience with Prednisolone. I have had PMG for 3.5 years and am still on 16 mg.I have been down to 7/8 and failed to stay there or below 15 on several occasions . Most recently I ended up in hospital with pain and mobility disability. I was there a month . After admission I was found to have Covid as well. Just last week I began to have similar symptoms when doctor had reduced Pred from16to 15. So, I took more of everything and got in a commode in hopes that being able to get to the toilet would keep me out of hospital.

I had by then withdrawn from this group because I did not feel I should be taking advice from anyone other than my own doctor , or giving it. What I have had were two major attacks, one of which was quite dangerous. So, my best advice is to see your doctor! There don’t seem to be an short cuts. I hope you will soon be well.