Fastest and safest way to get off prednisone

[arvine]

I have postef most of my history and story fee times on this site, Have been on prednisone so 71/2 years, started at 40 mgs back then , was down to 4 mgs dec 2022, but rheumy increased pred at that point to 40 again, bcause of potential GCA, then used dead slow method to get to 6 mgs spring of 2023,, have had many things happen sincevsummer of 2023, trauma, losing son etc, last fee mos several physical emotional issues, most recent , injury to lower left glute , possible tendon or muscle tear near back lower pelvic bone, painful, stretched Jan 1 2024, felt snap, had ultrasound, MRI warranted, having on this tuesday, I feel pred has been a factor in this injury, want to know the best fastest wsy to taper now, at 6 mgs currently and want to get down to at least non toxic dose, advice, thoughts please thank you

[PMRpro Ambassador]

At this dose you can only taper as fast as your adrenal function will let you. This is already a dose that most doctors feel has fairly low adverse effects and even stopping your pred tomorrow won't undo what has already happened. Don't, whatever you do, stop the pred suddenly as that could make you very ill, needing hospital treatment. You can only continue with the DSNS approach and hope that your adrenal function wakes up as you do so. There is no other way that will achieve that, just slowly reducing the pred dose as you have been,

There is lots of info about adrenal function the FAQs.

[arvine in reply to PMRpro]

Thank you, my rhuemy just told me 6 mgs is not considered low dose, and having taken pred for 7 would have had no affect on muscles, tendons organs etc, but of course advised to continue tapering

[DorsetLady PMRGCAuk volunteer in reply to arvine]

Well he’s out of sync with most then - this is just one site, but most say the same -

WHAT SHOULD BE THE DEFINITION OF CONVENTIONAL TERMS FOR GLUCOCORTICOID DOSES?

Answer

We suggest the following terminology:

* Low dose ≤7.5 mg prednisone equivalent a day

* Medium dose >7.5 mg, but ≤30 mg prednisone equivalent a day

* High dose >30 mg, but ≤100 mg prednisone equivalent a day

* Very high dose >100 mg prednisone equivalent a day

* Pulse therapy ≥250 mg prednisone equivalent a day for one or a few days.

[arvine in reply to DorsetLady]

oh thank you

[PMRpro Ambassador in reply to arvine]

As DL says - I think most rheumatologists would disagree with that opinion. Most people on longterm pred start to have some effects on muscles and be more prone to muscle strains and tendinitis. But you can't taper any faster now than your adrenal glands will allow.

[arvine in reply to PMRpro]

ok thanknyou

[Avadip12 in reply to PMRpro]

Yes it’s well documented that tendons and muscles can be affected by high steroid doses. I had Achilles tendinitis when I was first on 20 mgs steroids .

[arvine in reply to Avadip12]

Thank you, is there a link or website documenting these affects, would like to refer to my rheumy

[Avadip12 in reply to arvine]

Yes if you google tendonitis caused by steroid use . There is information there .

[arvine in reply to Avadip12]

Thank you,

[Grammy80]

I can sympathize with you. Prednisone has done a job on my muscles and a few other things but stopping pred or hurrying it and getting GCA....is not the answer. I've been on it for over four years and still ride the rollercoaster of dosage. If I had to take a low dose forever, I would rather than risk further damage to my vision. It is a pain in the 'glut' for sure, but take your time. You have had quite a year. Last year sent me from 1 mg to 60 mg and I did not suffer the pain and loss you did. Be patient💞

[arvine in reply to Grammy80]

Thank you Grammy80, yes it d been and still is very tough , everything

[Grammy80]

Arvine, I cannot imagine. Please take a deep breath, be kind to yourself in every way and let yourself just coast until the warm weather comes...then take it slow. 💞💞fd

[arvine in reply to Grammy80]

Thank you I ll try

[Persevere99]

Hi

Devils Claw, a herb, with nil side effects, has powerful anti inflammatory properties.

All the best

Persevere

[DorsetLady PMRGCAuk volunteer in reply to Persevere99]

But it may interfere with drugs... so that should be checked out...

[PMRpro Ambassador in reply to Persevere99]

You can't say it has nil side effects. It increase gastric acid secretion so that might tip the balance into a problem for some. And it interferes with a considerable number of medications which could result in serious adverse effects.

webmd.com/vitamins/ai/ingre...

It shouldn't be used by anyone on prescription meds without medical advice.

[arvine in reply to PMRpro]

Thank you

[bussell]

A year ago I had the same experience with suddenly severely torn gluts. It was absolute agony to start with, but the good news is that it seemed to heal surprisingly quickly and the pain abated quickly too. Do hope the same goes for you! You already have more than enough to cope with. (Having been on pred for two years at that point I feel sure that had something to do with the already weakened muscles.) Very best wishes.

[arvine in reply to bussell]

Thank you, been 3 weeks tomorrow had this injury happen, simply from stretching too much I guess, and sometimes think it s healing other times hurts very sore, difficult to sit, put any pressure on that area , MRI this tuesday, did tests show you tore tendon or muscle ?

[bussell]

MRI showed full tearing of gluteus minimus tendon and tearing of the gluteus medius, associated severe trocanteric bursitis. No wonder it hurt! My GP, bless him, admitted he was out of his depth and referred me to a rheumatologist and connective tissue specialist. I saw him quite quickly (paid up for private) but by then it was already much less painful. He said that surgery was an option, but as I wasn't Emma Radocanu, but an 83 yr old, whose best tennis days were behind her, best leave it alone. surgery v intrusive and no guarantee of brilliant results. I couldn't walk the dog for a few weeks, but after that gradually back to normal and my 10,000 steps a day. Hope your situation is no worse and possibly better. I wish you luck and keep us posted!

[arvine in reply to bussell]

Oh gosh that sounds positive, I am 76 and do not want surgery of any kind, see what MRI shows but symptons similar im sure it s a tendon tear, I can walk very short distances with it, but sitting or pressure causes pain and soreness, although at some times seems slightly better , I think it is healing a bit too,