Pred reduction problems

[Clucket]

Since late last year I have increased my pred from 4 to 4.25 then up to 4.5 , then after a month or so reduced back to 4.25 where I stayed for a few weeks but kept on feeling things were not right. My neck has got bad and I kept having various other muscle pains and problems. So as I had not felt right for so long I thought I will add 5mg for 5 days then decrease back to 4.5,. For the first time after increasing 5 then dropping down, I now am feeling the lack of pred, presumably like dropping down a dose, whilst my body adjusts. But I have not felt this before. Is this normal or is my body needing a higher dose of pred than I expected. I can only decrease .25 at a time so is my increase not enough. I felt OK on 4.5 last summer, but then I got really stressed late in the year and still feel stressed though not quite as bad as at the start. Hope someone can help, as I am now not sure whether I will feel better in a few days or whether it will get worse.

[DorsetLady PMRGCAuk volunteer]

Probably combination of 2 things - you weren’t on the increased dose long enough - we usually suggest 7-10 days although you can stay there for 14 days without an impact on dropping back down… and when you do drop back down go to just above the dose that caused your issue -so in your case to 5mg or 5.5mg.

and although you may have felt okay at 4.5 previously you do say you have had stress between then and now…

This link explains more fully.

Plus your adrenals may well be struggling - so have a look at this link -

healthunlocked.com/pmrgcauk...

As you are about 3 years into your PMR, there may be some time to go yet, so very small step are you are doing will help both your illness and your adrenals.. and a slower tapering plan as well if not already

[Clucket in reply to DorsetLady]

Thanks for the help.i will add 5mg for another 4 or 5 days then go back to 5mg. How long should I stay on this before reducing to 4.75. I used to reduce monthly.

[Bcol in reply to Clucket]

Just chipping in here, I have never reduced in anything less than five weeks, apart from at the very beginning when I was on high doses, and even then only if I felt totally comfortable with where I was. Better to have an extra week or so to be sure, rather than risk starting a yoyo up and down, particularly if the stress you were feeling is still there.

[DorsetLady PMRGCAuk volunteer in reply to Clucket]

If monthly suits you then continue with that… but we always say, listen to your body rather than watch the calendar.

[PMRpro Ambassador]

All been said really - but I want to emphasise not being in a hurry at this stage, even if you are only tapering such a small amount. To me it sounds as if the 4.5mg simply wasn't quite enough - even a slowly dripping tap will fill a bucket left long enough. And maybe it was already under 5mg that was setting off the drip.