Can/should I top up for 5 days?

[kangaroojohn]

I am tapering slowly and steady on 4.5mg pred for PMR. I feel reasonable but would like to feel better for the next five days for a family occasion . Can/should I inrease my dose for just five days and if so, by how much please ? Thanks

[DorsetLady PMRGCAuk volunteer]

We don't usually recommend doing that except maybe on a long haul flight or something that you have no control over...

..but you can increase for a few days if you really think it's necessary - any up to 5mg for a few days won't impact on you drop back down... but I would query your comment -

I feel reasonable but would like to feel better -

that implies you don't have thing fully under control - which is a tad worrying!

[PMRpro Ambassador]

I agree with DL's question - did you feel better at a higher dose? You should never feel worse at the end of taper step than you did at the beginning - which really means you should feel as well as you did on the starting dose.

Or do you think the difference you feel is that there is less of the high dose pred boost that some people experience?

[kangaroojohn in reply to PMRpro]

I currently mostly feel a little unsteady (lightheaded?), tire quite easily and have mood swings (which could be due to another cause), but have no pain. As a result of DL and PMRpro's responses I will not taper down again until these symptoms are gone.

I am not sure about the "high dose pred boost"

[DorsetLady PMRGCAuk volunteer in reply to kangaroojohn]

I currently mostly feel a little unsteady (lightheaded?), tire quite easily and have mood swings (which could be due to another cause), but have no pain.

Would say they are mainly adrenal related...so hold at current does, and give them [adrenals] time to catch up - not sure if you've already seen this - apologies if ive linked it previously-

healthunlocked.com/pmrgcauk...

..and if you increase Pred, you may well undo the "nudging" of the adrenals - so if you can I'd try and weather the few days... unless it becomes unbearable.

[PMRpro Ambassador in reply to kangaroojohn]

Lots of people experience a false sense of energy on higher doses and this drives them to do too much but it then disappears as the dose falls. This is the reason so many doctors try to tell us "everyone feels better on pred" - no we don't!

[kangaroojohn in reply to PMRpro]

Thanks very much DL and PMRpro. I will try and stay with 4.5 on account of the possible nudging issue.