Dose timing for non-pain symptoms?

[kangaroojohn]

I have been on 5mg pred for about five months and my symptoms are fatigue, some head spinning/ balance issues and mood swings, but no pain. I normally take the pred at 7.00 AM

Would my symptoms also improve if I took my pred at 2-3 AM?

[DorsetLady PMRGCAuk volunteer]

Would say the are adrenals stuttering - se this for more info-and whist timing changes may help a little, the only thing really to nudge them into working is time, very slow taper - and patience

healthunlocked.com/pmrgcauk...

[PMRpro Ambassador]

Not necessarily. The 2-3am timing is to reduce the symptoms due to the shedding of the inflammatory substances in the early morning. What you are describing are signs of poor adrenal function - due to the body not being able to keep up with the reducing level of corticosteroid in the form of the pred dose and produce a top-up of cortisol. The 7am dosing is providing a similar spike of steroid in the body as normal production of cortisol would do. If you took the pred earlier, all that would do is shift that forwards, I don't know it would help through the rest of the day.

5mg is accepted nowadays as being plenty to suppress adrenal function and is a difficult dose - it may not be quite enough to let you function well but isn't allowing your adrenal glands to wake up again. As we age, the return of adrenal function after longterm pred may be very slow and need a bit more encouragement than it gets at 5mg - or it may not wake up at all. Either way, a lower dose to try may be even more uncomfortable than what you are experiencing at present.

Have you spoken to your primary care provider?

[piglette]

Sounds like the deadly fatigue caused by the adrenals having to wake up and they have decided they don’t like the idea.