What to expect from a 10 percent reduction?

[Quintius]

After 4-5 months on 7.5mg prednisone I have reduced to 6.8 (approximately). I have been on 6.8 for 10 days now and I am ok except for being fatiqued. Is that to be expected even though the reduction is less than 10 percent? And for how long should I wait before going back to 7.5mg? I have to get at least some energy back as I have a few freelance jobs to do.

[SnazzyD]

You may be entering the phase where the Pred dose is getting below the level of glucocorticoid that you need to function. Your normal natural cortisol production has been switched off because your Pred dose surplus has meant the adrenal glands don’t need to work.

This level of dose can be tricky if for you, the level is a bit high for the adrenal glands to wake up properly to make up the short fall. If the level is below what you need to get through a day (PMR aside) it’ll make you feel tired. The only way to get your adrenal glands back into action is to keep slowly reducing. The body hopefully registers the shortfall such that the adrenal axis starts to work. There is no easy way to get through this and putting a dose up just puts off the evil hour. This is separate from PMR. Do have a read of this from the FAQ’s.

healthunlocked.com/pmrgcauk...

[Quintius in reply to SnazzyD]

Thank you for the quick reply. I kind of new the answer, but guess I was hoping/dreaming of an "easy fix". But good to be reminded about postponing the evil hour. I will focus on that.

[SnazzyD in reply to Quintius]

The most inconvenient aspect of this is that one may have to slow down one’s activity and stress in order to be able to reduce.

[jls93 in reply to Quintius]

I completely agSmazzyD. The "metabolic door" you went through (taper ) has lead you to a physiologic "corridor" in which your adrenal s are beginning to adapt (wake up) to challeng the lower pregnisone dose creates...It's tempting to want to "get it (taper) over with", however this physiologically phase you're in proceeds at rate to which your body adapts to this new challege...as previously stated.

Hang in there, gradual successes is best for our body....

Our brains tendency to create expectations is where the tapering process is tricky....

Try to be good to yourself..this forum has a great deal of knowledge, experience,compassion to connect with.

Everyone wants to help us succeeded...

Take care of yourself

;-)..

[DorsetLady PMRGCAuk volunteer]

Fatigue is quite likely to be adrenals -at the levels you are on they need to be nudged slowly into working again . At higher doses of Pred they will have been asleep.

Have a look at this link from the FAQs-

healthunlocked.com/pmrgcauk...

If you don’t have any return of PMR problems-then preferably don’t increase your Pred.

It really just a matter of time, very slow tapering at as small a reduction at each stage as you can to get the adrenals to start working. Appreciate you are working, but rest when you can.. they won’t be rushed.

It can be quite difficult, but if you can you manage to get through it without increasing dose it will be better in the long run. Stay on each dose for longer than before..and give them a chance to “catch up”.

[Quintius in reply to DorsetLady]

Thank you for replying so quickly and like SnazzyD pointing out that it serves me better in the long run to be resilient. I needed that reminding.

[piglette]

Sounds like the adrenals’ Deathly Fatigue may have raised its ugly head. I just gave into it and became a zombie!

[Quintius in reply to piglette]

You are probably right, but can't give in. At least not for the next couple of weeks.

[piglette in reply to Quintius]

I must admit I did go up 1mg in the end as I was like a wet rag.

[Quintius in reply to piglette]

[PMRpro Ambassador in reply to Quintius]

Then go back and wait until that is over and done will and taper again. This is NOT a race.

[Quintius in reply to PMRpro]

I will keep NOT A RACE in mind.

I find the tapering proces so difficult understand. I have had days with fatique at every level while tapering and it is hard to figure out if this particular period of fatique differs from the other periods. But I guess i will know in a few days. The fatique phase usually lasts 3-5 days. I am on my 5th today.

[DorsetLady PMRGCAuk volunteer in reply to Quintius]

Would say what you describe as typically steroid withdrawal symptoms - and they vary greatly from person to person… for some it’s almost a return of initial symptoms, for others [like me] it was irritability, for other just a feeling of being slightly off colour. One of the reasons why a slower tapering plan can be helpful -you introduce the new lower dose incrementally over a number of weeks - rather than an abrupt change from one day to next..and as small a drop as possible -even 0.5mg can make more of a difference than you, and doctors realise.

[Quintius in reply to DorsetLady]

Maybe I could have tapered more gradually. I went straight from 7.5 to 6.8. I will do it differently next time. Or maybe even make the adjustment now if I am not better tomorrow or the day after.

[DorsetLady PMRGCAuk volunteer in reply to Quintius]

Ok - let us know how things go please…

[Quintius in reply to DorsetLady]

I will

[loverumba]

If you break a leg, you cannot expect to dance normally. Trying to do all the things you used to do will lead to more stress and likely exacerbate the PMR.

[Quintius in reply to loverumba]

True. But I still have to make a living with that "broken leg".

[Viv54]

Hi its hard but it does work , take it from someone who has rushed it twice !! I am now 0n 7.5 from 20mgs rest when you can ,dont drop till your body feels ready. At the end of the day i hope we will all get there , I am tryimg to get to 7 but this is the hard one for me, i struggle with it. So i just carry on knowing that i will do it ,just not yet ! Best of luck Viv.

[Quintius in reply to Viv54]

Thank you. And I will cheer for you

[PMRpro Ambassador]

10% is just an easy recommendation - and if the 10% or even a 5% change in dose takes you below the dose YOU need at the time, you will feel it. Just fatigue is OK, especially at this stage - this is the realm where your adrenal function has to wake up and join in the game and that also takes time. What isn't OK is if the PMR pain starts to reappear.

Either way - the smaller the change in dose and the longer the time between, the better your body is likely to adjust without you feeling it too much - and that is the aim of the game.

And if you have commitments coming up that make either result unhelpful - delay your reduction for a week or two - it is nothing in the big picture if it avoids a flare.

[Quintius in reply to PMRpro]

I timed my tapering wrongly. I knew assignments werecoming up but the urge to go to a lower dose got the better of me. I will plan better next time.

[DorsetLady PMRGCAuk volunteer in reply to Quintius]

Ahh - my advice (and did it myself) never reduce before potential stressful time (even a nice holiday) … 😊

[PMRpro Ambassador in reply to Quintius]

It happens more than you can imagine!!!!