Should I adjust my dose

[Beinkc]

I’m one year in with PMR, started prednisone at 20 and am currently on 7. I have been on 7 for two weeks and experiencing minor aches in the wrist and back of legs of a morning. Usually this diminishes by afternoon to barely noticeable. My question is, should I continue on with 7 for a few more weeks hoping it will eventually eliminate the issue or should I up my dose. My doctor has allowed me to adjust my dose as my body needs. I previously had a flare around 9 that was handled by the protocol suggested here (up 4 for one to two weeks, then down to 10). I see my doctor about every couple months and the last few visits my inflammation levels have been slightly elevated. I think the last time my levels were normal was when I was at 12. I’m just wondering if my body will eventually adjust to my dose and reduce the inflammation or if I need to up the meds to reduce the inflammation and then begin the slow taper again. Thank you for any advice on this.

[PMRpro Ambassador]

For me, aching wrists are a sure sign the inflammation is starting to build up. Once the markers start to rise - that is confirmation for most people that the inflammation isn't being entirely dealt with. If that continues, you can end up back where you started so it is important to take the amount of pred you NEED. It isn't your body that adjusts and deals with the inflammation - it is having the right dose of pred. It sounds as if you have found your lowest effective dose - and gone past it. Were you better at 8mg? If so, you could try going back to that and see if that is enough. If not, you may need to try the flare approach again. But if you are flaring at a dose more than once, that is your body telling you to stop pushing your luck!!

[DorsetLady PMRGCAuk volunteer]

As suggested by PMRpro think you might be pushing too fast… and if your bloods are elevating that suggests your PMR isn’t under control properly. So follow her advice on getting back on track.

As we say many a time, you aren’t reducing relentlessly to zero - you are aiming to find lowest dose to control your disease - sound as if you are going below that too regularly.

Your doctors is one of the sensible ones allowing you to regulate your doses, so consider yourself as one of the lucky ones. Many would give their eye teeth for a doctor like that. 😊

You probably need to listen more carefully to your body, and ease up on reducing once you have got this current blip under control.

[Beinkc]

thank you for your advice.

[Beinkc]

More questions, I looked back at my blood test and saw that in July I had no inflammation and was on 12.5. My next appt was in October and I had tappered to 8 by then , ( obviously somewhere in here I tapered too quickly)but my blood test showed my sed rate was 33 and then again in December it was 35. Do you suggest I go back to 10 or should I go all the way back to 12.5?

[PMRpro Ambassador in reply to Beinkc]

It does show a rising trend - but hadn't gone up a lot from October to December. You haven't had a more recent test? I'd try 10mg and see what happens - but it would be handy to know what the sed rate is now.

[Beinkc in reply to PMRpro]

I go back to Dr in March and I’m sure she will retest then. I’m sure the inflammation is there because of the minor aches I’m experiencing. Thank you, I’ll start at 10 as you suggested