StorageStar

[StorageStar]

Hello, my first post. PMR started gradually last Spring, then hit me like a truck in late June, diagnosed and prescribed Pred in July after a couple of very painful weeks. Pred has worked very well for me so far. Started on 15mg, down to 7.5mg a couple of weeks ago without recurrence of symptoms. Then started alternating daily between 7mg and 7.5mg. Have been feeling slight return of symptoms, manageable vague aches and occasional “fizzy” head. Do I persevere or go back up and if so to what dose? By chance I discovered a few weeks ago that a colleague has PMR and she told me about this forum, it has been very helpful to me.

[DorsetLady PMRGCAuk volunteer]

Hi and welcome

Would say probably a combination of teetering between enough Pred and not quite enough and adrenals realising they need to wake up again.

So maybe back to 7.5mg initially and see if things improve. If not then you may need to treat as a flare, but give it a couple of weeks to find out.

But whether it’s just adrenals or both, although you are only tapering by 0.5mg a time you may need to stay at each dose longer than previously. I can become more difficult as you get on smaller doses, less excess Pred swishing around system to deal with PMR.

How often have you been tapering previously - and have you always used the alternate day approach?

Have attached a couple of links - one on adrenals, one containing dealing with a flare -

1.healthunlocked.com/pmrgcauk...

2. healthunlocked.com/pmrgcauk...

[PMRpro Ambassador]

Hi and welcome!

Like DL, I think your problem may have more than one factor underlying them. This is a really difficult dose for many people as it is a dose where adrenal considerations join in with the PMR. Above all, you need to slow down so that 1) you are sure the new dose is still enough before thinking of reducing further and 2) you allow your body plenty of time to catch up on all sides but especially for your adrenal function. It takes a lot longer than most doctors think!

[piglette]

As PMRpro says you are now at the dose where the adrenal glands start to wake up. Ideally you should not increase if it is the adrenal glands complaining. The effects tend to be different to the PMR/PRED side effects. Ideally if it is the adrenals complaining hang on at that dose until things improve. Good luck.