Best way to taper Pred to "help" PMR burn-out

I came down too fast - 7.5mg down to 5.0mg over a two month period - and relapsed.  Back to 7.5mg and now plan to taper much slower...0.5mg/month.

As for PMR burning itself out, this is waht we hear and hope for.  The docs tell us the average duration is ~2 years, but few poeple on this site believe that to be true.  As to why it "burns out"...well, anyone's guess.  Perhaps PMR is a virus o some sort of toxin (what it feels like to me) that simply runs its course like a very long cold.  Or perhaps we develop certain antibodies over time that couter its effects.  The Rheumies have no idea, and neither do I

Once down to 7.5mg ( down to 5.mg and you definately ask) and depending on long  you have been on pred  - you should ask for a Synathecen test.  Use the Search box at the top of this page right hadn side. 

You need to see a Consultant Endochronologist.

Sometimes the adrenals just do not wake up - but that is not often and depends on dosage, time and age increase.

If you look at your Blue Steroid Card it tells you to carry it for one year and tell any medic that you are still in the ;one year' peroid of time.  This is because it can sometimes take that long for those adrenals to become fully functional.

 

Hi Nick. I would ofhappily stayed at 5mg for a year however,my Gp encouraged me to continue tapering which I did 1mg every two weeks until zero however I did restart at 1mg and increased to 2mg as PMR pain started creeping in. Iwas comfortable at 2mg but upped to 3mg to be sure.IThen started having other symptoms such as headache etc so dropped back down to 2 mg.this I felt was my level  so waited two weeks and reduced .5 mg at at a time. My taper was pretty quick in comparison to many and I do not claim that it is optimum.i think it's important to. Recognise your own bodies symptoms to reduction and also too much prednisolone in your body as my DXA scan has revealed osteoporosis in my lower spine which my rheumy after other elimination tests thinks is down to the bone thinning effects of prednisolone...guess I'm trying to say bee cautious but don't be afraid to try reduction in response to your bodies symptoms

I think there is no reason at all not to continue to reduce, their use of the 10mg for a year is just the way they have chosen to reduce the tapering too fast/far problem. 

No, there have been no real studies comparing ways of tapering, that is most of the problem, it is all anecdotal and mostly "informed" by the terror so many doctors feel about using pred at all and the way they use it elsewhere: to reduce a flare of whatever until the real management drugs kick in again. Our management drug is pred - just at a lower dose than we need for a flare.

The 2 years? I think a lot of patients are TOLD  it lasts 2 years, are sent back to the GP and come off the pred but put up with the symptoms because they are told they must be imagining them! Or something of that sort. Many patients don't get as far as rheumies in the first place and even then are given totally unreal expectations. "The patient failed..." - as if it were our fault.

And it is slowly being postulated that maybe PMR DOESN'T burn out in a few years. Certainly, the potential to have it doesn't go away, but it may become quiescent enough to not require pred - or it may not.

Hi Nick,

i have had PMR for about 3 1/2 years. I didn't pause as I reduced but my body got down to 5 mgs of Pred and I couldn't reduce further for about 9 months. I guess for me that is where I started to have adrenal issues. Eventually I reduced to 4 1/2 but again I couldn't reduce further for at least 6 months (maybe longer - I would have to check my diary). Then I easily went down to 4 mgs.....but couldn't reduce to 3 1/2 so I think I've now successfully gotten down to 3 3/4. 

My goal was to reduce to the lowest level I could to get my Pred dose down....but not too low as I had a nasty flare in the past and I don't want to experience that again. I just listen to my body and go slowly slowly. 

thank you all for comments!. I will continue slowly to reduce my dose and carefully monitor any signs of increased PMR symptoms. Reduction from 8-->7.5 was the first time I actually experienced increased anxiety and return of some of PMR symptoms. It lasted only during the first week of taper... Then it was pretty much gone afterwards. In fact it felt as if muscles had more strength then before reduction.