Fatigue does it improve?

we are all different, but now on 3mg/day and no longer feeling the wall staring fatigue of a year ago and higher pred.

I don't have as much energy as I used to 4 years ago, pre pmr, by any stretch of the imagination. I'm older, but still feeling the effects of pmr.

Somewhere on this forum I wrote a copious narrative on fatigue. Buried in the 15,000 references to fatigue that the search pops up. Maybe someone else can find it. 

If you only have PMR 40mg was a very high starting dose - meaning it has taken much longer to reduce and exposed you to a lot of pred that probably wasn't necessary. If your diagnosis was GCA that is a different matter. However - what is done is done.

The fatigue is not generally improved by the pred - which is used to suppress the inflammation caused by the autoimmune part of the PMR. It is also the autoimmune part that causes the fatigue and that has to be managed by pacing and resting appropriately. At high doses of pred it may be balanced out by the Duracell Energizer Bunny effect pred has for some people - but that isn't all good as it encourages people to think they are cured and to rush about doing things that really remain too much for their own good.

However - now you are down to what is called the physiological dose level - the amount of steroid the body requires on a daily basis to function properly - your adrenal glands have to start to take up the slack and top up the amount you take as pred. As you reduce further it is possible that you may feel MORE tired as that process starts to kick in - and it may be slower than you would like. But reduce slowly enough and for the vast majority of people adrenal function returns. One top PMR rheumy likes to keep his patients at 5mg (if they can get there) for up to 9 months - which allows the adrenal function to sort itself out and the rest of the reduction is often far easier.