Reaching lowest dose of Prednisone

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I was diagnosed last November with PMR and started on 20Mg of Prednisone. It relieved the pain

immediately, and I have slowly been reducing the dose. I was on 8.5 mg on 3/30/14 and started using Eileen H's slow reduction method. I was in the midst of the reduction schedule and took 7.5 on 4/23. The next morning I was in agony. I took an 8.5 dose that day and wasn't completely better when I went to bed. However, this morning I woke with only mild stiffness that disappeared with an 8.5 dose. My question is how common is it to have a flare-up or does it indicate that 7.5 is too low for me. I really was hoping to get off of the prednisone. Any comments would be appreciated.

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  • Posted

    I realize that some of these posts are 4 years old, but if anyone new is out there, I'd like to introduce myself. I am a 49 year old female that started showing signs of PMR 1.5 years ago (so I had just turned 48). First off, I'd like to say that yes, contrary to what most doctors have told me, I am proof that PMR happens to people in their 40's, not just in their 70's like I was told by 3 different physicians. I was at the point where I could barely get out of bed, and I wished I would die so I wouldn't have to move. I had every blood test you can name. Long story, but I finally started on a Medrol pack, and within the first dose, I felt better. It took one year, but I have almost gotten my dose to what I feel is an acceptable level of discomfort that I can live with. So I have been on Medrol (methylprednisone) for about 1.5 years now.

    I have tapered my dose to 8 mg alternating with 7 mg, and found that it is the right dose for me. Initially it took some time for me to figure out how to taper without flaring. I tried 8 mg alternating with 4 mg, then 8 mg alternating with 6 mg, and it just was not enough. I can take a level of discomfort, as I think all of us are used to, but I don't want to be in pain that it makes me miserable every time I move. One of my doctors (my obgyn) freaked when I told him I was on steroids, but he didn't understand the magnitude of PMR and what it can do to a person, so I told him just to concentrate on his area of expertise and leave my rheumatology issue to the other doctors (an IM and Rheum). My rheum also wanted me to start on Plaquenil, which I did, and after 4-5 months, it's doing nothing. That's b/c I finally got it in my head that my body NEEDS these steroids to function. So, in the case of all of us with PMR, we NEED these to function, and no other medication is going to help us. I understand the reluctance of doctors to have their patients on long-term steroids, but in our case, they are absolutely needed for us to live. It took me over 1 year to realize this, and I don't let myself feel bad now when I tell a doctor I am on a low dose of steroids. I will continue to periodically try to reduce the amount I take, but if it doesn't work, I'm not going to be depressed or mad at myself about it. PMR is what it is - a syndrome that responds only to steroids. I have read on other sites that PMR runs it's course in about 3-5 years, and then people can finally get off steroids. Have any of you experienced this yet? If yes, how long did your PMR last? If no, how long has it been since you were diagnosed with PMR? (BTW - for comparison - 8 mg of Medrol is the equivalent of 10 mg of Prednisone - which is considered a low dose for all of us worried about side effects).

    • Posted

      You are unlikely to find many people actually on the forum who are off pred - they are mostly away living life again - but there is a thread with comments from people who did get off pred.

      https://patient.info/forums/discuss/pmr-gca-website-addresses-and-resources-35316

      is a link to our resources post with loads of links. One is to the NE of England charity site and they have a section Our People with potted histories of members - most of who have got off pred.

      This is the link to the zero pred discussion

      https://patient.info/forums/discuss/zero-prednisone-discussion-450915

      I know a few people with GCA who got off pred in about 5 years. PMR tends to be a bit more variable but I have friends who got off pred in 2 years or so as well as some who took longer. A couple of ladies had PMR for about 3 years first time round and then had a second dose a few years later. Both have been off pred altogether for about 5 years now if I remember correctly and are back running their large gardens - despite being in their late 70s and early 80s now,

    • Posted

      Hi Eileen - thank you so much for your reply. I will definitely check out those links you sent. But I am encouraged that you know of some people with PMR who eventually did get off Pred b/c their symptoms subsided.

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