Reducing prednisolone dosage.
Posted , 7 users are following.
Am in a quandary about reducing my pred dosage. Have had too many other problems going on requiring help from my GP so PMR does not seem to enter the picture. I started in April 2014 with 30mg prednisolone and eventually decided to reduce the dosage using the suggested method obtained from the Pred group ie 7days 10mg 1 day 9,6days 10mg 1 day 9 etc. Am now reducing in halves and have reached 4 days 6 1/2 one day 6.Apart from my unrelated problems and feeling pretty tired a lot of the time the PMR does not appear to be causing much of a problem. Am wondering if it would be safe to reduce by 1mg instead of 1/2? Am anxious to get it down as quickly as possible because I have gained almost 3 stone in weight while taking it and am having great difficulty in reducing the weight. Also have apparently developed diabetes and have been told to exclude sugar etc from my diet. On top of that have had a bone scan for suspected problems - all it seems attributable to the pred. Would be grateful for any advice.
0 likes, 6 replies
Oregonjohn-UK Jaydy
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nomoreflipflops Jaydy
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MrsO-UK_Surrey Jaydy
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"the PMR does not appear to be causing much of a problem". Well it's excellent to hear that good news. And this is undoubtedly due to you having reduced/tapered as slowly as you have, so why upset the applecart and go any faster now? Plus you have done extremely well to reach your present dose within just a year. It is especially important to reduce slowly around your present dose anyway, as your adrenal glands will be trying to kick back in with their own natural production of steroid (cortisol), having been suppressed by the long term artificial steroid.
You will find your steroid weight will start to slowly disappear now, with a little help from you, of course! Your blood sugar levels should also then improve - be aware that "to exclude sugar" means keeping a watch on your carbs, many of which turn to sugar in our bodies. Restricting those will also lead to weight loss.
Good luck with the result of your bone density scan - do come back and let us know how you get on.
judy50581 Jaydy
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EileenH judy50581
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EileenH Jaydy
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I too put on over 3st with the combo of PMR and pred - one sort of pred just made the weight I'd put on with PMR due to inability to exercise redistribute itself to face and middle and then another sort made me gain massive amounts of weight. In the last 2 and a bit years, while still on pred (another sort though) starting at 15mg and now at 4mg, I have lost all that weight. How? By cutting carbs drastically.
Several people have found cutting carbs has helped them either lose weight or not put it on and they have no signs of diabetes. Pred changes the way our bodies process carbs - leading to weight gain, raised blood sugar and raised cholesterol. All can be helped by avoiding carbs in the first place.
You should have had the dexa at the beginning and should have been on at least calcium and vit D supplements the whole time. If they didn't do a bone scan at the beginning they can't say it was the pred - it may not have helped but only about half of patients on pred develop osteoporosis - there are several on the forums who had it right at the start at a stage it can't have been due to pred like Judy.
As MrsO says - you probably aren't having PMR problems because you have reduced so slowly and are still on a dose that is managing the symptoms well. But at this stage - your body has to start to produce its own corticosteroid and the adrenal glands that do that now have to get into gear again - continuing the slow reduction helps them adjust to each small dose. Reduce in bigger steps now and you risk problems there - excessive fatigue and other problems and if you go too fast you can even become quite ill. Some top experts keep their patients at 5mg for up to 6 months or more for that reason - it avoids more problems.
More haste, less speed...