Reduction of 1 mg preds a week?
Posted , 7 users are following.
After recovering from a flare, Ive been tapering very slowly down from 12 mgs preds, now midway between 10 and 9, and not doing to badly. When I was diagnosed in April my blood results very high, but after a month they have been down below normal.
My GP insists that I should now reduce my 1 mg a week, go through the pain and continue down. I read a similar qyestion on the forum yesterday, it seems to be something coming from the Nuffield? Has anyone any further details.
0 likes, 21 replies
FlipDover_Aust jancorb
Posted
I'm on Methtrexate AND Actemra and only reducing .5mg a week - and at 5mg daily I'm really starting to struggle - not with PMR but all the other aches and pains that were masked by the pred - planter faciitis, arthritis in my toes, a tear in my medius gluteus, hip bursitis.... you name it. I'm not sure I want to get my 'old' body back!
jancorb FlipDover_Aust
Posted
Indeed, the side effects of prednisolone are well known, but we also know the pain we had before the medication, not something I'm in a rush to experience again. I wonder what dose of preds would be relatively safe to take over an extended period? Anybody know?
FlipDover_Aust jancorb
Posted
Some people will say that zero is the only safe level - others will say anything under 7mg is ok. Who knows?
There are a couple of people on here who are on pred for life - I think because their adrenals have gone into complete failure. But I'm often wrong. (don't tell Mr Flip that!)
EileenH jancorb
Posted
What is called the physiological dose is about 7.5mg - that is the amount the body makes every day of cortisol which is essential to life (though since the bioavailability varies from 50-90%, I suppose it may be more like 12-13mg for some people and that also accounts for why some people need a higher dose to manage the pain/stiffness).
Anyway, most doctors stop worrying once you get down to this dose - the body doesn't care whether the corticosteroid available to it is natural or synthetic and when you are at a dose above this level it doesn't make any more. In much the same way your heating boiler doesn't create more heat when the thermostat knows the room is warm enough. At the physiological dose the system that makes the cortisol has to wake up and start to function again - to top up the slightly lower dose to the required amount so from there down, theoretically your body has the same total amount of corticosteroid present and you shouldn't suffer side effects as they are due to excess steroid.
But - everybody is different. I have had no side effects (that i can tell at least) this summer while on more than 10mg after a flare that needed 15mg again to manage. My consultant said get to 10mg by the end of the summer, 8mg would be better, but you need what you need. I seem to have managed the 8mg again.
jancorb EileenH
Posted
I understand your explanation, will bear it in mind when I have my next consult with my GP ,
Your consultant seems to have a more reasonable approach to our dilemma,.