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To increase pred or not?

Posted , 15 users are following.

nick67069
nick67069

I have been on 4mg since August 1 and when I tried to go to 3.5 in September, symptoms came back, so I went back to 4mg. In a last 2 weeks I am having relapse of symptoms, although I have not changed my dose recently or have done anything to cause it. My guess is that it might be related to colder weather. On a top of that, last few days I picked up a cold from my daughter.  I am still working on a cold, but wonder what to do with pred.  Last night, just for experiment, I took 5mg instead of 4. This morning most of the symptoms are gone.  I am reluctant to go back to 5mg, so I was thinking to do something different. Now a question(s).

Should I go back to 5mg or try to do this "cleansing" once a week and stick with 4mg most of the time?

Assuming that the experiment works ( once a week 5mg, and 6 days of 4mg), is there any issue with that longer term?

0 likes, 51 replies

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  • mimi1950
    mimi1950 nick67069

    Posted

    I am way more confused than you so I'll be following this thread...I keep getting into these PMR ruts where I think of every other reason possible for the return of pain .. anything that doesn't require upping the pred. I'm at a higher dose than you but experiencing return of PMR symptoms after a cold .

    Hope you feel better soon..

  • daniel08939
    daniel08939 nick67069

    Posted

    It is my experience that if you are on the proper dose of prednisone you do not have pain. I am currently at 4.5 and the plan is to drop .5 mg every 30 days. If after a drop the pain return I will go back up to the previous dose. If that does not stop the pain I plan to add another 1 mg. When there is no pain, you are at the right dose. You do not have to stay at the higher dose for a month. If I had to go back up to 5 mg after a week I would try 4.5. If I flared again I would think that my body was trying to tell me that 5 mg is were I needed to be and would stay there for 30 days then start reducing by .5 mg again.
  • EileenH
    EileenH nick67069

    Posted

    If the "cleansing" works - go for it. I can't see any reason for it to be a problem, I've done similar at times in the past.though usually with a higher one-off dose. The more you are on a lower dose the better all ways round - providing the symptoms stay away properly. It's only like finding the last stage of the DSNS reduction is OK but going to every day the new dose isn't. It's sort of suggesting that the 5mg is more than you need, it is somewhere under 4.5mg but not quite down to 4mg. 

    But 5mg is still a very low dose, well below the physiological dose so while I understand your reluctance, there is no shame! I do know of people who regularly go up a bit for infections or for the winter. Both together... 

    • Poupe
      Poupe EileenH

      Posted

      Had a question regarding dosage.  I am on 7.5 mg and will be starting my reducing in dosage but wondered how the rest of you handle the mg. cutting.  Given I have a 5 and 2.5 mg pill not a whole lot of ways to reduce.  Do each of you have a number of different mg pills.  Thought of getting a 2 mg from my doctor but to reduce by 1/2 mg. makes that a challenge as well.
    • Silver49
      Silver49 Poupe

      Posted

      I know your question is for Eileen but in the UK we have1, 2.5 and 5mg tablets. I noticed that the 2.5s have a marker to cut in half. 
    • Reeceregan
      Reeceregan Poupe

      Posted

      Hi Poupe, 

      Here in Australia we have 1 mg pills. I started on 50mg and am down to 13. I have had 25mg, 5mg and 1mg so cut each one as needed. . I currently take 2 x 5mg and 3 x 1mg. When I get to the 10mg dose  I will need to cut the 1mg in half in order to reduce by half milligrams from then on. Reading back over this I hope I haven’t confused you, but if you can get the 1mg just cut it. Good luck. 💪

    • Poupe
      Poupe Silver49

      Posted

      Thanks Silver49.  To drop 1/2 mg is difficult with the dosages.  For instance I will cut the 2.5 in half which gives me 1.25 and then the next drop is difficult so I will go from 7.50 to 6.125. Hoping that is not too much of a drop since I have had a flare up before but I was reducing way too much and way to soon.
    • EileenH
      EileenH Poupe

      Posted

      Where are you and what are you on? Prednisone, prednisolone (and gastro-resistant or plain white) or medrol (methylprednisolone)? As far as I know it is possible to get 1mg tablets even in the USA although some insurances won't pay as they are proportionally more expensive.Medrol may be more of a problem.

    • Reeceregan
      Reeceregan Poupe

      Posted

      Sorry Poupe,  just realised I hacked your question to Eileen, my apologies, must be the “pred head”. 😜

    • Poupe
      Poupe EileenH

      Posted

      Hi Eileen,

      I am on Prednisone plain white taking 7.5mg presently.  I will see if my doctor can write a prescription for 1mg which I am sure are able to split.

    • EileenH
      EileenH Poupe

      Posted

      If you have plain cuttable tablets then cutting the bigger ones and adding multiple 1mgs you can get almost everything. Cut a 5 to give 2.5 and add 1s to taste...
    • EileenH
      EileenH

      Posted

      PS - check with local pharmacies so you can tell a sceptical doctor that they DO exist! 
    • Michdonn
      Michdonn Poupe

      Posted

      Poupe, EileenH is correct here in the states we have 1 mg Phed and the DSNS taper method is great been using it since last spring. I just mark my calendar with pencil and erase any changes. It would work better if I slowed down, but I probably won't!

      Think positive and try to smile. 🙂

    • gerri38206
      gerri38206 Poupe

      Posted

      How is your diet.  I go to straight juicing to get the nutrients in and give your body a break from any trigger foods or foods that create inflammation

       

    • Michdonn
      Michdonn gerri38206

      Posted

      gerri38206, my wife and I are on an anti-inflammatory diet, I know it has helped her, she has not had a migraine in 206 days and used to have 3 or 4 a week. Has the diet helped me, I don't know, but think so. I am not going off it to find out. Think positive with a smile on my face. 🙂

    • Anhaga
      Anhaga Michdonn

      Posted

      Hi Michdonn, have you or your wife figured out if it has been the complete change of diet, or do you think she may have one or two migraine triggers?  I find I really have to avoid foods with added (even if called natural) flavours in any kind of food, so eating a diet free of processed foods has really reduced my headaches. 
    • Michdonn
      Michdonn Anhaga

      Posted

      Anhaga, my started on the diet, I followed, she then did a bit of a modification for me. It has made a major change in her life and I believe it is helping me. If I have taken foods out of my diet that can cause inflammation, how can it not help.

      Thinking positive with a smile. 🙂

    • Poupe
      Poupe EileenH

      Posted

      Hi....once diagnosed with PMR is there any type of timeframe a person could get diagnosed with GCA as well?   
    • EileenH
      EileenH Poupe

      Posted

      Not one you could fix accurately. I know people for whom PMR was the first sign of GCA within a short time whereas others had PMR which chugged along for a few years and then GCA appeared. Others never developed GCA, "just" PMR. One lady had GCA, tapered to zero in a couple of years and then developed symptoms of PMR another couple of years later. 

      GCA and PMR are very possibly the same disorder but at opposite ends of a spectrum. It is thought that some people with "just" PMR would show signs of large vessel inflammation if they had the right imaging done but it is an expensive and not widely available technique with a few risks of its own so isn't done for everyone routinely. If a patient with "just" PMR symptoms is put on a typical PMR moderate dose (up to 20-25mg) and all the symptoms resolve no-one thinks anything of it. If they don't, or the symptoms are typical of GCA they look more closely. 

      So sorry - how long is a piece of string!!!

    • lilian05079
      lilian05079 gerri38206

      Posted

      Hi gerri38206

      I agree with you about juicing. .I juice every day. At the moment i'm juicing carrot, fresh ginger fresh tumeric and pineapple with tablespoon olive oil for the tumeric to go through the system as it is fat soluble. The pineapple contains bromelain in that thick bit in the middle which most people throw away which is also anti-inflammatory ..all these are helpful for easing inflammation. I use it for my osteoarthritis and bursitis which, at present is not painful due to cortisone shot.......happy juicing!! my very best wishes to you gerri...

    • lilian05079
      lilian05079 Michdonn

      Posted

      Hi michdonn (smiler)

      Hope your anti-inflammatory diet is serving you and your dear wife well...i also went on an anti-inflammatory diet and it has served me well.....not only helped with inflammation also with digestive system.....keep smiling michdonn and having that amazing positive attitude you always carry with you.....my very best wishes to you and your dear wife....

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