Don't worry about adrenal insufficiency too much. If your husband still needs prednisolone for PMR there isn't much that can be done. Just be wary of anyone who encourages "long term" prednisone use.

My rheumatologist wanted me off prednisone as soon as possible. She also made sure I was aware of the consequences of long term prednisone use. She encouraged me to taper off and tried everything she could think of to help me to taper off. However, she also made sure I had enough prednisone to manage the pain.

There were intervening factors besides PMR. My rheumatologist said there was a "full range" of problems so it wasn't "just PMR." I don't think I'm the only person here with multiple problems. In a way, PMR only is relatively easy to treat as long as a person can get off prednisone relatively soon. Thirteen years for me was way too long!

The advice to taper slowly was given to me at the onset on PMR because of the potential for adrenal insufficiency and not necessarily for causing a PMR flare. Unfortunately, the longer a person takes prednisone every day the more likely and the more difficult the problem with adrenal insufficiency becomes.

Cortisol is called the stress hormone. Any stress might cause an "inflammatory flare" but it isn't always PMR just because we happen to be diagnosed with PMR. In my opinion, it is more likely that that our body's natural inflammatory response is not being regulated well. This is especially true when our prednisone dose gets into single digits,

I just wish I had been more aware of the magnitude of the problem that adrenal insufficiency causes. It wasn't until I was able to get to 10 mg after 10 years when I realized it was adrenal insufficiency. A person who had an adrenal crisis explained everything to me.