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How to go from a 7 day 50 mg prednisone to the previous 14 mg

Polymyalgia Rheumatica (PMR) | Last Active: Mar 17 7:12pm | Replies (7)
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@myrlyn3b

Thanks for your advice.
When I’d had to do a short course of high dose prednisone in previous years when I didn’t have PMR my adrenal glands only had the interruption of added cortisol for 5 days so when I stopped after the five days I’m sure it wasn’t too hard for the adrenals to kick back in. I never had a problem with it.

This time since I’ve been on prednisone for about 9 months starting at 24 mg and now down to 14 who knows how my adrenal glands are going to respond with the temporary high dose and then an immediate drop to 14.
I don’t want to deal with adrenal insufficiency problems so trying not to make an error.
I’m hoping someone might have had this situation and can tell me how it went for them.

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Replies to "Thanks for your advice. When I’d had to do a short course of high dose prednisone..."
DadCue | @dadcue | Mar 17 11:37am

I did a "prednisone burst" many times for other conditions unrelated to PMR.

You are wise to be concerned about your adrenal function. However, going back to 14 mg of prednisone is enough to manage your need for cortisol.

Approximate Prednisone Dose Ranges:
Physiologic: 5 mg (usual average adrenal output)
Supra-physiologic: 10-20 mg
High supra-physiologic: 50-250 mg (max adrenal output)

Your need for cortisol varies considerably depending on the day. However, 14 mg of Prednisone is an adequate replacement dose for most days.

According to my endocrinologist, problems with adrenal insufficiency begin to surface when your prednisone dose is tapered down to less than 10 mg. Not everyone will have a problem. It depends on dose and duration of time you have been on Prednisone.

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megz | @megz | Mar 17 7:12pm

Adrenal insufficiency isn't usually a problem till around 5mg dose when the dose normally produced by our body is reached. Steroid withdrawal is a different thing, and it can be the problem with moving too fast on reductions at higher doses - except in the case of a very short term rise and drop of prednisone.

I hope someone who has had your current experience replies.

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