What steroid dosage did you start on? Did you find the right dosage?

All I know is taking the "proper dose" of Prednisone is very complicated!

Prednisone replaces the hormone cortisol which your adrenals produce. Your cortisol levels are variable during the day depending on many factors such as stress levels both physical and psychological, infections, and whether you are active or sedate. The amount of cortisol in your system is regulated. Cortisol levels are high when you need it and low when you don't need it. The body has a mechanism to regulate cortisol levels and it is called the HPA axis.
https://www.verywellhealth.com/hypothalamic-pituitary-adrenal-hpa-axis-5222557#:~:text=The%20hypothalamic%2Dpituitary%2Dadrenal%20(HPA)%20axis%20involves%20the,adrenal%20glands%20to%20release%20cortisol.
Prednisone overrides the HPA axis and takes this mechanism out of auto pilot. There is no such thing as a normal dose of prednisone because your body's need for cortisol is variable and depends on all the factors already mentioned.

The best you can do is to take enough prednisone to meet your body's needs. Your 5 mg dose of prednisone is called the physiological dose. It is enough for your "average days." It might not be enough for those days that aren't so average. That is why you have good days and not so good days. It is hard to predict what a day will be like so therefore it is hard to know how much Prednisone to take on any given day.

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

In the following link there is a table about Prednisone doses depending on the condition being treated. The overall Standard dosage for adults is anywhere between 5–60 mg per day depending on the condition and other factors.
https://www.singlecare.com/prescription/prednisone/dosage
The normal range for PMR is said to be somewhere between 5 -25 mg. Your 5 mg dose is in the lower range but generally you should take the lowest dose that is effective. It is better to let your doctor help you decide what prednisone dose to take. The patient is in charge of monitoring their symptoms and communicating to the doctor what those symptoms are. Anything else is called "self medicating" and that is frowned upon. However, self medicating happens all the time.

I wish you well and I hope things go well for you as you progress in your PMR journey. Everyone has a different journey so there is no "correct dose" of Prednisone. However, a "stable dose" is important because the body likes stability and maintaining homeostasis.

"Homeostasis is defined as a self-regulating process by which a living organism can maintain internal stability while adjusting to changing external conditions. Homeostasis is not static and unvarying; it is a dynamic process that can change internal conditions as required to survive external challenges."

wow, this is soooo helpful!!! I understand much better now. thank you. This means of course I now have even more questions - feels quite complicated in terms of trying to self-manage.

Do most PMR patients work with a rheumatologist? Or a primary care? My primary care seems to want to pass me on to Rheumatology and I am waiting, could be several months.

So I think I understand that the variations that I'm experiencing are normal for this disease, which is why people self medicate (I've been tempted but prednisone scares me and I'm only two weeks in.) Frustrating! I love the quote about homeostasis; that is a great reminder, life is like this....thank you.

wow, this is soooo helpful!!! I understand much better now. thank you. This means of course I now have even more questions - feels quite complicated in terms of trying to self-manage.

Do most PMR patients work with a rheumatologist? Or a primary care? My primary care seems to want to pass me on to Rheumatology and I am waiting, could be several months.

So I think I understand that the variations that I'm experiencing are normal for this disease, which is why people self medicate (I've been tempted but prednisone scares me and I'm only two weeks in.) Frustrating! I love the quote about homeostasis; that is a great reminder, life is like this....thank you.

wow, this is soooo helpful!!! I understand much better now. thank you. This means of course I now have even more questions - feels quite complicated in terms of trying to self-manage.

Do most PMR patients work with a rheumatologist? Or a primary care? My primary care seems to want to pass me on to Rheumatology and I am waiting, could be several months.

So I think I understand that the variations that I'm experiencing are normal for this disease, which is why people self medicate (I've been tempted but prednisone scares me and I'm only two weeks in.) Frustrating! I love the quote about homeostasis; that is a great reminder, life is like this....thank you.

"So I think I understand that the variations that I'm experiencing are normal for this disease, which is why people self medicate (I've been tempted but prednisone scares me and I'm only two weeks in.) Frustrating! I love the quote about homeostasis; that is a great reminder, life is like this....thank you."

You are a quick learner ... especially when you say that you have even more questions! I asked many questions but the current standard of care for PMR is to take prednisone. Unfortunately, there aren't many alternatives to prednisone.

Treatment with prednisone for PMR has stayed basically the same for more than 50 years. Fortunately, there is more PMR research being done. Treatment is beginning to change and the future looks more promising.

Hi @deborah57, If you aren't already keeping a daily log with your level of pain when you wake up in the morning along with your prednisone dosage for the day, you might consider starting one. It was recommended to me by my rheumatologist and it helped a lot when I was tapering down on the prednisone.

Hello,
I have started on 5 mg Prednisone about 2 weeks now while I wait to see a Rheumatologist. My Dr. said this dose is just to carry me over until then.
I am wondering how the proper dose of Pred is determined- I seem to have good days and not so good days, and I'm wondering if increasing the dose would be a good or a bad idea, and if the good/bad days are caused by other factors (diet, weather, etc) or is it just the nature of this disease that the pain increases/decreases? It's a little crazy making as I doubt feel very confident around making plans to do things, or I make plans and then I have to let them go because I'm just not up to it.
Any thoughts appreciated. Thank you so much.

All I know is taking the "proper dose" of Prednisone is very complicated!

Prednisone replaces the hormone cortisol which your adrenals produce. Your cortisol levels are variable during the day depending on many factors such as stress levels both physical and psychological, infections, and whether you are active or sedate. The amount of cortisol in your system is regulated. Cortisol levels are high when you need it and low when you don't need it. The body has a mechanism to regulate cortisol levels and it is called the HPA axis.
https://www.verywellhealth.com/hypothalamic-pituitary-adrenal-hpa-axis-5222557#:~:text=The%20hypothalamic%2Dpituitary%2Dadrenal%20(HPA)%20axis%20involves%20the,adrenal%20glands%20to%20release%20cortisol.
Prednisone overrides the HPA axis and takes this mechanism out of auto pilot. There is no such thing as a normal dose of prednisone because your body's need for cortisol is variable and depends on all the factors already mentioned.

The best you can do is to take enough prednisone to meet your body's needs. Your 5 mg dose of prednisone is called the physiological dose. It is enough for your "average days." It might not be enough for those days that aren't so average. That is why you have good days and not so good days. It is hard to predict what a day will be like so therefore it is hard to know how much Prednisone to take on any given day.

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

In the following link there is a table about Prednisone doses depending on the condition being treated. The overall Standard dosage for adults is anywhere between 5–60 mg per day depending on the condition and other factors.
https://www.singlecare.com/prescription/prednisone/dosage
The normal range for PMR is said to be somewhere between 5 -25 mg. Your 5 mg dose is in the lower range but generally you should take the lowest dose that is effective. It is better to let your doctor help you decide what prednisone dose to take. The patient is in charge of monitoring their symptoms and communicating to the doctor what those symptoms are. Anything else is called "self medicating" and that is frowned upon. However, self medicating happens all the time.

I wish you well and I hope things go well for you as you progress in your PMR journey. Everyone has a different journey so there is no "correct dose" of Prednisone. However, a "stable dose" is important because the body likes stability and maintaining homeostasis.

"Homeostasis is defined as a self-regulating process by which a living organism can maintain internal stability while adjusting to changing external conditions. Homeostasis is not static and unvarying; it is a dynamic process that can change internal conditions as required to survive external challenges."

All I know is taking the "proper dose" of Prednisone is very complicated!

Prednisone replaces the hormone cortisol which your adrenals produce. Your cortisol levels are variable during the day depending on many factors such as stress levels both physical and psychological, infections, and whether you are active or sedate. The amount of cortisol in your system is regulated. Cortisol levels are high when you need it and low when you don't need it. The body has a mechanism to regulate cortisol levels and it is called the HPA axis.
https://www.verywellhealth.com/hypothalamic-pituitary-adrenal-hpa-axis-5222557#:~:text=The%20hypothalamic%2Dpituitary%2Dadrenal%20(HPA)%20axis%20involves%20the,adrenal%20glands%20to%20release%20cortisol.
Prednisone overrides the HPA axis and takes this mechanism out of auto pilot. There is no such thing as a normal dose of prednisone because your body's need for cortisol is variable and depends on all the factors already mentioned.

The best you can do is to take enough prednisone to meet your body's needs. Your 5 mg dose of prednisone is called the physiological dose. It is enough for your "average days." It might not be enough for those days that aren't so average. That is why you have good days and not so good days. It is hard to predict what a day will be like so therefore it is hard to know how much Prednisone to take on any given day.

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

In the following link there is a table about Prednisone doses depending on the condition being treated. The overall Standard dosage for adults is anywhere between 5–60 mg per day depending on the condition and other factors.
https://www.singlecare.com/prescription/prednisone/dosage
The normal range for PMR is said to be somewhere between 5 -25 mg. Your 5 mg dose is in the lower range but generally you should take the lowest dose that is effective. It is better to let your doctor help you decide what prednisone dose to take. The patient is in charge of monitoring their symptoms and communicating to the doctor what those symptoms are. Anything else is called "self medicating" and that is frowned upon. However, self medicating happens all the time.

I wish you well and I hope things go well for you as you progress in your PMR journey. Everyone has a different journey so there is no "correct dose" of Prednisone. However, a "stable dose" is important because the body likes stability and maintaining homeostasis.

"Homeostasis is defined as a self-regulating process by which a living organism can maintain internal stability while adjusting to changing external conditions. Homeostasis is not static and unvarying; it is a dynamic process that can change internal conditions as required to survive external challenges."