Let me send you a clip from Dadcue on this site. He is a true survivor and understands better than me. Most of my longer term experience comes from my wife who I am the caretaker.

Corticosteroids have the effect of suppressing the anterior portion of the Pituitary gland with resultant cessation/disruption of the Pituitary gland in secreting that hormone ACTH. ACTH is the hormone that communicates with the adrenal glands via a negative feedback loop in regulating the production of cortisol. Cortisol is a life essential hormone produced by the adrenal glands. Cortisol is necessary at a cellular level for every cell in the body for basic physiological functioning. Cortisol is also the body’s primary anti-inflammatory reagent.

Prednisone is never discontinued abruptly when (dosage of 5 mg or greater for 2 weeks or longer) for the reason of steroid induced Pituitary suppression. A slow and gradual taper is necessitated to ensure that the Pituitary gland can be coaxed back into function. Not all Pituitary glands are able to successfully “re-boot.” Some Pituitary glands will remain forever suppressed and at a physiological standstill. The longer the duration of continued use of prednisone the higher the risk of acquired secondary AI(Adrenal Insufficiency). Likewise, the higher the dose of prednisone over time the higher the risk of acquiring secondary AI.

Each step down titration in dose is done with the purpose of lowering the blood serum level of circulating cortisol to an uncomfortable level (eliciting symptoms of low cortisol - nausea, severe muscle/joint pain, diarrhea, low blood pressure, low appetite, chills/sweats). Each step down titration in dose is meant to coax the Pituitary gland to “awaken” from its suppressed/retired state. The longer you have been on prednisone would be a negative prognosticator for a successful Pituitary reboot. Most likely, you will need to remain on a replacement level of corticosteroid (hydrocortisone is preferred) for life. You will need to take daily medication to provide for corticosteroid normally produced by the adrenal glands.