1. < Polymyalgia Rheumatica (PMR)

Good information to know about prednisone.

Posted by DadCue @dadcue, Jun 28 7:13am

Sometimes the information we receive about prednisone is overwhelming. I stumbled across the following that contains information about Prednisone that doesn't seem too overwhelming.
https://www.ncbi.nlm.nih.gov/books/NBK534809/

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

dlb3 | @dlb3 | Jun 30 1:41pm
In reply to @tuckerp "I think Dr treating PMR have a pretty tough job. They disease requires long term steroid..." + (show)
@tuckerp

I think Dr treating PMR have a pretty tough job. They disease requires long term steroid use.(>two weeks). Its also about the only thing right now that works over night. They try to do some due diligence to make sure its not something else. But they know when they start you on the prednisone it will work over night and you most likely will not be able to taper off. Most testing for how your cortisol is doing requires you be on less than 4mg of prednisone. By then most everyone is having a flare and its almost impossible to reliably test. The patient becomes its own worst enemy. Dr's just try to make it work. I know of no other drug right now that can treat inflammation for PMR as well as corticosteroids. All the things you mentioned are great and yes we should be doing them but how many of us do. The steroid replaces our bodies cortisol. The body has plenty to fight inflammation with this increase in prednisone. Its when you start to taper off the prednisone then you run short because your adrenal system has shut down. All the drugs you mentioned and Cushing's disease are over produced cortisol. Our problem is our bodies have shutdown production or adrenal insufficiency. I know of no other drug that replaces cortisol in our body other than corticosteroids.

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I read somewhere that when you have adrenal insufficiency and low cortisol levels that you might be able to receive hydrocortisone injections to help boost the cortisol. This is a discussion I will have with my endocrinologist. I have been prednisone free for almost 2 weeks now managing any pain that I have with anti-inflammatory diet, physical therapy exercises and ibuprofen. It feels really good to be off of the prednisone. I am going to have my cortisol level. Tested in about two weeks.

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tuckerp | @tuckerp | Jun 30 1:51pm
In reply to @dlb3 "I read somewhere that when you have adrenal insufficiency and low cortisol levels that you might..." + (show)
@dlb3

I read somewhere that when you have adrenal insufficiency and low cortisol levels that you might be able to receive hydrocortisone injections to help boost the cortisol. This is a discussion I will have with my endocrinologist. I have been prednisone free for almost 2 weeks now managing any pain that I have with anti-inflammatory diet, physical therapy exercises and ibuprofen. It feels really good to be off of the prednisone. I am going to have my cortisol level. Tested in about two weeks.

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My opinion. Hydrocortisone is the drug of choice for those that suffer from Addison's disease. Long term steroid use can also cause AI because your body is not able to fully restart on its own. But hydrocortisone is a corticosteroid. It just has less punch for long term use. Hydrocortisone, prednisone , methylprednisolone, dexamethasone, are all corticosteroids. So your only trading for the little sister to prednisone. You will still experience all the side effects that prednisone offers. Sounds like your doing good.

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dlb3 | @dlb3 | Jun 30 1:58pm

Got it! Thanks so much. Just hoping my adrenaline gland will recover from eight months of prednisone therapy.

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DadCue | @dadcue | Jun 30 2:42pm
In reply to @dlb3 "I read somewhere that when you have adrenal insufficiency and low cortisol levels that you might..." + (show)
@dlb3

I read somewhere that when you have adrenal insufficiency and low cortisol levels that you might be able to receive hydrocortisone injections to help boost the cortisol. This is a discussion I will have with my endocrinologist. I have been prednisone free for almost 2 weeks now managing any pain that I have with anti-inflammatory diet, physical therapy exercises and ibuprofen. It feels really good to be off of the prednisone. I am going to have my cortisol level. Tested in about two weeks.

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Keep up the good work. Assuming PMR symptoms are controlled, taking the lowest possible dose of prednisone is a good way to get your adrenals working again. Being on no prednisone is the best thing by far as long as the pain is tolerable or the pain can be controlled with something else.

Hydrocortisone is given instead of Prednisone because it is preferred by endocrinologists when adrenal insufficiency is diagnosed. It is still a good idea to see an endocrinologist if you have been on Prednisone for a long time and can't taper off or have recently tapered off Prednisone.

Hydrocortisone won't help boost your cortisol level. Hydrocortisone is another synthetic form of cortisol just like Prednisone.

I understand the confusion. Hydrocortisone is the treatment for adrenal insufficiency because some endocrinologists think hydrocortisone doesn't suppress the adrenals as much as Prednisone does. My endocrinologist said there wasn't any clear difference between hydrocortisone and prednisone. Both medications are synthetic corticosteroids and both suppress the production of cortisol from the adrenals.
https://www.medicinenet.com/prednisone_vs_hydrocortisone/drug-vs.htm#what_are_prednisone_and_hydrocortisone

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tuckerp | @tuckerp | Jun 30 2:57pm
In reply to @dlb3 "I read somewhere that when you have adrenal insufficiency and low cortisol levels that you might..." + (show)
@dlb3

I read somewhere that when you have adrenal insufficiency and low cortisol levels that you might be able to receive hydrocortisone injections to help boost the cortisol. This is a discussion I will have with my endocrinologist. I have been prednisone free for almost 2 weeks now managing any pain that I have with anti-inflammatory diet, physical therapy exercises and ibuprofen. It feels really good to be off of the prednisone. I am going to have my cortisol level. Tested in about two weeks.

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I think you have a handle on it for what thats worth. You got this. Your body may have a hard time restarting fully. I have read it can take years to fully restart. Even then when you require a little extra boost due to an infection or stress your body may not be able to produce it. The hydrocortisone can give you a lower level of boost to prevent a relapse.

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glinda47 | @glinda47 | Jun 30 3:28pm
In reply to @tuckerp "I dont need to take meds for PMR . Mine is in remission but LDN seems..." + (show)
@tuckerp

I dont need to take meds for PMR . Mine is in remission but LDN seems interesting to me. Some have said it doesnt work and it may not. Its meant more for RA type inflammation. But worth a try.

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I agree, worth a try. It does not scare me except for the possible stomach upset and a little anxiety as I already have that issue lifelong. But, I have to try something, start with a very small does and a clean capsule and go from there.
Have not ruled out CBD.
Thx for sharing and hoping for the best for your taper! Sounds like you've got this.

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1 reply
tuckerp | @tuckerp | Jun 30 8:04pm
In reply to @glinda47 "I agree, worth a try. It does not scare me except for the possible stomach upset..." + (show)
@glinda47

I agree, worth a try. It does not scare me except for the possible stomach upset and a little anxiety as I already have that issue lifelong. But, I have to try something, start with a very small does and a clean capsule and go from there.
Have not ruled out CBD.
Thx for sharing and hoping for the best for your taper! Sounds like you've got this.

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My wife is on a life long journey with steroids. She is fighting GBM. She takes a cbd/thc capsule at bedtime. She sleeps 12 hr a night. I tried one of her capsules and felt anxious. When I did sleep my dreams were just wierd. So it doesnt work for me.

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2 replies
glinda47 | @glinda47 | Jun 30 11:13pm
In reply to @tuckerp "My wife is on a life long journey with steroids. She is fighting GBM. She takes..." + (show)
@tuckerp

My wife is on a life long journey with steroids. She is fighting GBM. She takes a cbd/thc capsule at bedtime. She sleeps 12 hr a night. I tried one of her capsules and felt anxious. When I did sleep my dreams were just wierd. So it doesnt work for me.

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I'm a religious skeptic, but I believe somehow we're being tested.

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jlo2252 | @jlo2252 | Jul 1 8:15am
In reply to @tuckerp "My wife is on a life long journey with steroids. She is fighting GBM. She takes..." + (show)
@tuckerp

My wife is on a life long journey with steroids. She is fighting GBM. She takes a cbd/thc capsule at bedtime. She sleeps 12 hr a night. I tried one of her capsules and felt anxious. When I did sleep my dreams were just wierd. So it doesnt work for me.

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Prayers 🙏🙏🙏🙏for your wife. Wishing you peace and strength in this health journey you are both on.

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