That 7 mg dose of Prednisone is a tough dose to get past. I had many problems at that dose of prednisone just as many people seem to have. I think two things are happening at that prednisone dose. It is the beginning of what is considered the physiological dose of prednisone. The physiological dose of prednisone corresponds to the amount of cortisol the body needs to function.

The prednisone we take essentially replaces the cortisol that our adrenals produce. When we take Prednisone in excess of 7 mg daily, the body gets used to having more cortisol than it needs . The adrenals stop producing cortisol. The longer we take prednisone in excess of 7 mg, the longer it takes the adrenals to respond when there is a need for more cortisol. It can take weeks or months for the adrenals to resume the task of cortisol production after we take prednisone for a long time.

Prednisone is called an exogenous source of cortisol. Exogenous sources of cortisol are man-made (synthetic) glucocorticoid medicines like prednisone that we take for PMR..

The cortisol that the adrenals produce is called an endogenous source of cortisol.

Our body doesn't really care where the cortisol comes from as long as it equals the physiological amount of cortisol that the body needs.

At 7 mg the body begins to sense that there isn't enough cortisol. Our bodies are very clever about getting what our bodies need. When it doesn't have enough cortisol our bodies start to complain in the form of prednisone withdrawal symptoms. Our bodies tell us, "more cortisol please" in not very polite ways. It is more like our bodies demand more prednisone since our adrenals aren't producing any. We usually succumb to the prednisone withdrawal symptoms and take more prednisone. That is the first problem that usually happens.

If we don't succumb to prednisone withdrawal symptoms there still is a shortfall of cortisol. One of the functions of cortisol is to regulate inflammation. Assuming the inflammation caused by PMR is still being produced then it builds up and we experience a flare.

Whether our symptoms are from prednisone withdrawal or a flare of PMR is hard to distinguish and it is likely a combination of both happening at the same time. In any case our symptoms are eased when we take more prednisone.

Except taking prednisone in excess of 7 mg won't encourage the adrenals to produce cortisol. Many of us get stuck on 7 mg of prednisone.