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DiscussionWeaning off of prednisone & pain management
Polymyalgia Rheumatica (PMR) | Last Active: Oct 25 10:23am | Replies (156)Comment receiving replies
Replies to "I couldn't tell for sure. I had to go with what my endocrinologist said -- my..."
Addendum: The following excerpt are the words of a true expert on the subject. She told me the following:
"With more than 10 years of prednisone dosing under your belt, I would surmise that the possibility of prednisone tapering would be fraught with disappointment and failure. 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 fact that you have been on prednisone for more than 10 years would be a negative prognosticator for a successful Pituitary reboot.
What does this mean?
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."
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How is it the pituitary gland is affected? You need to remember that Prednisone disrupts the entire HPA axis. The Hypothalamus-Pituitary-Adrenal axis.