Hello @rnm
I am 76 and was diagnosed with pmr in Dec of 2018 if I remember correctly. I started on 20 mg prednisone. I had already been having dexascans every two years because of having had a broken bone in my foot. I already knew I had osteopenia. I was already taking Vitamin D, 2000 IU daily, and am still taking that dose. I opted to not take calcium supplements because my dad had a few bouts with kidney stones so I try to get enough calcium with my diet. The first scan after being diagnosed with pmr was a little worse than the previous scan. The endocrinologist I was seeing suggested Reclast as a bone medicine. After reading about all the possible bone medicine choices, I decided on the Reclast mainly because it's a once a year infusion - no pills to worry about. I have had two doses. My scan did improve. Last year I had a nasty fall, no broken bones, and decided to wait til the 2026 scan before making a decision about another dose of the Reclast. I did not seem to have any side effects. All those bone meds can have side effects.
As far as my prednisone dose, I have never gone above the 20 mg. My nemesis has been tapering below 7 mg. Right now I am at 2.5 mg. I have had flares while tapering but have never felt as bad as when the pmr started.