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← Return to Trouble going below 3mg
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Polymyalgia Rheumatica (PMR) | Last Active: Jun 10 3:21pm | Replies (27)
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I've done a similar tapering schedule since 7mg, at a reduction rate of .5mg every 3.5 - 4wks for a drop of 1mg every 7-8 weeks, same as that schedule. You've done well to get to 3mg. I'm currently doing a week on 3.5mg before starting the incremental taper to 3mg in a few days.
My new rheumatologist said to stick to the same schedule since it was working. Interesting you say you had a little trouble at 2mg. My next rheumatology appointment is September when I should be at 2mg. He said if I was going to have problems, it might be around then. Let's both hope for the best. So far, so good.
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It seems that 3 mg or less is the magic dose to allow for adrenal recovery. My endocrinolgist wouldn't even discuss adrenal insufficiency with me until I could maintain a 3 mg dose of Prednisone AND until I didn't need Prednisone anymore to control PMR.
At the 3 mg dose, I was told not to even think about tapering any lower. I was ordered to stay on 3 mg until my adrenals recovered. I didn't always stay on 3 mg and I pushed the limit but I said that I stayed on 3 mg. Without the biologic, I wouldn't have been able to get anywhere near 3 mg.
In any case, my cortisol level did improve. I'm still amazed that my endocrinologist said 3 mg was such a small dose that I didn't need to taper after my cortisol level was adequate. The biologic I was taking controlled PMR so I wasn't too worried about a "flare." The thought of an adrenal crisis scared me more so I did a fast taper from 3 mg to zero.
It is good you are working with your doctor.