← Return to Down to 1mg prednisone and then extreme fatigue sets in.

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@jedhorovitz

My history is very similar. PMR started about 10 months ago with extreme pain. 40 mg prednisone for two weeks knocked out the pain. Doc reduced dosage to 20 mg and I had mild discomfort. Went to 10 and pains came back. 15 for about 5 months and then (at my urging) went down to 10 for a couple months. Now at 5 per day. "Only" symptom is serious muscle fatigue which doc says is either from PMR or prednisone "withdrawal", or something else we haven't pinpointed yet. (Argh) He has me tapering off completely over two more weeks. This seems really fast compared to most of the posters here. I am aware that every person has a unique experience but mine seems outside the norm. Or the gentle folks on this forum have worse than average cases. Thoughts?

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Replies to "My history is very similar. PMR started about 10 months ago with extreme pain. 40 mg..."

That sounds like a big disaster waiting to happen. You've been on prednisone a long time, so your adrenal glands are probably offline. When I started tapering down from 5 mg, my rheumatologist told me to taper 1 mg per month. I also take weekly Actemra injections, so my PMR and GCA are controlled by the Actemra. My biggest risk with each 1 mg step down is running into adrenal insufficiency. If you go from 5 mg to 0 in one step, you could feel really bad in the best case, and maybe go into adrenal crisis in the worst case. You could also have a bad PMR flare. Most people who are not taking a biologic drug like Actemra or Kevzara taper a half milligram a month in order to avoid a flare or adrenal insufficiency.

Waaaaay outside any norm.
Be careful, and aware of adrenal insufficiency and adrenal crisis. Unless I am missing something, I agree with the “…disaster waiting to happen” reply by someone else.
If possible, you should get a second opinion stat.