@anniz

It is really difficult to know what to do when we get to a prednisone dose of 5 mg or less. That is approximately the dose when our bodies start to realize our cortisol level is too low.

When we exercise, it should cause a normal "healthy spike" in our cortisol level to provide energy for the workout. This cortisol spike is normal and helps to regulate the inflammation from exercise and the increased cortisol level promotes muscle repair.

When our adrenal function is suppressed by Prednisone, our body has no way to generate a cortisol spike. That in turn causes excess inflammation and our muscles don't recover very quickly.

I wish someone had explained this to me when I first started Prednisone. My very first side effect from long term Prednisone was "exercise intolerance." The very first thing I noticed after I tapered off prednisone was how my exercise tolerance improved. After every physical therapy session it took less and less time for me to recover.

When I took prednisone for PMR... it could take days or weeks for me to recover from exercise. I'm convinced that PMR was only part of the problem and being on Prednisone caused most of the problem. When PMR was first diagnosed, I remember taking more prednisone so I could exercise because my body wasn't producing enough cortisol. PMR was at its worse when I was first diagnosed but I could still exercise if I took enough Prednisone.

It is medically understood that prolonged use of prednisone and similar corticosteroids causes adrenal suppression (or adrenal insufficiency). This means the body's adrenal glands stop producing sufficient natural cortisol because the medication is providing a synthetic version.

Prednisone replaces the naturally occurring hormone cortisol. The seriousness of this should not be underestimated. I was NOT addicted to Prednisone but my body depended on me taking Prednisone after my adrenal function was turned off.

I was never sure how to overcome this problem until an endocrinologist explained it to me and helped me to successfully taper off Prednisone. It was also very helpful when my rheumatologist switched me to a biologic medication that didn't suppress my adrenal function.