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How are you tapering prednisone?
Polymyalgia Rheumatica (PMR) | Last Active: Jan 5 12:01pm | Replies (31)Comment receiving replies
Remember that if you’ve been on prednisone a very long time, even when you’ve been off it for a while you still may require “stress dose steroids “ during high stress events ( illness, accidents, etc). So be cognizant of this and if you’re ill or break a leg, etc, watch for signs of adrenal insufficiency and contact your doctor if they appear.
Replies to "Remember that if you’ve been on prednisone a very long time, even when you’ve been off..."
@laura1970 I was doing so well tapering. Just prior to getting PMR I had terrible pain from a torn meniscus. It was treated with a cortisone shot. Soon after I developed PMR and started at 20mg/day. Very soon after taking my new steroids, my knee pain disappeared. I did very well tapering to 2mg/day. I am using methylprednisolone instead of prednisone and the pill only comes in 4 mg. I can slice it down to 1 mg. So to go down from 2mg to 1.5 mg I alternated days of 2mg, 1mg, 2mg,1mg, etc. I did OK for about 10 days when my knee pain came soaring back and PMR symptoms were starting in my neck and upper arms. I believe like you, my knee was causing adrenal insufficiency. I called my Rheumatologist and she agreed that I should stay on 2 mg daily for now. My PMR symptoms have disappeared. On Jan. 2, I will see an orthopedic Dr for my knee.
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@laura1970
After a long time on Prednisone it was difficult for me to know if I still needed prednisone for PMR or because I had adrenal insufficiency since both conditions cause muscle and joint pain. Corticosteroids are the treatment for both conditions.
To a certain extent, after prednisone suppressed my adrenal function, it caused me to be "dependent" on prednisone to regulate my inflammation levels. My adrenals weren't producing enough cortisol to regulate inflammation for me.
According to my rheumatologist, both PMR and adrenal insufficiency have similar symptoms like muscle pain and fatigue making a precise diagnosis challenging after prolonged prednisone use. It was easier to differentiate my symptoms when Actemra controlled PMR without suppressing my adrenal function. After my adrenals recovered it was much easier to taper off Prednisone. It was still a slow taper but not for years.