Fatigue and brain fog continues 7 days to end of taper

It sounds like you are having adrenal problems. When you take prednisone for more than 3 or 4 weeks, your adrenal glands stop make cortisol. Cortisol controls how much energy have. To your body, prednisone looks like cortisol, so when you take prednisone your body thinks you have plenty of cortisol, so it doesn't make any more. As you taper prednisone down to around 5 mg of prednisone a day, your adrenal glands need to wake up and start making some cortisol again. But it can take quite a bit of time for the adrenal glands to get fully active again. Depending on how long you've been taking prednisone and the dose level, it can take several months.

Tapering from 40 mg of prednisone a day down to 0.5 in 5 months is very fast. Most people take at least a year, and some people take a lot longer. PMR usually lasts a year or 2, and you need either prednisone or some other drug to control the PMR while it is active.

I would recommend you talk to your doctor about increasing your prednisone dose and then tapering slower to allow your adrenal glands time to wake up. You might need to go back to somewhere between 3 and 5 mg a day, and then taper slowly to see how your body handles ease dose. From 5 mg down to 0, I tapered 1 mg every 4 weeks.

@jeff97 I started prednisone 1/23/26. A month ago took ACTH which came back my adrenal glands was producing cortisol, CPR normal, sed still high. The fast taper was because impact to mental health. Between pmr and prednisone i don't know my body anymore. Thank you for info.

It is a very fast taper and at high doses of Prednisone, mental health issues can cause problems. A terrible dilemma. It's quite possible that the brain fog is from PMR inflammation that has not been properly controlled, and fatigue is almost certainly from the illness still being active or at least your body still being in recovery mode. CRP being normal could well because the Prednisone dose prior to the blood test was enough to control the PMR.

Are doctors suggesting that your PMR is in remission and that medication is no longer required. Have they suggested anything to replace prednisolone eg a DMARD or biologic medication? Even NSAIDs can help a little if PMR is at low impact levels, but the shouldn't be taken with prednisolone other then very short term and very I frequently.

Have your adrenals fully woken up? Talk to your doctor. Maybe you need a morning cortisol test.

The prednisone wreaks havoc on our bodies; I read that it could take a year to get back to normal,after the taper ends. AI says that taking ashwaganda or rhodiola can help with your symptoms,but only take these at the end of your taper,and talk to your doctor first. I'd make sure I'm eating as healthy as I can too. Try some turmeric/curcumin to get the inflammation down.

Consider coffee, too?

@mp71 For what it's worth, I felt fully recovered 6 months after stopping prednisone. I started at 60 mg a day for GCA, and took prednisone for 13 and a half months. I felt mostly recovered within a month of stopping, but it took 5 more months to regain full strength.