Reducing predisone side effects

@pmrsuzie Why, once you are down to 2mg heading for 1mg, would you become concerned with tapering taking longer? If it is working, don't fix it! - would be my motto at that low a dose.
I know you have a personal goal but your body does not have the same goal. Everyone's goal is to have a successful taper not being at a certain dosage for a doctor's appointment. Slow and steady wins the race when it comes to treating PMR.
That said, alternating dosage for a week or more worked very well for me, especially at low dosages. Unfortunately, my inflammatory markers aways returned even with a slow and paced taper.

@pmrsuzie
I started the alternating plan in June tho I did 2.5 then 2 every other day then I’d do 2.5 for a day then 2 for 2 days then 2.5 then 2 for 2 days then went to 2 all week this past week. I’ve been feeling sluggish this past week and feeling kinda low these last few days. Curious. Wonder if it’s the lowering to 2mgs?
I’m going full 2 mg this week for the next few weeks see how it goes. I also see my rheumatologist in August. I know he wants me off prednisone!
(I am on methotrexate so that could be causing my fatigue? )

Here goes, eh?

@jabrown0407
"Why, once you are down to 2mg heading for 1mg, would you become concerned with tapering taking longer?"
Isn't going from 2 to 1mg a 50% drop? The tapering process invokes aches, pains and possibly stirs up my Meniere's. And I certainly don't want to be in bed throwing up - which is what Meniere's can do to me. These are the problems I had getting from 3 to 2mg. I was at 3mg for months, took several weeks to get to 2mg. Been at 2 mg for a few weeks. Maybe I should stay at 2 mg longer. My PCP said to stay at 2mg til I see him in August. Maybe that's what I should do. Hot, humid weather is here now and that in itself will be unpleasant. I'm talking myself into staying at 2mg. Like everyone here, I just would like to be eliminating
prednisone from my diet.

Yes it it, but from what you said I inferred you successfully tapered from 3 to 2 which is a 33.3% drop.
Alternating is gentler and since you mentioned the difficulties you have had then alternating makes sense.

You might try extended tapering
Hd =high dose, Ld=low dose

Hd, Ld; Hd, Ld until you feel safe
Hd, Ld, Ld, Hd; Ld, Ld until you feel safe
Hd, Ld, Ld, Ld; Hd, Ld, Ld, Ld until you feel safe
Then straight low dose.

Again you might want to let your doctor know and/or discuss with him before doing it.

What you really want is to successfully eliminate prednisone. I have had to restart it every time I get off. One of the things you don't know about until it's you.

I wish you success on your journey.

@pmrsuzie
I don't know if it helps, but I had your same concerns. Our Mentor here gave a little bit of advice from his Doctor, so on the last 2 mg down, I did a so-called sound-check on my body. What hurts, how bad is it, is it lasting more than a few days. I would get nervous as well. For me, the consensus that I read into was a very, very slow taper at the last two mgs. I did quarter mgs steps and would pay attention to the pain levels as I got down to 0. I don't know if that helps, but it worked for me. I completely get your concerns. So far, so good, thankfully.

I am reducing ever so slowly and after one month of 5 mg started to take 4,5 mg a couple of days ago. Today I have been really not great. Headache, extremely fatigued and a slight increase in physical discomfort. This seems to happen for a week or two until my body adapts to the new dosage. I have watched this over the past months every time I reduce a little more. Started with 30 mg in August 2025. Maybe try to only go 0.5 mg at a time

Once we have tapered down to 5mg prednisone and below, aren't we at the mercy of our adrenals because they need to start waking up and producing cortisol again? I'm not there yet. I just decreased from 9mg to 8mg this morning. Isn't there a morning cortisol test to verify that our adrenals are back to working, or else how do we know they are? I have a rheumatologist (PMR) appointment in two days and I'll be discussing this among the many questions I have.

@dvorahberlin
I started at 15 mg in December, 2025 and this week am at 4.5 mg. I am noticing some discomfort at this stage and may stay at this dosage for a while. I had been tapering 1 mg per month before mostly and reduced to tapering 1 mg every 2 weeks. I hate the weight gain (15 lbs) .

I'm just now at 10mg...I've been cutting my 4th 2.5mg pill in half and tapering in tiny increments for a week before the actual taper,in an effort to 'sneak up on it', and maybe my body wont notice? I just want off, and to feel like myself. I hate the weird feeling, the depression,and yes, weight gain! ugh

@pmrsuzie I would follow your PCP’s advice. One problem I’ve had, is second-guessing the dosage. Heat and humidity makes me feel so much worse. I told my rheumatologist a month ago that I wanted to taper-off my prednisone completely. I’ve gone from 5 mg. in a month to 0. Hip pain came back, better today. Knuckles are hurting some. A lot of stffness going walking, and going up and down stairs. I think muscle atrophy is a lot of my problem, so trying to keep-up my protein intake, and walking 1 mile a day. All that being said, if 2mg. makes you feel better right now, follow PCP’s advice. Try doing things you enjoy this summer. That will make you feel better mentally, too. Don’t get discouraged. Prayers!