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Reducing predisone side effects
Polymyalgia Rheumatica (PMR) | Last Active: 6 hours ago | Replies (39)Comment receiving replies
@kjoed53 I;ve read that adrenals start to wake up at 7.5. How did your appointment go? Mine is this afternoon.
Replies to "@kjoed53 I;ve read that adrenals start to wake up at 7.5. How did your appointment go?..."
The physiological dose of prednisone ranges from 3 to 7 mg daily. It is probably closer to 5 mg which is the amount of prednisone that "adequately replaces" the amount of cortisol the body needs every day. It depends on the day and the amount of stress you experience which is why cortisol is called the "stress hormone."
I think 7 mg is not quite enough Prednisone to handle something stressful so that is when we start to have symptoms of a low cortisol level. I also think it explains why so many of us have a flare when we reach 7 mg of Prednisone when something stressful happens.
An endocrinologist told me I had to remain on a Prednisone dose of 3 mg or less for an extended period of time in order for my adrenals to start to function again.
Some sources say 3 mg of Prednisone is the"physiological" dose, meaning it mimics the amount of cortisol the adrenal make during "low stress" days. The adrenals are capable of producing much more cortisol when stress is high. In any case you need to be less than the physiological dose for the adrenals to begin to wake up.
The adrenals don't wake up very quickly so it takes a long time to taper off Prednisone. When my cortisol level was low, I was told not to taper my Prednisone dose any lower than 3 mg for as long as it took for my cortisol level to improve. Meanwhile, I was told not to increase my Prednisone dose unless I absolutely needed to. It was difficult to stay on 3 mg when someone else said to increase my prednisone dose for "niggles of pain."
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@mp71
Supposedly our adrenals produce the cortisol equivalent of taking between 5 and 7.5mg prednisone. I'll be at 5mg when I see my rheumatologist next. That is the magic number that satisfies both my rheumatologist and my hematologist-oncologist in the tapering process. I'm awaiting blood work results to submit to my insurer for kevzara. Everything should be available by tomorrow and hopefully I will get approved sometime next week. When I reach 5mg prednisone, we'll see how I feel before testing adrenal function. I also got a prescription renewal for 90 days of 3mg LDN to relieve some of the tapering pain. How was your appointment?