What Time in the Morning do you Take your Pred?

Posted by p0rtia @p0rtia, 4 days ago

Here's the thing: I sleep fine on pred, lucky me. I take it around 7 AM, currently 11.25 mg. At this dose I have mild to moderate PMR shoulder stiffness/pain, and less often hip stiffness, upon rising around 7, which goes away as the afternoon wears on, so that by 4 PM I often have zero stiffness/pain. In the evening I get achy for other, mostly non-PMR reasons. Go to bed around 10.

So I often start to wake up around 4 (adjust cpap, pee) then go back to sleep. But more often that not lately, when I'm half awake, I realize I have no pain, no stiffness, no nothing. I wave my arms around and have full, easy range of motion. Which is weird, since by that time the pred has almost completely worn off, and even if my adrenal glands were producing cortisol, this is the cortisol down time. This has happened half a dozen or more times that I'm aware of in the past month. In fact I've occasionally awakened at 1 or 2 AM and realized I have the same lovely pain-free movement.

Has anyone else experienced this?

I think, wow, this great, and go back to sleep, dozing till 6 AM or so. By which time my shoulders are most often mildly to moderately stiff/sore (at this dose). Repeat.

I can actually feel the return of the mild stiffness, minute by minute, between 4 and 5ish AM.

I've read a few posts here that reference people taking their pred at 3 or 4 AM, but I haven't found a thread on the topic (apologies if I've missed it and am duplicating).

Anyway, I'm going to try it. I'll be curious to see if it makes a difference, or just shifts the times I mention above by a couple of hours. I should probably aim for 3 AM, to give the pred some time to work its magic; not sure I'll be able to convince myself to do that when push comes to shove. But we'll see.

But. my real question is, why is this happening? My previous experience with other musculoskeletal issues (when I haven't been on pred) has been that nights can be the worst. Maybe the MSM I'm now taking? But I take that in the morning too (it has a half life of 12 hrs). Or the protein I'm now obsessed with increasing?

I get it (thank you Mayo Connect!) that IL-6 and other proinflammatory cytokines are likely being released during that early morning period, when the pred is at it's lowest effectiveness, so I get why the stiffness returns then. But why do I feel at my best between 1 AM and 4 AM? Though as I write all this, I'm thinking, well, it's because the pred has done its work for the day, and the IL-6 is at low ebb, and you're having a "normal" refreshing sleep. Which hasn't been my experience in quite some time.

Thoughts?

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

Thank you. The Yogurt with walnuts and blueberries sounds like a great way to take the prednisone. I too have to wait awhile before having any coffee.

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Profile picture for boomermeg @boomermeg

@wendypics
I take mine (Only since 7/31/26), by 7:30-8am. I think I'm going to try earlier like 6:30am. I did today because I find it still affects the depth of my sleep in early AM hours.
I drink a big glass of water 1st thing every morning.
Then a small glass of A2/A2 Organic grass fed low fat Keifer, then a Greek yogurt with walnuts and blueberries. Then I take my Prednisone with another big glass of water. I searched re stomach issues/Prednisone/coffee and it suggests to wait 1 hour after Prednisone before drinking coffee due to the acid in coffee. I wait at least 1/2hr. So far I haven't had any stomach issues. I have GERD (but don't take Proton pump inhibitors and haven't for years due to side effects/possible osteoporosis), only use Tums if needed but I try to avoid foods that cause reflux. I don't suggest anyone do what I do regarding GERD, just reporting. It's my thought that dairy is a good way to help protect the stomach, but probably any good solid food will help. I've used milk in the past too, but when first took Prednisone noticed some pain so went to my Keifer/yogurt and plenty of water.
Hope you find what will help you avoid stomach issues from the Prednisone.

(I'm highly lactose intolerant but the A2/A2 keifer doesn't have the A1 casein beta protein that's problematic, and for some reason I can eat Trader Joe's low fat plain Greek yogurt with no problems).

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@boomermeg I should have added that at 15 mg and 12.5 mg it doesn't make any difference when I take the pred in the morning. I'm currently trying to establish my Lowest Effective Dose, or as I know think of it, my Lowest Effect Zone.

The drop to 11.25 brought a return of mild upper arm and hip symptoms. Which went away when I started the 4 AM regime.

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