Stress will cause you to need more prednisone to create more cortisol - fight or flight. This may be the reason for the up and down days. Unfortunately, this is a trial and error, as I am finding, but cortisol solved A LOT of my symptoms. Please look up my last post by Sean L. Roop. It gives you my symptoms and my journey through hell to get to a somewhat simple answer. Sounds like you are on the right path, but just may need some adjusting. Also check your hormone levels, especially testosterone total and bio-available. I am also taking androgenic testosterone to supplement my 97 ng/dL bio-available test. Both cortisol and testosterone low levels is a problem with your adrenal gland - Adrenal Fatigue (like a touch of Addison's, if that makes sense). Look up Addison's Disease and read about it. I am betting you have at least adrenal fatigue, as almost 67% of the nation post 9/11/2001 have at least some. No wonder we are all so tired. We are all worried about the world in general, whereas we lived in a basic fantasy land up until that marked day. So sad, really. All my best to you on your journey. Sean L. Roop BTW - GET A GOOD ENDOCRINOLOGIST!!!!! A GOOD ONE!!!!!