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PMR Dosages and Managing Symptoms

Polymyalgia Rheumatica (PMR) | Last Active: Jun 1 1:21pm | Replies (445)

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@kmeikle1

7 mgs. is tough because you're low enough that your adrenals need to kick in but they were sleeping while the prednisone did their job. Hardly a medical explanation, but getting below 7 is a challenge for many. And sometimes it's necessary to stick it out because it's not that the PMR is worse, it's that the adrenals aren't doing their job. And you need to give them time to wake up. Once you stabilize, you could try heading down again very slowly. Half mg. at a time.
Trouble tapering for me involved the return of some symptoms only not as severe as when I was first diagnosed.

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Replies to "7 mgs. is tough because you're low enough that your adrenals need to kick in but..."

Hi, I am specially interested to read the very wide range of experiences of people tapering their Pred. dosage. I was given a pattern of monthly reductions by Rheumatologist, while my friend who developed PMR at almost the same time as I did, was given a very different pattern by her GP (neither based on test results) Three months in, a subordinate member of my hospital's Rheumatology team advised slowing my tapering down. Instead of 15, 12.5, 10, 9, 8,7 etc monthly, he recommended monthly reduction : 10, 10 and 9 on alternate days, 9, then 9 /8 alternate days and so on. This was based on no test results, no recurrence of pain, simply a preference on his part. Having already developed the full range of unsightly side effects, I was disappointed to have to prolong the process. I have had no in depth explanation of theories relating to this with Rheumatologist. I am interested in what I understand in your message to suggest that the adrenal system should be expected to start kicking back in around 7mg. Can anyone confirm this, either as medical knowledge or anecdotally. Thanks in advance for all your advice.

I’m just seeing this discussion on tapering. I’ve been on the same route since 2020 when diagnosed. I agree w the slow taper, and sometimes we just can’t force it. I’ve had at least three flares, two of which were after receiving my vaccines for Covid. I just had to ramp up again but came down quickly ( as directed by MD). I’m also more closely monitoring my exercise/ foods/ stress and trying to manage these variables Exercise daily but not excessively. Taking higher dose of good quality omega 3 too. Noticing my normally inflamed hand joints are noticeably normal. Maybe helping GCA/ PMR ?? So with that said, it’s all an individual experience. My doc just told me again about “ self limiting” disorder. started 4.5 and fingers crossed. Hoping this is the last round but more prepared for setbacks mentally. Take care everyone!