I understand what it's like to try to make these decisions. After 18 months on prednisone I was down to 8 mg with good symptom control and no serious side effects. My rheumatologist said that I could not stay on a dose that high and he recommended adding methotrexate which I finally agreed to do. I had read about all the possible side effects plus no alcohol. I told him I had one beer a day and he said I could continue that but I cut back to 3 a week. At first it was brutal. I had every possible side effect but it mellowed out some and my labs are looking good: no liver issues with the methotrexate. I'm about to drop to 5 mg prednisone. So far pain is under control and fatigue is the main issue. I see the doctor soon and I see more decisions in my future. If I can't go to zero on the prednisone am I willing to put up with a 2 drug regime indefinitely? Am I willing to get off the prednisone, which is so effective at controlling sx's, and put up with just methotrexate for 2 years, which is what the doctor wants me to do? If I'm on methotrexate that long I would give up alcohol, which I don't really want to do. Or do I talk him into letting me try just a low dose of prednisone indefinitely? I'm now at 2 years on the prednisone. There isn't much to improve about my diet and exercise habits and I don't have other health issues. Tough things to figure out.