PMR flare at a drop from 8 to 7 mg of prednisone?

Posted by barracudacool @barracudacool, Nov 26, 2023

Going below 10mg of prednisone has been difficult. The drop from 8 to 7mg of prednisone triggered a major flare of pmr in my hips and right leg. I know that this 8 to 7 drop is a big one for some people. Can’t walk. Went back up to 8mg but flare just keeps getting worse. Tried 15mg. Nothing. This morning I took 20mg to try to eat back the pain and inflammation. So frustrating. I have been doing so well with my drops. And am also on methotrexate. But now yikes. Anybody have any suggestions.

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I'm kind of in the same boat. Ten months into this PMR now. Was down to 5mg in Sept. and had a flare up triggered by rapid change to cold weather. I went up to 8mg and my hips and shoulders wouldn't respond. called my doc and he said to go up to 15mg for ten days which did work. Then down to 10mg where I've been for a couple of months now. I'm concerned about any drop in prednisone right now because we're headed into winter months and on the 10mg I get what I call mini flares after mild to moderate physical exertion that calm down and don't progress to a full blown flare up. It's like walking a tightrope. And also like a security blanket staying on the 10mg. I'm not sure, but I think from here I might be weaned by .5mg/month instead of 1mg/month? I don't know. Have to set up another telehealth appointment soon with doc. I do think for the most part weaning should be done gradually. I may have been weaned too quickly. But then how do we quantify the flare ups that just don't make any sense. I know we're all different and some of us have co existing medical problems. Sorry I don't have any suggestions. I feel safer staying on 10mg for now thru winter.( then continue the weaning?) When I was first dx. in Feb. had to stay on 20mg for 2 months. Wish you the best and hope your body begins to compensate soon.

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@lungranger77

I'm kind of in the same boat. Ten months into this PMR now. Was down to 5mg in Sept. and had a flare up triggered by rapid change to cold weather. I went up to 8mg and my hips and shoulders wouldn't respond. called my doc and he said to go up to 15mg for ten days which did work. Then down to 10mg where I've been for a couple of months now. I'm concerned about any drop in prednisone right now because we're headed into winter months and on the 10mg I get what I call mini flares after mild to moderate physical exertion that calm down and don't progress to a full blown flare up. It's like walking a tightrope. And also like a security blanket staying on the 10mg. I'm not sure, but I think from here I might be weaned by .5mg/month instead of 1mg/month? I don't know. Have to set up another telehealth appointment soon with doc. I do think for the most part weaning should be done gradually. I may have been weaned too quickly. But then how do we quantify the flare ups that just don't make any sense. I know we're all different and some of us have co existing medical problems. Sorry I don't have any suggestions. I feel safer staying on 10mg for now thru winter.( then continue the weaning?) When I was first dx. in Feb. had to stay on 20mg for 2 months. Wish you the best and hope your body begins to compensate soon.

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Thank you. It helps to know others have issues with these lower level drops. So frustrating when you are doing well and then BAM! I know the flare was triggered by more than just the drop from 8 to 7mg of prednisone. Lots of stress lately. Im going to give 20mg a few days to settle this down. See my doctor on Tuesday.

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@barracudacool, @lungranger77 and others struggling with tapering, you might want to give this tapering plan on HealthUnlocked.com a try.

--- Dead slow and nearly stop reduction plan (Tapering)
https://healthunlocked.com/pmrgcauk/posts/131189593/dead-slow-and-nearly-stop-reduction-plan

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Thank you. I had planned to start doing that but waited 1mg drop too long. Lol. Once I get back to 10 this is what I’m going to do. Thank you for reposting. Good news last week with my other blood work. So far everything looks good despite being on prednisone for about a year.

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@johnbishop

@barracudacool, @lungranger77 and others struggling with tapering, you might want to give this tapering plan on HealthUnlocked.com a try.

--- Dead slow and nearly stop reduction plan (Tapering)
https://healthunlocked.com/pmrgcauk/posts/131189593/dead-slow-and-nearly-stop-reduction-plan

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Thanks John. I read the intro page on that site. I have wondered about the withrawal mimicking a flare. Thought I was was overthinking things (which I can do very easily). But lately emotional stress is not hampering me as much as when I started on this journey. I have to thank my therapist for that help. So far what I read makes sense. At the same time the frustration of this disease challenges my ability to stay objective. I'm sure I'll learn some more on that site. Thanks for all the feedback and resourses you provide. I'm going to focus on what I can be grateful for today.

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@johnbishop

@barracudacool, @lungranger77 and others struggling with tapering, you might want to give this tapering plan on HealthUnlocked.com a try.

--- Dead slow and nearly stop reduction plan (Tapering)
https://healthunlocked.com/pmrgcauk/posts/131189593/dead-slow-and-nearly-stop-reduction-plan

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People on HealthUnlocked.com have flares doing this taper as well. If it works for some people ... great. However, there is no evidence that this method works any better than any other tapering method. There is no tapering method that works statistically better than any other tapering method.

Last I knew ... the person who takes credit for this tapering method has taken prednisone for PMR for nearly 15 years and apparently is unable to taper off using her own method.

That 7 mg dose of prednisone is a tricky dose. It trips up an amazing number of people.

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Hey well I disagree with that. Quite a few people have reported success with this. My doctor actually just recommended this approach to the taper. For me it’s worth it to try. Doing other tapers have not worked for me.

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@lungranger77

Thanks John. I read the intro page on that site. I have wondered about the withrawal mimicking a flare. Thought I was was overthinking things (which I can do very easily). But lately emotional stress is not hampering me as much as when I started on this journey. I have to thank my therapist for that help. So far what I read makes sense. At the same time the frustration of this disease challenges my ability to stay objective. I'm sure I'll learn some more on that site. Thanks for all the feedback and resourses you provide. I'm going to focus on what I can be grateful for today.

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My doc says it’s both at these levels. Withdrawal and flare. I’m reading upon cortisol and renal issues

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@barracudacool

Hey well I disagree with that. Quite a few people have reported success with this. My doctor actually just recommended this approach to the taper. For me it’s worth it to try. Doing other tapers have not worked for me.

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I always encourage people to try anything and see what works and doesn't work for them. Good luck with whatever you try.

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Pmr is so difficult. So different for each one of us. I have no pain in my shoulders or arms. All in my hips, legs and lower back. Feels like my legs are encased in concrete. So thank goodness I have you folks. Makes the journey a lot easier.

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