1. < Polymyalgia Rheumatica (PMR)

The lowest effective dose, how is it defined?

Posted by megz @megz, Aug 6, 2023

Since starting on 15mg of prednisolone for PMR on 10th May (12wks ago), my sole focus has been to "reduce to the lowest effective dose in the shortest possible time" as per the drug company's directive to minimise side effects and reduce the overall cumulative dosage.

I'm now at 8mg and the pain has returned after practically no pain, It's at tolerable levels but disappointing after having been pain free. I assume I've reached the lowest effective dose, or maybe overshot it by 1mg by reducing so quickly. So what is an "effective" dose?

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megz | @megz | Dec 30, 2024
In reply to @dadcue ""The medical mob now says the physiological dose is around 5mg (4-6) rather than the previous..." + (show)
@dadcue

"The medical mob now says the physiological dose is around 5mg (4-6) rather than the previous estimation of 7-8, but cortisol levels for individuals vary."

Whatever the physiological dose is, my endocrinologist said I needed to be on "significantly less" to coax my adrenals to respond to a cortisol shortage. I also had to maintain that dose for an "extended period of time." There was no other way.

It wasn't a pleasant year but I didn't have a PMR flare.

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Yes, I understand you had issues with low adrenal function after taking various doses of prednisone for 12 years or so, so what you've done was right for you. There are lots of variables in the lives of individuals. At this stage I have no evidence of adrenal insufficiency, so will keep to the same plan for now.

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