Hi Steve. You will find the right combo. You will get there. MTX will take a while up to 3 months to kick in and help and you may have to increase the dose. Don't forget to take folic acid as the MTX steals it from your body. I seem to remember you need to be taking it a couple of days apart from your MTX. Have they got you on anything to protect your bones and joints rom the steriod. Hope all oes well, let us know how you are doing. Best wishes. Autumm

Hi Steve, Autumn is correct about taking folic acid around twelve hours after taking MTX. The folic acid protects the brain from MTX effects. I used to take Leucovorin which is a high dose folic acid around twelve hours after the MTX. Some people will a take a 1mg folic acid each day for the rest of the week after the MTX. Folic acid is in B vitamins too.

Once your blood work shows that it is fine to start tapering, then you should be able to taper without a problem. Issues begin when trying to taper below 20mg on Prednisone. I tapered Prednisone slowly and carefully by a half milligram every fourteen days or longer once I went down to 19mg and below.

Keep in mind that high doses of Prednisone will cause pressure in the eyes. I saw my eye doctor to run a pressure check while on high doses of Prednisone. Infact, anytime I increase the Prednisone, I will see the eye doctor for a fast five minute pressure check. If my pressure were too high, then I would need to take Glaucoma drops. Fortunately, my pressures have always gone down to a safe level where the permanent daily eye drops were not needed.

I also needed to watch my blood sugars while on high doses of Prednisone. The steroids at high doses will cause high blood sugars. I would eat a lot of salads, leafy green veggies, and "boring" low sugar foods while on high doses of Prednisone. I would eat several small meals instead of the regular three large meals a day. Do ask the doctor about the appropriate foods/diet and portion sizes for you while on high doses of Prednisone. Avoid starches like breads, corn, candy, spaghetti, sodas, etc..so that blood sugars will not spike.

I hope you feel better soon. Autumn always mentions that our DM/PM is like a marathon and not a sprint, which is a great analogy. This DM takes time and patience. You will see improvements over time, but be patient with yourself. Keep us posted.

I'm with the others, you will figure out the right combo. Everyone is different so you might need to just try to be patient while you figure out what works for you. Johns Hopkins told me to take 1 mg of Folic Acid daily except the day I take the MTX. So far so good.

" Hi SteveSpringer - Perhaps your MTX needs to be increased? Or your steroid may have to be increased again just while you are flaring then start to taper again when you feel better.The steroid is a love/hate affair - Love it to feel better and hate it when trying to taper as it can give withdrawal symptoms similar to the flare itself. I have experienced this several times as I am now down to 1mg but it has been a very long time and tapering down at 1/2 mg at a time roughly every 4 to 8 weeks. I would suggest having another word with your Doctor or Rheumy - as most people have said, it is a very slow process to feel better and to taper off the steroid. "