Polymyositis & Dermatomyositis Support Group
Polymyositis (PM) is a type of chronic inflammation of the muscles (inflammatory myopathy) related to dermatomyositis and inclusion body myositis. The inflammation is predominantly of the endomysium in polymyositis, whereas dermatomyositis is characterized by primarily perimysial inflammation.
Hi all, I am still tapering and now on 4mg Pred (plus 20mg MTX) and have been for a month now. I daren't try tapering again as I have an upset stomach which has lasted 3 days which is unusual for me. Also feel not brilliant and some itching and tiredness "out of the norm" for me - I was wondering anyone have any ideas? Is it the taper? I would have thought after nearly a month I would have felt a bit better?
If you take a bisphosphonate for bones either daily or weekly by pill, then that will really stir up the stomach juices.
Keep in mind that when you lower the Prednisone or any of your medications, if there is active disease then you will begin to know something is not quite right. Itchy skin and tiredness could be liver issues which Prednisone and MTX keep under control. Do have the doctor run some blood work if you feel like something is not right. Your liver enzymes could be rising for a potential flare. The tiredness and brain fog could also be from the low cortisol effecting your adrenal glands (located above the kidneys.)
Anytime you go below 5mg of Prednisone, it is important to have a good endocrine doctor help you taper lower without flare. An endocrine doctor deals with stomach, liver, pancreas, basically the endocrine system. You might be tapering too quickly if you can tell something is not quite right. It is also really important to support the kidneys when below 5mg of Prednisone since there is a risk for renal insufficiency. The renal glands are above the kidneys and they produce the cortisol. Watch your blood pressure frequently and blood sugar frequently. A drop in BP or blood sugar could be an emergency situation when tapering below 5mg Prednisone. I drink Gatoraid which has sodium, sugar and electrolytes to support the kidneys. The tiredness and brain fog could definitely be a lower blood sugar, low sodium and/or lower BP all which can happen from tapering.
Do run some blood work to see how your liver is doing at this point. Talk to the doctor about adrenal glands and what to watch when tapering below 5mg Prednisone. I hope you will be able to totally taper off. Keep us posted. Best Wishes.