Always when i get up at 2am for my pred, I am feeling the best I have, and best I will feel, since this all started
I feel normal from head to toe.
So instead of trying to overthink it, I am just going to be thankful,and use it as my goal, and reason to reduce slowly, when the urge to hurry reduction comes about . I know the pred will make me feel awful soon, and I had to raise it due to symotom return, but I know now from all the counsel here, it was just too fast..
Enjoying this time. Thanks for giving me a place to share that at 2:59 am.
Well done Gina. Think positively and reduce very slowly (very very slowly) and hopefully you will achieve it with very little discomfort. All the very best Dave (tavidu)
Thank you for sharing this, Gina .I too, started my prednison treatment by taking it a 2 am before going to bed and thinking back, it's the only time I was feeling "the best I will feel".Then I broke my pelvis, then I stayed for two months in my daughter's house (that's in a time zone 9 hours earlier than mine) and got out of the habit.
Now, upon reading your post, I have realized that taking it when I first wake up in the morning, approximately around 9:30 is contributing to all the symptoms I've been having lately. I have been unsuccessful at tapering ...the pain, the stress from multiple,extraordinary family crisis, jet lag, depression, etc..made me yo-yo the Prednisone dosis..Now Im in a mess.I got lazy and started taking the pred with just water..For a time I took them at different times, even..
Your post has reminded me of how well I felt when I dosed at 2am..Thank you!
Hi Gina. Thanks for sharing your post! I'm just curious though, why 2AM? It appears there are others who also take their Prednisone in the wee hours, too. What have I been missing?
I have been on Prednisone for over a year and just take it after breakfast because I thought it's best to take it after eating. No?
I actually learned it from this site, and its addressed expertly on other posts
My rudimentary understanding, is the chemicals released in your body
around 4 am are the ones that cause inflammation, so you are hitting that time with the steroids. I ( also learned here ) leave a snack by my bed, usually yogurt.
Also for me , what is does is I can sleep thru some if the early side effects I get from the pred, and have a more productive day.
I set an alarm, but thats just me , I am guessing there is a bigger window,
and hope someone else responds to give you a much better clarification.
You are so right I do know pred is one of the best worst drugs around!
I caught and got on pred very early in, never had the debilitating situations so many of you did. So when the symptoms of pmr / gca gone, and you feel bad in so many other ways, everyday on it, at the higher doses ,it does take some fortitude to keep popping it in my mouth.
Conversely, when I dropped to fast, and yikes that shoulder neck pain reappeared, I was glad to have it .
Guessing pred and I will have a love / hate relationship,until the pmr decides to pack its bag
The inflammatory substances (cytokines) that trigger the inflammation that causes the swelling and pain/stiffness are shed in the body at about 4.30am. A study showed that the optimum time for RA patients to take prednisone to avoid/minimise morning stiffness was 2am - the peak level of steroid in the blood was reached shortly before the cytokines appeared and they never got to cause inflammation - result, far less stiffness and the patients were mobile far sooner in the day. One form of prednisone has been developed where it has a coating which breaks open after 4 hours to deposit the entire dose at once in the stomach. You take it at 10pm, it releases at 2am, the steroid level in the blood is high at the right time - and you didn't have to wake up to do it! There are people in the USA using this form but it is not available in the UK except privately as it is expensive.
The later after 4am you take your steroids the more inflammation has been created and the more work the pred has to do. Many people notice that if they wake and get up during the night before 4am they are able to move quite freely - it is a very different matter afterwards. So some people wake early, take their steroids and settle down for another couple of hours in bed. By the time they get up the pred is starting to have an effect and they are able to get going for the day.
Doctors often say to take pred with your breakfast, about 8.30am. This is based on another study that showed there was more adrenal suppression when the patients took 5mg before bed than if they took 15mg at 8-9am so the thought was that the return of adrenal function when the patient stopped taking pred would be better. That works well for patients on short courses of pred, up to 6 weeks or so. But we take pred for months, often years, and there will be adrenal suppression whatever time you take the steroid tablets.
For some people the antiinflammatory effect of the steroids doesn't last the entire 24 hours and some of them split their dose, taking some in the morning and some later in the day. Others take their pred at night and some later in the day. What it comes down to is that everybody is different and if you aren't entirely happy with the time you are taking the tablets - it may be worth experiementing a bit to find what works best for you. And once you identify THAT you often are able to manage with a slightly lower dose overall. Which is all to the good.
I have learnt an awful lot since PMR appeared on the scene - foggy brain or not!!!! Mind you - the number of times I've written some of it I jolly well should know it by now
I meant to say - you mentioned the window, I suspect you can take prednisolone later than you take prednisone. Prednisone has to go through the liver to be turned into prednisolone which is the active form.
I've felt quite well all the time I've been on pred, except for a few side effects like skippy heart and muscle weakness. The other side effects were mostly hidden, although potentially serious. But I have felt since about the first month that prednisone was stealing my basic good health. I think what it amounts to is that I've aged tremendously over the past nearly two years, far faster than I would have had PMR and pred not entered my life. But I suppose it was bound to happen eventually. I would have preferred to have entered my decline a decade from now, but there really is no "right time" to get old.
After 4 months I finally found out I had PMR and was put on 20 mg predisone - told to take it 1st thing in the morning. This was great for the most part except it seemed to wear off in the early morning and I'd be hurting until a couple hours after taking the next batch of prednisone. Back in February I talked the doctor into splitting the dose and that has worked so far, dropping 2.5 mg once a month. The only side effect I'd rather not have is that it really messes up my sleep, averaging 1-3 hours a night. At age 62 and still working full time it'd be nice to get more sleep. However, I'll gladly accept it instead of being an invalid like I was before prednisone! Currently I take 10 mg in the morning and 5 mg in the evening. In May it'll drop to 7.5 in the morning and stay at 5 in the evening. This will be my 2nd try to get down to 12.5 - first time flared nicely and had to go all the way back to 20 mg to get relief. Just found this forum a day or 2 ago - very interesting things to read!
Have you tried taking the extra 5mg earlier in the day? For some people it seems to then carry them over to next morning with less effect on sleep patterns - which I know can be a real problem for some.
Yes, here in the U.S. we have the coated prednisone called Rayos (available in 1 mg form too). For me with my insurance, it is just about $10.00 a month - very inexpensive. I take it as Eileen suggested and it works great that way. Now I'm at 3 mg Rayos in evening taken at 10pm and 3.5 regular pred taken in the morning when I wake up. With this combined total of 6.5 I am beginning to feel better as, I hope, my adrenals begin to slowly awake. I'm slowly working down to 6 mg.
Eileen, no I haven't tried taking the 5 mg earlier but maybe I should. Up to now I've been reluctant to adjust from the schedule set by my rheumy specialist but maybe I should be experimenting a bit. If a 2 pm dose would carry me until morning and help with sleep, well that's sure not going to hurt my feelings. Thanks, I'll give it a shot once the pmr settles down from this weekend's mess that I mentioned on gina's "Boost" discussion.
I will check into Rayos. Waking up by alarm at two is getting disruptive as now not going back to sleep.
Going to try to split as well as early last evening felt horrid, no energy or strength and nauseous After much reluctance took 2.5 . after hour or so felt a little revived.