Please note "?" in the subject. I am not suggesting here anything, I just want to share what I have found and get your feedback.
EileenH started me thinking about this? Reading around the forum, it seems that it is the most common to take it in the morning. Due to extended day, I split my dose into two parts, one in early morning ( for me 8am) and one after dinner. But after hearing from EileenH that the actual peak in cytokines release is about 4am, made me question early morning dose. You see, pred takes about 2 hours to peak and it is only in the system 3-4 times longer before it is flushed out. If we can optimally time our medication to the peak of cytokines release, then the dose ( theoretically) could be less then "wasted" miss-timed dose.
I found exploratory study that tried to answer those questions.. What is interesting is that the cytokines release ( fig 1) has two peaks; The highest one is at 4am, but there is a second peak at 9am. This correlates pretty well with majority of recommendations suggesting taking preds early in the mornings. I wonder if there is a better way to optimize timing ? ..
I will tell you my thouths on this... I would like to split the dose and time it for both peaks. How can that be done? Simple, take one dose before 2am that would be peaking at 4am and do another dose early in the morning, before 9am. Note: I am already taking my preds in 2 parts... Main dose (now 7.5mg) is at 8am and I was taking second dose in the evening... I decided to experiment to delay second dose later and later.. Last night I took it just before 2am.... I call it "pred sandwich " [cool] .... Two cytokines peaks are placed between two doses of pred.
I would post the link to the web site where I found the study from Bristol, UK, but last time I posted a link, my message never got approved. Please google for title "Circadian variation in plasma IL-6 and the role of modified-release prednisone in polymyalgia rheumatica". It was published in Future Medicine , .pdf format.
What do you guys think?