How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. David Your Own Question

Dr. David
Dr. David, Board Certified Physician
Category: Medical
Satisfied Customers: 27748
Experience:  Experienced Physician trained in New York City. I'm ready to help.
Type Your Medical Question Here...
Dr. David is online now
A new question is answered every 9 seconds

I have been on Prednisone since 2010 for PMR. I have tried

Resolved Question:

I have been on Prednisone since 2010 for PMR. I have tried to wean down three times but the symptons return. I am now at 2 mg per day but for the last several weeks I have pain and stiffness throughout my whole body. My blood tests have been fine and my doctor says that 10% of people with PMR still have good blood tests. Now she wants me to take a blood test re my cortisole levels and she think that my system may now not be able to create my own because of prolonged Prednisone use.

Is it possible that I do not have PMR now? But that my immune system has got so used to Prednisone that it cannot function on its own now? If so, now what?
Submitted: 7 months ago.
Category: Medical
Expert:  Dr. David replied 7 months ago.
Hello, this is Dr. David. I have read your question and I'm ready to help.

most likely you still have PMR if you still have pain and stiffness throughout your whole body.

it is not your immune system which has gotten use to the prednisone. the prednisone suppresses the immune system and keeps your PMR symptoms less.

but prolonged steroid use will supress your own body's ability to make steroids or cortisol. this is a normal issue. if you gave a normal person 3 years of prednisone, this suppresses their pituitary secretion of ACTH which is the hormone the pituitary tells the adrenal glands to make cortisol because there is already enough cortisol in your body from the 2mg of prednisone which is a very very low dose.

so your doctor is checking your or ACTH level and AM cortisol levels which might still be low, but that is normal since you are on 2mg of prednisone. if that dose works for you to help you suppress your PMR, then that is fine to continue. because between the 2mg of prednisone and the low amounts of cortisol your body is making, you most likely are having enough steroids and the right level for your body.

does this make sense?

do you have other questions?
Customer: replied 7 months ago.

But the burning and aching sensations I have now are not the classic PMR symptoms i.e. shoulders to elbows and bottom to knee. These sensations are in my hands, feet, and calves too. Could the continued use of Prednisone cause these?


 


If I no longer have PMR, what are the chances of my body getting back to normal with making its own cortilsol.? If I do still have PMR, why has the pattern of discomfort changed in the last few weeks? What are the chances that I will have to stay on Prednison for the rest of my life?

Expert:  Dr. David replied 7 months ago.
most likely long term use of low doses of prednisone 2mg is not causing the burning and aching sensation of your hands feet and calves. these are still most likely from your PMR.

your body can make its own cortisol if you taper very slowly off of prednisone. most likely you are making some cortisol currently since the 2mg of prednisone is such a low dose. but your body will never make as much steroid as you would if you took extra steroids by mouth.

sometimes PMR pain can move around and change. this is the nature of the disease.

there are other immune suppressing drugs your doctor can try like methotrexate and others which can be used by themselves or with steroids.

also if you have been taking prednisone for such a long time, you have to take calcium and vitamin D supplements to help support your bones which can become weak from steroid therapy.

Dr. David, Board Certified Physician
Category: Medical
Satisfied Customers: 27748
Experience: Experienced Physician trained in New York City. I'm ready to help.
Dr. David and 3 other Medical Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Thomas, MD's Avatar

    Dr. Thomas, MD

    Board Certified Physician

    Satisfied Customers:

    44473
    Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/DrThomasMd/2012-7-25_134438_Imagess1.64x64.jpg Dr. Thomas, MD's Avatar

    Dr. Thomas, MD

    Board Certified Physician

    Satisfied Customers:

    44473
    Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
  • http://ww2.justanswer.com/uploads/MY/mysticdoc/2012-6-8_15615_mysticdoc3.64x64.jpg Dr. D.J.'s Avatar

    Dr. D.J.

    Board Certified Physician

    Satisfied Customers:

    13579
    MD
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor

    Satisfied Customers:

    2522
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/DR/drappapo/2013-8-16_22576_drdavid.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    224
    Treat children/young adults, former chief resident, multiple publications
  • http://ww2.justanswer.com/uploads/DrDLove/2009-08-12_141522_DrDLove.jpg Dr. D. Love's Avatar

    Dr. D. Love

    Doctor

    Satisfied Customers:

    11042
    Family Physician for 10 years; Hospital Medical Director for 10 years.
  • http://ww2.justanswer.com/uploads/DO/DoctorRich/2012-9-12_72454_Doctorweb.64x64.jpg Dr. Natasha's Avatar

    Dr. Natasha

    Doctor

    Satisfied Customers:

    8749
    American Board Certified in Emergency Medicine and Ivy League trained. Medical Review Officer trained in Drug Testing