Everyone is different and it may be that a starting dose of 15mg for polymyalgia rheumatica and 40mg for giant cell arteritis (60mg in the case of ischaemic, or eye symptoms), is not perfect, but it is the dose specialists have generally agreed as being the lowest possible dose to get the symptoms under control. However, very large and very small patients may find that they need a bit more or a bit less. As you start to reduce your steroids after a few weeks of treatment, you may find that your symptoms return to some extent when you drop your dose. This does not necessarily mean that you have dropped the dose too far. Give it a few days. You need to pay close attention to how your body feels and reacts, to discuss this with your doctor. There is evidence that people who reduce too rapidly, without giving their bodies time to adjust, may experience ‘flares’. Our experience listening to hundreds of people’s experience over the years has been that, once you get to about 10mg, tapering should be very gentle indeed, no more than 1 – 2 mg at a time. It is the cumulative dose over time that needs to be kept to a minimum, and this is why repeated going up and down again should be avoided unless a relapse has been formally diagnosed.
