Reducing Prednisolone (Cortico-Steroids)

[Ringlet]

I wondered if anyone has experience trying to reduce their Prednisolone dosage.
I've been taking Prednisolone for an auto-immune condition for five years.
Many times I have tried to reduce and always ran into problems because symptoms of the auto-immune disorder would return.
Over the last 8 months I have been reducing the dose by half a milligram per month with no ill effects. The GP had said the auto-immune condition may have gone into remission and to try and reduce the steroid as much as possible.
When I got the dose down to 8 milligrams per day, I started to feel shaky, extremely tired, light headed and couldn't walk in a straight line.
Today I couldn't stand upright, and blood pressure was low at 86 over 52.
Is this because of reduced Prenisolone, and what can I do about it?
The auto-immune symptoms have not returned at 8 mg but the weakness and general feeling of being ill is horrible. Any examples of experience would be very welcome.

[Sqad]

A bit more information needed here Ringlet.

For what auto immune disorder are you taking the steroids and what whas your maximum dose and for how long did you take it? What dose have you reduced to and what steroid are we takling about?

Are you taking any other medication other than the steroids?

Please answer all the questions as it is important.

I can see no association between your low BP and your steroid withdrawal regime.

[Buenchico]

Hypotension gets a mention here, Sqad:
https://www.verywellhealth.com/does-prednisone-tapering-minimize-withdrawal-190242

[Sqad]

Indeed it does Buenchico but this is unusual and only occurs when high and long standing doses are suddenly stopped, which does not seem to be the case here. Low BP in such circumstances is due to suppression of the Adrenal Glands which has been noted for the past half a century, but is unusual.

[Ringlet]

Many thanks for the answers. Jura, I had been told before exactly what you said - that coming off Prednisolone should not be attempted without the back up of another medication. But my rheumatologist didn't agree. He said that Prednisolone could be reduced to zero if unless symptoms returned. I wasn't happy with that, to be honest but didn't question him.
Sqad, the AI condition is Polymyalgia Rheumatica and the prescribed cortico-steroid is Prednisolone. Condition was diagnosed by Rheumatologist five years ago, although symptoms had been present for about two years before that and were attributed to arthritis.
Inital dose of Pred was 50 mg, reducing to 25 mg after three months.
Since then the dosage has fluctuated from 25 down as far as 10 mg depending on symptoms - sometimes a flare up occurs and dosage has to be increased quickly.
Other medication I take are Clopidogrel, Rosuvastatin, and Vit D, B12 and C supplements (prescribed).
At the start, when Pred dose was high, my BP was high and Amlodipine was prescribed. But since the Pred dose was reduced to 25 mg or below BP has been more normal and Amlodipine was discontinued last year.
In October last year, I was on 10 mg Pred and began reducing by half a mg approximately every six weeks. There was not return of PMR symptoms so I began to think maybe the condition had gone into remission, as I had heard of this happening with other patients.
So I persevered with the reduction of Prednisolone.
Some time ago, however, a GP had explained that when dosage of Pred exceeds 10 mg, the adrenal glands cease to produce Cortisol, and it is important if reducing below 10 mg, to do so very slowly so adrenal glands may be slow to start cortisol production again.
So I reduced with great caution, but felt no ill effects at all.
But when I reduced to 8 mg I began to feel very unwell - lightheaded, dizzy, and utterly exhausted all the time and unable to think properly, or concentrate to read. I have also lost over a stone in weight and my appetite has all but disappeared.
I googled the symptoms and related it to Prednisolone and found that the list of symptoms of cortisol deficiency exactly match my symptoms.
I was hoping someone with experience or knowledge of taking Prednisolone could give me some more information about the relationship between reduction of prednisolone and the symptoms I have been experiencing.

[Sqad]

Thank you for that complete and helpful reply.

Lists of side effects from pharmacolgical drugs seem to be endlless and one can easily find one's own symptoms, which may be dangerous.

I would suggest blood tests from your GP, if you haven't already had them and if normal, return to Prednisolone 10 mgms daily and if there is a improvement in your symptoms it would suggest an association between withdrawal and symptoms.

[Ringlet]

Thanks Squad,
Last blood tests I had were in february I'm going to ask for telephone app with GP to discuss it.
Tue and Wed are bank holidays in Northern Ireland and waiting time can be up to three weeks, so it could be a while before anything gets done.
I feel as if I had no bones - arms, legs and body are floppy and weary all the time. Can't think of anything else it could be, so blaming the Prednisolone.

[Sqad]

Interesting, thanks for the feedback and keep us informed.