Weaning off Prednisone...

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IMPORTANT NOTICE:

Consult a licensed health care provider before embarking on this regimen or using any supplement in combination with, or in lieu of any Rx drug. This information may or may not be helpful for you.

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Prednisone is an important, potent and potentially very dangerous R_x drug. The general consensus is that once you take 5-7 mg per day, your adrenal cortex stops producing its own cortisol all together, the hormone that Prednisone and other corticosteroids simulate. The numbers are inexact as every person is different. Some say the switch over starts at 3 mg, others as high as 10 mg, but the point remains. Put in enough substitute and the body compensates by halting it’s own production of the real thing.

There are other routines which do not stretch-pulse (see below) and which remain ‘at level’ for longer or shorter periods than this routine. You may need to blend routines, depending on your own situation. Pay attention to your own body and the feedback it gives you.

If you have been on Prednisone a very long period of time, e.g., 5 or more years, at doses > 5 mg/day there is a possibility that your Adrenal Cortex is badly damaged. Cortisol, the natural corticosteroid produced by the Adrenal Cortex, or a similar equivalent hormone, is necessary for survival. If the Adrenal Cortex has been permanently damaged, your survival may depend on staying on Prednisone or a similar drug indefinitely. This is but one of the many reasons why you should consult a licensed health care provider before engaging in, and during the process of, weaning.

You may need help, or to incorporate another remedy to aid you in getting off of Prednisone and/or other corticosteroids, Methotrexate, Plaquenil, Ibuprofen and/or other NSAID’s, various DMARD’s, Cox-2 inhibitors, cytotoxics, et al, or to replace them when you are in a flare.

You will probably need to strengthen and repair your Adrenal gland if you have been on Prednisone, and possibly other glandular systems if you have been on any OTC or R_x drugs for any rheumatic or arthritic diseases. The most effective items we know of for this are those from Systemic Formulas.

ASSUMPTIONS:

Start at your point in the routine, e.g., 7 mg is STEP 4, 17 mg would be in advance of STEP 1. While most people are able to take fairly large reductions in dose above STEP 1, some, especially long-term users, e.g., 17 years, may not be able to tolerate reductions greater than ¼ mg. Please read STEP 1 for further instructions.

Starting Dose 10 mg 1/x day

Relatively ‘clean’ diet (i.e., no caffeine, other stimulants, recreational drugs, etc.)

Relatively ‘clean’ lifestyle (i.e., nonsmoking, no alcohol at this time, etc.)

Dietary issues such as caffeine, soda, diet soda, excessive sugar, beef and dairy products, and any other single food stuff that you eat more than ten times a week can put a ‘load’ on the body system.

If your diet consists of these sorts of things, or if you repeatedly eat the same thing, e.g., toast in the morning, sandwich at lunch, and rolls at dinner (wheat, yeast, etc., 3 times in one day), all times mentioned will probably need to be extended.

Lifestyle issues such as smoking and drinking do the same. There are also drug-specific issues with alcohol, amphetamines, etc. Involve a physician with frequent (at least 1/x wk) checkups if this is an issue.

Prednisone is available in 1 mg tablets. You will need as low-dose tablets as you can get to simplify the logistics of this routine.

If at anytime during the routine you do not stabilize, go back ONE step and remain there until stable. This routine must be done slowly. This is not a matter of will power nor personal achievement. It is a function of weaning a glandular system from a man-made substance that causes it to cease production of it's own product and putting that complete glandular system back “on line.”

At STEP 11 the clock will become an issue. Do not dose by “clock edict.” If you are comfortable stretching further/faster than listed, do. But do NOT do it if you are uncomfortable. Discomfort is a very important sign. Pay attention to it, slow down the stretches if needed, pause at a level for a time if needed, etc.

Ensure you are STABLE. Stability is the key to making this routine work and weaning off of Prednisone as well as Ibuprofen and other such drugs.

If you are enjoying an unclean diet, use this time to address that as well. Increase your intake of ‘pure’ water, i.e., filtered, reverse osmosis generated, bottled, etc., until urine is extremely light or near clear. Temporarily restrict (read: remove) beef and red meats from your diet and any food that leaves a sour or otherwise odd taste or feeling in your mouth.

If you find that you are fatigued a half hour or so after eating any food, restrict that as well. Contrary to the popular myth that you need a ‘nap&’ after a meal, food that causes you to need a ‘nap’ is food that is taking energy away from you. It is not good for you, even if it is “good for people.” Food that makes you tired is food you are allergic too. Food that makes you feel ‘energized’ is food that is good for you.

Common suspects for food-related issues include yeast-risen breads, wheat, milk & dairy products, and sugars such as candies. If you are suffering allergies, try to filter your air as well (portable HEPA filters are helpful for this.)

The concept here is to reduce the ‘overhead’ on the body system. Doing these things will enhance both the speed and extent of your success. They may help; They may not be necessary; They are beneficial, regardless.

STEP 1. Take your routine dose of Pred (Prednisone) daily for two weeks. Make sure you are stable.

TAKE YOUR PRED AT THE SAME TIME EVERY DAY UNTIL STEP 11 IF YOU CANNOT GET TO STEP 11 THIS WAY, READ 11-18 AND START USING THE STRETCH METHOD TO WORK YOUR WAY DOWN EVEN SLOWER

STEP 2. After two weeks, reduce your dose by 1 mg You are now at 9 mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.

STEP 3. After 7-10 days of STABILITY, drop 1 mg. You are now at 8 mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.

STEP 4. After 7-10 days of STABILITY, drop 1 mg. You are now at 7 mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.

STEP 5. After 7-10 days of STABILITY, drop 1 mg. You are now at 6 mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.

STEP 6. After 7-10 days of STABILITY, drop 1 mg. You are now at 5mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.

STEP 7. After 7-10 days of STABILITY, drop 1/2 mg. You are now at 4-1/2mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.

STEP 8. After 7-10 days of STABILITY, drop 1/2 mg. You are now at 4mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.

STEP 9. After 7-10 days of STABILITY, drop 1/2 mg. You are now at 3-1/2mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.

STEP 10. After 7-10 days of STABILITY, drop 1/2 mg. You are now at 3mg. Stay there 7-10 days AFTER you stabilize, assuming that within 3 days after the drop you feel some discomfort and that remaining at the new dose the discomfort settles down.

STEP 11. Things often start to get dicey from here on out. At about 3± mg, your body has to start producing its own corticosteroids. This is where you start "stretching" or "pulsing". Stay at 3 mg until stable for 7-10 days.

Now the routine changes... Start stretching the periods between doses. If you normally take your Pred at 9:00 am, move it off to 10:00 am on day 1, then 12:00 noon on day two, then 3:00 pm on day four, adding an additional hour to the between-dose periods every day or couple of days.

Do NOT get in a hurry. DO write things down. It will be very hard to keep track and see where you are and what is working if you don't. Try also to keep a diary of your foods eaten. You may find a correlation to a particular foodstuff with pain and if so, be able to limit or eliminate that foodstuff from your diet for the time being.

By now your dosage intervals should be looking something like this: Hours between doses - 24 / 25 / 26 / 27/ 28 / 29 / 30

There are two concepts at work here:

1. Stretch the intervals between doses out to such an extent that you slip into the next quantity drop without a major change.

Example - 3 mg at 24 hr doses is roughly .1250 mg/hr. Obviously there are high/low blood levels along the way but this gives a rough starting point. 2-1/2 mg is .1042/hr.

2. Pulse the adrenal gland's workload so that it exercises / sleeps / exercises / sleeps / exercises, etc. It has been "off-work" a long time and will take a good deal of "exercise" to get back in shape. Stretching out the length of time between doses has the effect of dropping the dose while still "pulsing" the adrenal gland with.

Example - Within minutes after the Prednisone hits the bloodstream, the adrenal gland will slow or stop production of your own corticosteroids. As the Prednisone is processed out of the bloodstream, the adrenal gland is forced to start coming "back on line."

STEP 12. You are at 3 mg., you have stretched your doses out to 30 hrs. drop your dose 1/2 mg to 2-1/2 but go back to taking your Pred every day at the same time, e.g., 9:00 a.m. daily.

After 7-10 days of STABILITY, start stretching the periods between doses again, as in STEP 11. If you normally take your Pred at 9:00 a.m., move it off to 10:00 a.m. on day 1, then 12:00 noon on day two, etc., until you get to 30 hrs. between doses.

STEP 13. Drop to 2 mg. STAY there until you are stable for 7-10 days. Then start stretching the dosing periods out again until you hot 32 hrs this time. As you see, you are very, very slowly working your way both DOWN and OUT on your dosing. 32 hrs matches the next drop.

STEP 14. Once you hit 32 hrs between doses, drop to 1-1/2 mg but go back to taking your dose at the same time every day, i.e., 9:00 a.m. (or whatever time it is you prefer)

STAY here until you are stable for 7-10 days. Then start stretching the dosing periods out again until you hit 36 hrs. this time. As you see, you are very, very slowly working your way both DOWN and OUT on your dosing. 36 hrs. matches the next drop.

STEP 15. Once you hit 36 hrs between doses, drop to 1 mg. At 1 mg your adrenal cortex is definitely working. Here it is working / resting / working / resting, where before it was asleep -- working / sleeping / working / sleeping. There has been a change but you must be very careful. STAY here until you are stable for 7-14 days. Notice the stability length has changed. If you are Up and Down, you are not stable. Stability is the key to finding the opportunity to exercise the adrenals more.

Start stretching your dosing periods out again until you hit 32 hrs. this time. As you see, you are very, very slowly working your way both DOWN and OUT on your dosing. 32 hrs. matches the next drop.

STEP 16. Once you hit 32 hrs between doses, drop to ¾ mg but go back to taking your dose at the same time every day, i.e., 9:00 a.m., or whatever. STAY here until you are stable for 7-14 days.

STEP 17. Once you hit 36 hrs. between doses, drop to ½ mg but go back to taking your dose at the same time every day, i.e., 9:00 a.m., or whatever. STAY here until you are stable for 7-14 days.

After you are stable 7-14 days, start stretching your dosing periods out again until you hit 48 hrs. this time. As you see, you are very, very slowly working your way both DOWN and OUT on your dosing. 48 hrs. matches the next drop.

STEP 18. Once you hit 48 hrs. between doses, drop to ¼ mg but go back to taking your dose at the same time every day, e.g., 9:00 a.m., or whatever. STAY here until you are stable for 7-14 days. After that, start the stretching routine again. There won't be any other drops. Continue stretches until you need some pain relief. Do not dose by “clock edict.” Your next step is Pred-free!

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