Hi, Panorama. That's a nice "algorithm," but most people on steroids find that it's not quite that simple!

Steroids are a complex issue. Some doctors begin with lower dosing, having every other day being zero so that the adrenals can keep working. Every situation is different, so I always laugh when I read algorithms. Our bodies are unique and cookie-cutter doctoring is dangerous.

And what rules over a method of withdrawal is always a patient's symptoms. Too fast of a withdrawal can cause an adrenal crisis, which is life threatening.

So many things like overall metabolism, liver/kidney function, other meds and conditions come into play.

That would be great if you could be symptom free. What they've been having some luck with at Mayo, or example, is Rituximab. It's not for everyone but it can be quite amazing for some people.

Be wary of any "promises" with MG. Sure, many people have gone into remission, whether it's drug-free or drug-induced. But MG isn't predictable and can even come back after remission.

Do you have an expert to go over all of the options with you? That is the best way to go. I don't know where you live but there are a few experts across the country who have real experience with more cases.

I hope you find something that works for you.

Annie