After being diagnosed with MG in Dec. 2008 my teatments starting early in2009 have been 2 monthly IVIG's per month, 2000 mg of cellcept x2. 60 mg of mestinon x5 and prednisone 120 mg every other day. I have said before I have expieriencied everything this desease has to offer.

Fast forward to Feb. 2010. Significant inprovement. That's when my neuro started reducing my pred intake. First 100 mg EOD, then 80, ect., and last month from 20 mg to 15 mg EOD.

When I went from 40 to 20 mg EOD, I started increased fatigue. Now it is much worse and I am unable to do a lot of the things I did earlier in this year. For example, I could go out in the evening maybe for dinner or for a get together or play some cards. Now getting out of my chair in the evenings is quite a chore. My days can be like this also.

I have read a lot of posts about tapering off of pred, but no mention if the tapering resulted in more fatigue. Wondering if anybody else has had this happen to them.

Could be the reduction of pred has nothing to do with the way I am feeling but the damage the pred is has done to my body. Osteoporosis and osteoarthritis.

Any thoughts.

Tony

Tony- I too have experienced everything this disease has to offer, haha, sounds like a good thing..but no as you know.

But, the first time i was tapering off prednisone, I went from 80 every day down to 20 a day for the remaining time. I havent been off prednisone fully, just lower dosage. Yet I know as you go down in mgs, your body gets weaker, just because your used to having it there. So you reason (most likely) why your still experiencing weakness would be because your dosage is too low.

I just got off of cellcept and now am starting imuran, 2nd week. Its okay, just very weak still and being in college and being weak is annoying as hell.

I can sometimes get to class, then have to come back and sleep for 2 hours to get up to do homework. No excersize, nothing.

Its hard for sure, but just make sure get to your level of comfort with prednisone, of course with talking to your doctor first.

Im having IVIG starting next week to get me strong enough to be able to do everything a college kid should. Cant wait.


Hope you feel better.

Tony, Do you mind defining "fatigue?" It's funny, I had a doctor play a semantics game with me the first time I thought I had MG. I said, "My muscles feel weak." He said, "You mean fatigued?" To me, fatigue had always meant tired and weak meant weak! But to doctors, fatigue is a word they use for weak muscles. And if they are being an @$$, then they use it for both things to tick you off.

So, is it a case of your muscles being weaker or are you "sleepy tired?"

If you are weaker, it could be MG. I think a trip to your neuro is a smart thing to do to make sure.

If you are sleepy, it could be that you're having signs of adrenal fatigue. Going off of Pred too quickly can cause that to happen. While on Pred, in case you don't know already, the adrenals go "to sleep." Pred is doing their job for them! It can be very hard to get off of Pred due to that.

Don't assume it's the Pred withdrawal. It's always good to get an opinion from your primary doc if it doesn't get better. An endocrinologist can work with your neuro on getting you off of Pred, if that's the goal. But don't expect a neuro to be an endo.

I hope you can figure out what's going on and feel better.

Annie

Hi Tony, its great you've posted this, I've been thinking about it for a while. I can't seem to get below 15mg, as when I do I get double vision, but as its been years(about 2)since I tried it, I can't remember if I had muscle fatigue or not.

Annie, wow, I thought it was just me that had the fatigue/tired problem with Drs. My Dr almost had me in tears once over this......... Now I always say "I'm muscle fatigued, NOT tired" anyway I'd better stop here, or I will get waaaay off topic.

Whether it's fatigue or weak muscles It's a feeling that i do not want to use the energy it will take me to get out of chair. I know I can do it and know I can also do some minor chore but it is also going to be very difficult to do.

This will happen when I am sleepy tired and I will dose but also when I'm alert and I might sit for hours watching TV wide awake.

My reduction of pred has been at 2 month intervals. Last month from 20 to 15mg. but I took 20 mg yesterday and again this morning.

I got up this morning feeling pretty good. ( 5 A.M. ) So I went golfing and played 12 holes. Would have played more but It was getting warm and I knew I would pay. I took my wife to the DR. today, waited 3 hrs. and its now 5 P.M. and i'm feeling pretty good.

It is hard to believe that 5 extra mg's could make such a difference.

But I just had my IGIV infusions 6 and 7 days ago and maybe they are just starting to kick in but I am going to do 20mg's EOD. I'm going to call neuro and tell him but sure he will be ok with him until I see him next.

Extra pred or IGIV. Still a mystery. I'll keep experiencing with the pred.

Hi Scrubbs,
If you are looking for some sensible pred taper schemes, you may consult
http://neuromuscular.wustl.edu/mtime/mgrx.html
(It's the last reference in the "Useful sites for MG" on top of the page)
As far as I am concerned, I never taper more than 10 % for each step.
Before doing that, I noticed that for about a week, I felt rather dizzy (weak?) and I assumed that the step was too big (i.e. going from 25 to 20, which is 25 %...). With a 10% step, the transition has ever been smooth without any odd sensation.
My step length is 3 to 4 weeks.
Maurice.

I tapered from 60 daily to 10 EOD and it took about 6 months. When I first started tapering, I went down 10 per day each week until I got down to 20 where I got real shaky and weak. Talked to the neuro and he said I tapered to quickly so we went back up to 40 daily and tapered 10/day every other week. This time everhthing went fine until I an now down to 10 EOD where I will probably stay for a while.

You probably should talk to your neuro about your symptoms and maybe change your taper rate.

Good luck!