279/365 – Questions over steroid reduction

My post a couple of days ago about the struggles to get off prednisolone raised some questions with readers. Thank you for taking the time to ask these questions and I’ll try to answer them as best as I can below.

Firstly I was asked whether my single figure milligram doses are done with the same measurements as those on larger doses like 60mg.

If it is prednisolone and is measured in milligrams then, in short, yes. I started out on 20mg and have reduced to 2mg over the last year. 

I would definitely enquire with your doctors about the availability of 1mgs in your country as the pills definitely exist.   

Secondly, I was asked why I’m keen to cut down my prednisolone when I’m on a high dose of aziathioprine.

My consultants plan for me is to get down to a low or no steroid dose and then start reducing the aziathioprine slowly to see how my body responds.

He had pushed me to get down on the steroids as immunosuppressants are his preferred treatment for me due to the long-term side effects of prednisolone. I’m aware that aziathioprine also has long-term side effects  but as I say I also hope to start reducing this shortly. 

Thirdly, I was asked whether not having muscle tone is a symptom of MG as I lack it. 

Firstly, I’m going to assume that this question was asked out of genuine curiosity and didn’t mean to sound as catty as it did. Having or not having ‘muscle tone’ is completely subjective and I would disagree with you on your remark that I don’t have any. 

Anyway, as I said, I’ll treat it as good natured curiosity. I’m not aware that not being able to get muscle definition is a side effect of having myasthenia – the condition takes away many people’s ability to exercise and be mobile  which in turn can mean loss or lack of definition. At present I’m incredibly lucky that I can still exercise and I know it may not always be this way. 

Aside from my genes, I’m slim rather than bulky because I prioritise long distance cardio exercise (running, cycling, hiking etc) over muscle training. 

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