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High dose steroid - how to avoid/manage side effects?

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Posted 6/28/2015 8:45 PM (GMT 0)
Aright. I am on predinisone 50mg/d for a week, then 40mg a day the following week, tapering 5mg week to 0. Basically that keeps me on pred for 2 months which seems longish (is that considered long term?)

My question is what are the things I can do to avoid some of the risks and side effects of pred while I am on it?

For example, I know it can cause osteoperosis, avascular necrosis, diabetes, pressure in the eye, etc...

Are there things I can do to help prevent some of these things from happening?

I am currently taking 2000mcg of calcium and 2000iu of vitamin d per day. Should I also avoid high sugar, high fat diets? Should I exercise daily?

j.
Posted 6/28/2015 8:50 PM (GMT 0)
Ok first of all it's good you are aware of it becaus Than you can do something about
I would try to limit things that are high in sugar because it raises your blood sugar limiting salt will help you out with fluid retention and swelling
As for the calcium taking 2000 at a time is wasting your money because your body can only absorb about 500 at a time
Unless you are taking a delayed release
But while it's important to get calcium too much can cause problems
( kidney stones, iron absorption)
If you would take 500 twice a day and than get some from meals that should be sufficient
Daily exercise will help with the muscle and bone loss but don't push your self
Maybe some light weights and walking but not more than you are doing currently
Hoping you are doing better soon
Posted 6/28/2015 9:05 PM (GMT 0)
Some side effects are not going to be controllable on your part, so keep that in mind, and also, you won't necessarily get all or possibly any side effects (I never got side effects from pred until the last time I went on it and it didn't do a thing to help my symptoms it just got me all bloated and caused weight gain which it never did before.

You might have issues with racing mind, nothing you can really do about that if it happens, but it can interfere with your sleep so taking all your pred first thing in the early morning helps with pred induced insomnia....your appetite might become enraged and you may even find strong cravings for salty foods, if you increase your water intake this may help you with both those issues.

Don't know about working out while on it cuz it can affect your bones, muscles and stuff so if anything try yoga type workouts instead of heavy weight bearing ones while you're on it..cardio activities should be fine too, I never had issues doing cardio and super light weights

I'm sure others will come along to give you some more tips...best of luck with it and feel better soon!
Posted 6/28/2015 10:29 PM (GMT 0)
A two month course and then ending is not long term. The problem is prednisone usually always works while you are on it and many start having symptoms again while tapering, when the dosage is often increased back up again and you are on it even longer or if you constantly flare a few times a year and continually jump back on the pred train. You need a good maintenance plan that works so when you taper off the pred your mtnc plan will keep you in remission. What is your mtnc plan?

It is important to note that pred has both side effects and withdrawal symptoms. The side effects happen while taking the med but withdrawal symptoms happen when tapering down. They are two separate things and the withdrawal symptoms can often be worse on the lower doses than when on the higher doses.
Posted 6/28/2015 11:16 PM (GMT 0)
Take calcium supplements (the chews are great), exercise if you can, drink plenty of water, cut out ALL sugar and sodium.
Posted 6/28/2015 11:37 PM (GMT 0)
You can't usually get bone damage in 2 months, especially when you are only on the higher doses for a few weeks. some folks hardly have any side effects.

except for some anxiety and trouble sleeping you may not have any effects.

watching blood sugar was good advice. taking the dose as early in the AM as possible may help too.

if you can't taper the possible side effects can be revisited. for now might be best to focus on the inflammmation the pred is hoping to address.

good luck

Post Edited (DBwithUC) : 6/29/2015 7:32:08 PM (GMT-6)

Posted 6/28/2015 11:55 PM (GMT 0)
Longterm steroid usage is rather subjective, I'd say a year is longterm. 2 months is not, no worries.

You cannot avoid prednisone side effects. Best you can do is a few small things to help reduce their severity:

  • Salt can increase the odds of water retention (bloating, moonface) while on prednisone, avoid as much salt as you can.

  • Take steroids in the morning to help reduce the odds of insomnia.

  • Take extra milk for calcium, and increase your potassium. I drank milk and had a banana each day.
Posted 6/29/2015 1:06 AM (GMT 0)
Yeah I just finished a three month course. I didn't even take calcium supps this time. I just work out five days a week. It's always the tapering and withdrawal that kills me. Headache for two to three days and acne breakouts after my last dose. Oh and I sleep at the drop of a hat no matter how much I sleep at night.
Posted 6/29/2015 5:49 AM (GMT 0)
The side effects are unavoidable, but also very individual. Prednisone made me tired, and made me lose weight like crazy... the opposite of what most people experience.

I don't know where you're at in your flare, but if you can boil some collard greens, kale, spinach, romaine, and any dark leafy green, you can get much more bio-available calcium than consuming supplements or dairy, if calcium is a concern. Lots of other great nutrients in there too.

I was told by my MD that 4 months is considered long term, and I was on 60mg/day for a couple of those. The truth is that "long term" will depend on what it does to your body. For some people a few months is long enough to start showing side effects while others use it for a half a year and nothing bad happens. It really depends on how your body metabolizes the drug and the things you do in your day to day.
Posted 6/29/2015 1:26 PM (GMT 0)
I've pretty much been on Prednisone for about 9 months. Varying from 40 mg down to 2.5. I also take a calcium supplement and take my pred in the morning. And all I drink is water. Don't have any known side effects yet but I know they can pop up years after like osteoporosis. But I don't really have a choice right now. Good Luck, oh but I wouldn't worry to much about 2 months...
Posted 6/29/2015 1:31 PM (GMT 0)
"Long term" prednisone use will 100% cause sometimes permanent damage to your body which I wouldn't even classify as "side effects". I would classify side effects as reactions to your body while taking the med which go away after discontinuing the med. The long term damage permanently damages your body and does not usually go away after discontinuing the med and prednisone has several which fit into this category. Once this long term damage occurs you are usually screwed, forever. That's why you shouldn't be on pred "long term".
Posted 6/29/2015 2:51 PM (GMT 0)
Exercise, drink lots of water, reduce salt intake, eat healthy snacks throughout the day to try and help curb the hunger that it causes.
Posted 6/30/2015 11:48 AM (GMT 0)
I found that pred did a number on my Adrenals. Around 5pm....I would crash hard every day. I took a supplement called Adrenal Fatigue while tapering and found it helped a lot. Licorice tea also helps your body create a "natural" steroid. Just be careful drinking licorice during a flare because it depletes potassium. We tend to lose potassium if we have D.
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