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Why not add Prednisone slowly?

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Ulcerative Colitis
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Posted 12/13/2019 3:26 AM (GMT 0)
It would be like a reverse "taper" at the beginning of Prednisone use, but more rapid, and in non emergency situations. With the usual taper at the end. What could be the disadvantages? I'm thinking that a gradual introduction might avoid being slammed by immediate side effects as the body adjusts, just as we adjust to gentle withdrawal at the end.
Posted 12/13/2019 4:17 AM (GMT 0)
The problem with this approach is that therapeutic value won't be achieved until you get to higher doses. The metabolic equivalent of prednisone that the body releases every day is equal to or less than 5mg. So as soon as you take 5mg of prednisone for more than 1 week, your adrenals are already going offline.

Prednisone side effects are more related to duration of use than what dose you're on. That's why no matter how much pred is taken, doctors try to get you off of it as soon as the disease shows improvement.
Posted 12/13/2019 4:41 AM (GMT 0)
In other words it's better to hit it hard and fast so you can see improvement sooner and then get off of it sooner, than introduce it very slowly. The slow approach means you won't achieve therapeutic value and control of your disease, and prednisone will be in your body for longer doing damage.

Studies show that the damage prednisone does can happen as low as 5mg. So you're not really sparing yourself by taking your time. It's an evil but necessary drug so the goal is to get in and out.
Posted 12/13/2019 2:14 PM (GMT 0)
Well said. Hit it hard with high doses early on, is the only way to do it. Side effects cannot be avoided.
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