Why is pred working so slowly?

as to why it's not working, who knows - I think one course is enough to alter the effectiveness of the next one -

if it was me, after that long w/o improvement @40, i would either go up, or go down -

i'll put pred in my body all day long if it's working - if it's not, I do something different -

hope you get something figured out soon -

Were you checked for bacterial causes to your uc flare-like symptoms (e.g. cdiff)?

Ipoop- I am currently taking azathioprine and allopurinol which I personally think are doing nothing. I have been on aza since June and when on a higher dose I felt as thoug it was helping me but I never got in to therapeutic range so never quite completely in remission. Then he reduced my aza dose significantly and added allopurinol to help me metobolize the aza better so it worked better but wasn't so toxic to my liver. Only been on the allopurinol for three weeks so my GI seems confident that once it kicks in it should work well. Problem is he wants to give it at least three months before he seems it a failure. Fair enough.

Plus I was doing ok plodding along until I got gastroenteritis last week which sent my flare in to overdrive and put me in this position.

The dose of prednisone is too low. Going higher than 40 mg isn't unusual.

You could try adding rectal meds and possibly supplements.

Curcumin and hydrocortisone enemas got me off Pred last time. However, I already knew that curcumin helped me before the flare so I just had to double my dose.

I've never had my CRP measured - I don't think all doctors do it. Would a doctor pull you off Pred because your CRP levels were improving even if you still had blood and other issues? How the patient feels should be most important.

No I don't think my GI would pull me off pred if I didn't feel well. But CRP is a good indication of inflammation in your body. Last time I was in pred, my CRP was at 5 after a week and I still felt didn't feel right or that my symptoms had gone. But I knew it wouldn't be long. And a few days later, my symptoms had gone.

NiceCupOfTea said...

iPoop said...
I respond slowly to prednisone as well, took several weeks before noticing a change.

Then it wasn't the Pred which got you out of the flare-up.

For a slow responder, it might take 2 weeks, 3 weeks absolute tops, to take full effect. It's not about giving your colon time to heal. Unlike other meds, steroids are not proven to heal the mucosa; if anything, they impair healing.

Basically, if Pred wasn't so easily available as an all-purpose sticking plaster, then GIs wouldn't be able to fob off their patients half as much as they do.

Everyone is different. Pred an work slowly in some people. It definitely was the pred that got me out of the flare in the summer as I suddenly got better. There would be other reason why I would have suddenly gotten better. I had started taking azathioprine but that wouldn't have worked in three days.

I am going to hang in there for another week on 40mg like I did last time. I think I'm today starting to see less blood. So let's see.

I do think I need a better maintenance regime but my GI thinks the aza/allo combo should work with me and thinks it is the safest option I have. He mentioned methotrexate if it failed. So will be about two months until completely off pred if all goes to plan and I will have been on the aza/allo for three months by then. If I start to flare again I will know it's definitely not working and need something stronger.

Happychick said...
Everyone is different. Pred an work slowly in some people. It definitely was the pred that got me out of the flare in the summer as I suddenly got better. There would be other reason why I would have suddenly gotten better. I had started taking azathioprine but that wouldn't have worked in three days.

All meds have an expected timeframe in which they start working. Pred is no different. If it takes several weeks to see any improvement, then it wasn't the Pred which was responsible, because it's not possible for Pred to take that long to start working in even the slowest responders.

Contary to popular belief, meds are not a necessity for remission. It's more than possible a flare-up will pass of its own accord after a few weeks or months in many people.

I have had flared before where my WBC was elevated slightly so yes all flares are different. Plus I'm on immunosuppressants at present which may be regulating it somewhat but obviously not doing what it should be doing as i am still flaring!

"Contary to popular belief, meds are not a necessity for remission"


absolutely true -


"It's more than possible a flare-up will pass of its own accord after a few weeks or months in many people."


absolutely true - people forget that our bodies were designed to heal themselves - while obviously it doesn't always work as well as it should, more often than not, if we and the medical profession would get the hell out of the way, things would progress rather nicely !

Happychick said...
Btw guys- I'm starting to see improvement on day 9 of 40mg steroids. Much less blood, a little less pain, stools are starting to form somewhat (but still not what they should be!) and slightly less colon rumbles. Still a way to go before I'm recovered though. I just feel as though this time my colon has taken a battering and will definitely need longer to heal. I had quite a bit of colon rest today too as all I ate was soup and very soft flaky salmon.

Awesome. Glad to hear you are doing better. Stay the course and give it more time.

And soy, lets trade immune systems for a while, and see how well the body heals on it's own. My immune system is pure evil lol. I think everyone here as different disease severity levels, for some with easier cases maybe natural healing is enough. While others of us are completely fooked with out the hardcore medications.

NCOT, yeah pred never brought me into a full healed/remission like state. It did improve me from 20+ bms a day to about 6. Took a full year of remi to finally pound my flare into submission/remission. Wasn't a suddenly woke up better thing either, rather a steady snails pace improvement continuously over a year...

Oh, I've got my shares of bruises, cuts, stiches, even broke a femur once all while doing stupid sh!t as a knuckle-headed guy. Those I healed from but there are most certainly limits to the body's own healing abilities. When my own body attacks me, I don't trust said body to heal itself on it's own. I even gave it ample time to heal if it wanted to, no dice.

All prednisone is not created equally. We all use generic prednisone and there are many makers. I had the same problem earlier this summer and I kept telling my doctor it wasn't working. I mean you know the awful side effects you get when you are on that much. I didn't have any side effects on 40mg. I was sleeping like a baby for one .Normaly I would be up all night. Finally transferd my script after I researched a couple of different pharmacies and found some prednisone by a different manufacturer. It clearly worked differently. Just something to consider.