Posted , 10 users are following.
As I understand, the body normally produces approximately the equivalent of 7 mg of prednisone daily. Also, taking prednisone suppresses the body's production where the adrenals quit producing any. If someone is taking around 7 mg of prednisone shouldn't there be relatively few side effects since it is really just the same as what a healthy person would have circulating in their systems?
0 likes, 29 replies
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Anhaga gilman
Posted
Ah, but it isn't quite the same. The body produces, as I understand it, a suite of various chemicals, whereas prednisone is just the one, and artificial at that, Imagine a single note sounded on one insturment, then compare that with a symphonic chord! You'll still get the melody, but all the nuances will be lost.
gilman Anhaga
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Sheilamac_Fife Anhaga
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I still don't get it Anhaga, it's the Predisolone that's causing the side effects... Am I being dense? I'm nearly at 5
Sheilamac_Fife Anhaga
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EileenH Anhaga
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Google nadf us secondary adrenal insufficiency for a good explanation. It also underlines the need for a SLOW taper.
EileenH
Posted
PS the body doesn't care whether it is a artificial or not - it isn't that fussy.
Anhaga Sheilamac_Fife
Posted
Apparently prednisone can still interfere with osteoblast (bone) function as low as 2.5 mg. It could be lower, they just haven't researched any lower than that. So if the osteoblasts are being affected, no doubt other things are. In my case I'm feeling a lot weaker physically, and having increasingly disturbing heart palpitations at the low dose of 3. Because I'm not experiencing much PMR pain and have full range of motion, I'm very slowly reducing to 2.5. At this point I think I have to pay attention to things like fatigue and weakness as much as earlier I was paying attention to pain. It's a bit of a catch-22 as I agree it's the pred causing the symptoms, but to wean more quickly would almost certainly make things worse. I know I still have PMR, although seemingly very well controlled, but these other effects are concerning. Earlier I dealt with increased ocular pressure, nearly to glaucoma level, and elevated blood sugar, nearly diabetic, but those side effects went away a while ago, probably as I got to 7 and lower. These other issues are more recent. As Eileen says, I'm older now than when I started this journey, but you wouldn't think that fourteen months on pred at mostly lower levels would have aged me this much. But it has. Perhaps it can be attributed to the fact that my adrenals and the other affected hormone-producing organs have not really kicked in fully yet. It could take years before things are back to whatever my normal should be by then, PMR or no PMR. It really is past time that the causes of all these immune disorders were researched so that we could avoid the powerful treatments. What if it turns out to be something as simple as imbalance in the microbiome coupled with some sort of nutritional deficiency? People suffered with ulcers and milky bland diets for decades before it was discovered that h pylori is responsible for the vast majority of ulcers. Medical history is littered with diseases which eventually were found to have nutrition or "germs" as the cause.
Anhaga EileenH
Posted
Okay, that's interesting. I'm sure I read early on that one of the problems with prednisone is it is just a single thing and the body is much more complex. But I'm sure I could never find that reference again, so bow to your expertise!
So what DOES explain the continuation of side effects at very low levels? I seem to have been completely thrown off kilter.
EileenH Anhaga
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That could be due to all sorts of things - including the PMR itself. I think too that you have a very naive view of medical research and how it is done to obtain valid and meaningful results! "What if it turns out to be something as simple as..." is not anywhere near as simple to study as you think.
Anhaga
Posted
http://www.ncbi.nlm.nih.gov/pubmed/16597193
Mrs_CJ Anhaga
Posted
Anhaga,
Re the last part of your comment, they are now thinking that Crohns is caused by a bacterium in the gut probably acquired in dairy products. There is positive work being done on a treatment. You can read about this by googling Vaccine to treat crippling Crohn's disease developed in London. The last news I read about this was a few months ago.
I am hopeful that if they can find a treatment for some auto immune diseases, like Crohns, it can possibly help others, like our PMR.
Anhaga Mrs_CJ
Posted
Thanks. I'm going to pass that on to a friend of mine with really bad bowel problems who has to have an infusion every couple of months.
Anhaga
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Did you notice that article is dated 2000.
Anhaga
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gillian82551 gilman
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EileenH gillian82551
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It isn't necessary to taper with other illnesses where pred is used. PMR isn't other illnesses...
However - this isn't to do with cortisol - you are still on enough pred to keep you above the point where it is needed. This is the result of reducing in too big a step and very probably to too low a dose to manage the inflammation in your body. Trouble is - your ESR may not rise again while you are on some pred, it doesn't always.
I would be on the look out for a more empathetic doctor.
And I'd possibly seek the advice of a physio, sport massage therapist or Bowen therapist - because it was them who kept me upright with similar problems with PMR that wasn't managed at all with pred. I had myofascial pain syndrome, spasmed muscles were trapping and irritating the sciatic nerve. It is often found alongside PMR. It is worth a try.
faye______00403 gillian82551
Posted
Sorry that you have one of those doctors that doesn't seem to know
a lot about PMR..... I have one of those also. You absolutely have
to taper slowly...as just about everyone on this forum will attest to.
Thankfully for me my doc came around to letting me deal with
the tapering. I get sed rate done and it's always okay but I still
have pain. I'm trying to get down from 20mg a day but having
a difficult time doing so. Keep telling your doc about your pain.
Anhaga gillian82551
Posted
I think, and stand to be corrected, that when you are at 10 the body will not produce the extra cortisol needed to deal with pain caused by your drastic 33% reduction. If it's pred withdrawal it should go away eventually, but you are just as likely to still be needing a slightly higher dose to deal with any residual inflammation you had. The blood markers are a useful tool but they should never override symptoms. I think you haven't been on pred very long, is that right? If you have only been on pred for a few days, up to two weeks, withdrawal shouldn't be much of an issue. Longer than that you need to taper. Returning pain could be the confirmation your doctor is looking for as that's what should, unfortunately, happen if you have active PMR.
Have you been alerted to the dead slow nearly stop reduction plan? Google those words plus healthunlocked and you will find it.
EileenH Anhaga
Posted
At 10 you don't generally need extra cortisol - there is enough corticosteroid circulating to not trigger any production of ACTH and hence cortisol. It is only in the case of severe trauma that your body might need more, not day to day functioning. Returning PMR pain isn't really in that sort of league.
The dead slow reduction is in the replies part of this thread:
https://patient.info/forums/discuss/pmr-gca-website-addresses-and-resources-35316
gillian82551 Anhaga
Posted