What to eat in the early hours when taking Prednisolone

Posted , 13 users are following.

Hello to all of you who take your daily dose of steroids in the early hours of the morning. My question is this, what do you eat before hand and why is it necessary to take steroids with food? I usually take my daily dose, currently 6mg, somewhere between 8am and 9.30am but because my whole body aches such a lot within an hour of getting up and I feel so physically exhausted until around 2pm, sometimes longer, I wondered if taking the steroids around 4am when I usually have to get up for th loo, would help. I tried this last night with a few dry crackers and managed to go back to sleep until 7.45. I don't feel quite so tired today but the aches are still there although not so bad.. Maybe they are not PMR related. Any advice

welcome. Thank you.

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  • Posted

    Hi Fran,

    I usually get up around 5 am and the first thing I do is take my Prednisone with some apple sauce that I keep in a fridge in my bathroom. It is easy to take and seems to work in terms of preventing stomach irritation from the meds.

    Also seems like the earlier I take the meds ( to coincide with when natural cortisol production is highest ) the better. 

    Good luck.

  • Posted

    I take my meds at 8 AM because I work graveyard shift with a cracker and that works very well for me .. and I'm able to go to sleep , but apple sauce sounds very good so I think I'm going to try the applesauce instead of a cracker for a while hope this helps you ..

  • Posted

    The reason for taking steroids with food is to reduce the irritation to the stomach lining which some people find a problem.

    The earlier you take the pred in the morning the better - a new batch of inflammatory substances is shed in the body every morning about 4.30am. The optimum time to take ordinary plain pred tablets to avoid the morning pain and stiffness was found in a study to be 2am so the blood level has reached its peak by about 4am and is ready and waiting to deal with the inflammation. Many people wake early and take their pred before settling down for another couple of hours - by then the pred has started to work. 

    Pharmacists have suggested that a glass of milk (not skimmed) or a yoghurt is all you need, and probably better than just a cracker. The people I mentioned variously take a sandwich to bed with them or a flask with some milk or a yoghurt (which will not come to harm without being refrigerated between bedtime and early morning, it has live cultures which will just keep working on the yoghurt). If you are worried get a cool bag - but when I was a child we didn't have a refrigerator but we still managed to survive!

    By the way, the pred doesn't help the fatigue - that is part of the autoimmune part of the PMR and must be managed by pacing and resting. There is a link about pacing at the end of this post:

    https://patient.info/forums/discuss/pmr-gca-website-addresses-and-resources-35316

    which has a load of info links about PMR as well as a reduction scheme that works well.

    Your muscles remain intolerant of acute exercise in PMR - overdo things and you will feel achy and unwell and it will take longer than usual to recover. If you pace things are easier.

    And for more about managing fatigue in chronic illness - google the spoon theory by Christina Miseriando.

    • Posted

      Very good advice.. I'm still learning .. I just got diagnosed in November... I'd rather have milk then a cracker, but the cracker was advised by a friend....

      Thank you

    • Posted

      I know - lots of people think a cracker is the thing to use when medication should be taken with food! The thought of eating a dry cracker before breakfast doesn't appeal to me at all! The milk/yoghurt lines your stomach instantly unlike the cracker.

    • Posted

      Hi Eileen, I'm veggie and don't drink cows' milk. Do you think a glass of coconut milk would be OK? Not the thin watery stuff as in a coconut but the cows' milk alternative. That would be easier than eating yoghurt. Thanks Sarah

    • Posted

      It does have a reasonable fat content so I would think so. Do you mean veggie or vegan? Is a sandwich too much to face? That's what some people use.

    • Posted

      Mish-mash, don't drink milk or eat meat but do eat some fish. I don't think I could down a sandwich at 4am and then hope to sleep again! I'll stick with my yoghurt but perhaps get the non low fat one. Also, I do take one Ranitidine (stomach calmer) a day, which should help, as I was anaemic after breast cancer as they had me on Naproxen for joint pain. I am older and wiser now!! 

    • Posted

      I have actually used ordinary pred with nothing at all. If you are on ranitidine it probably is less important. The only yog I use is full fat Greek - that I can eat any time!!!!!
  • Posted

    Fran, as a matter of interest, how were you first thing before you had PMR?

    I've never been a morning person and, three years on from coming out of the PMR tunnel and still no symptoms, I'm still rubbish in the morning so that was one thing that I didn't specially worry about as my pain was pretty well under control.  What I did find and complained about at length, was the over- hyped feeling the Pred. gave me. This was helped when my GP said try taking them at night. ( this would have been around 10.00PM as far as I remember ) Unusual, I believe, but maybe we're all unusual in our own way and have to cautiously experiment

    I took mine with plain live yoghurt. 

    • Posted

      It's so strange how something one person dislikes, another likes.  You didn't like the over-hyped feeling of the prednisone, but I loved it.  I felt stronger and could get onerous tasks done in minutes.  My husband, who is a doctor, describes it as a steroid high.  Unfortunately, as my body adapted to the 20mg of prednisone, it wore off.  I sure got a lot done during the holidays and never felt tired the next day.  

    • Posted

      I'm still waiting to experience a steroid high!!!!

    • Posted

      It does affect everyone differently, but the most important thing is that the  prednisone eliminated your pain.  
    • Posted

      Thanks Betty. Looking back I did sometimes feel very achy first thing in the morning but a couple of paracetamol usually did the trick. Not so now. I will try taking the pred with some yoghurt tonight.

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