Has anyone been told to maintain a consistent morning diet?

Posted , 8 users are following.

Since an "appreciable" portion of pred is excreted in the urine as well as the bowels, the implication is that PMR-GCA suffers need to maintain a consistent morning diet before they take their pred.

What happens if one morning I have eggs, bacon and a sweet roll and the next morning I just have a cup of coffee and a muffin? I believe that this will affect the amount of pred that was absorbed into the blood or excreted by the bowls. The eggs and etc. would mean that less pred would enter the blood stream. It seems to me that the lower the dose of pred one is on would make maintaining a pre-pred diet even more important!

Prednisone is readily absorbed from the gastrointestinal tract... The preconversion biological half-life of prednisone is about 60 minutes. Prednisolone is excreted in the urine as free and conjugated metabolites together with an appreciable proportion of unchanged prednisolone. Prednisolone has a usual plasma half-life of 2 to 4 hours

0 likes, 15 replies

15 Replies

  • Posted

    thats one thing my mum taught me ,,, to not mix medication , and always take meds on a full stomach , even panamax , ,,but then i dont like pills of anysort lol im hopeing i cam get off this prednisone this year , ,i keep all my blood test print outs , ,, for instance , i vary my breakfast to my liking , sometime i have a porrige , then a slice of toast , , this morning i had a poached egg on 1 slice of toast , that is before i take 1/2 mg prednisone and my bp tab , then i have my (super juice ) lol my blender is my friend ,lol 1 small handful baby spinich leaves , grated carrot , 1 granny smith apple ,1 pear ,1 kiwi fruit , and 1 can cocoanut milk , and 1 can water , , some time i have almond milk what ever is cheapest , , in 1 glass i mix in 1 teaspoon of wheet grass pdr , ,, tastes good , but looks green lol but i need to make myself drink more water , , hows that ,lol
  • Posted

    Nanna, Thank You! The reason I asked this question is to determine if the SAME pre-pred breakfast should be consumed rather than switching. I consume an English muffin with butter and a cup of coffee along with my pill. Approximately 3 hrs later I now have "breakfast". I believe that this will allow the same dose of pred to enter the blood stream each morning. I will ask my rhumatoligist at my next appointment in three weeks because we have not discussed anything like this yet. I also hate ANY pills but these are better than going blind...

  • Posted

    This is the first time I've heard of it. The instructions on my packet are 'Take with or just after food or a meal'. Now I know why. Fortunately, breakfast is the only time of day that I'm hungry, but my instructions do not even specify which meal, or how much food, never mind consistency. I do take them in the morning though. Thanks for this interesting information.
  • Posted

    As long as it is food it doesn't matter - it is to stop the pred irritating your stomach. Pred is excreted via the kidneys, what your gut is doing is immaterial.

    There are some medications which MUST be taken on an empty stomach so if you are told to take something without food - DON'T TAKE IT WITH FOOD.

    In PMR All your dose of pred should be taken as early in the morning as possible as a single dose. This gives the best results and improves the side effects.

    cc - stop obsessing! Relax and take your pills in the morning with any sort of breakfast and then work out how much you can manage to do!

  • Posted

    The general idea is to take prednisolone with food, any food which will line the stomach and help to prevent the prednisolone irritating the stomach. That is the sole reason behind any pill marked 'take with or after food.

    I have only two meds which need to be taken on an empty stomach and I take quite a selection of meds.

    When I've compared breakfast food with others there does seem to be a link between us in that the foods of choice mentioned - porridge, muesli, yoghourt, fruit, nuts, honey, go across the board.

    Hope this helps.

  • Posted

    Gosh. I never knew this either.

    I always take my meds after breakfast, which is quite lean, since I'd rather not eat at all in the morning - just a bowl of muesli with walnuts and coconut milk and a fresh fruit salad. I have a coffee an hour or so later.

  • Posted

    I read all blogs but haven't blogged myself for ages but was interested to know if It really is hampering my recovery from PMR by taking my pred after supper.

    I would like to know, although I may have mentioned it in the past, people's opinion on taking in the evening.

    If I were to try and change to mornings how would I do it?

    I am stuck on 5 mgs having tried unsuccessfully to reduce 4 times over the last 5 months.

    Glad to see Eileen H is still around with her ever valuable advice!

    DJ

  • Posted

    Hello all

    It doesn't matter what you eat before taking the Prednisolone (or Prednisone)......just EAT. If you include 'live' yoghurt and Manuka honey, all the better - the 'live' yoghurt will help line/protect the tummy and the Manuka honey can help boost our immune systems and help with esophagus problems etc.

    cc23145 - Coffee, like sugar, can stress the adrenal glands, which are already being suppressed by the high dose steroids, so if you can reduce or cut down your intake that may help, especially at the lower doses when those glands will be needing/trying to get up to speed again and produce their pre-steroid supply (cortisol) as the artificial steroid is taken away.

  • Posted

    Sorry - Should read "reduce or cut out your intake".
  • Posted

    No DJ, although it is generally recommended to take all the Pred in one go first thing in the morning (with/following breakfast!), if you have managed to reduce successfully down as far as 5mg, it is probably not "hampering your recovery".

    The 5mg dose can be a sticking point for many people and, if you aren't already doing it, and provided you feel well at 5mg, it can help to remain on that dose for many months (it was 5-6 months for me), and then try reducing in just 0.5mg decrements, tapering on just one day of the first week, two of the second, three of the third etc. It took me about 7 weeks to go from one dose to the next, so a snail's pace, but it eventually got me off Pred. Some people can manage 1mg at a time, but after several years on steroids for both PMR and GCA, and a severe flare at 5mgs, I wasn't taking any chances at 5mg the second time around!

    Don't worry about the length of time on 5mgs - there are unlikely to be side effects from this dose.

  • Posted

    Thanks for this input, Mrs O. I do know coffee stresses the adrenals, but I'm afraid I'm an addict for one cup a day (I did cut down!).

    I add a pinch (literally) of baking soda to make it more alkaline.

    You probably should have added alcohol to that list of sugar and coffee.

    DJ, the mornings are largely recommended for your preds as I understand you benefit more in the mornings.

  • Posted

    Light

    []"You probably should have added alcohol to that list of sugar and coffee."[/B]

    What, and make myself even more unpopular with those who are already baulking at the suggestion to cut down on coffee?!!!!! lol

  • Posted

    These are the directions for prednisone that I pulled off of the Prednisone data sheet. No coffee will be a killer for me. I will taper from a Venti to a tall over two months and then only drink 1 cup of home brewed. I will moved to the recommendation to take pills before 9 am. I will not obsess, I will not obsess, I will not ,,, I will, I ...lack off concentration is a side effect..

    Adults: The initial dose is 5mg to 80mg daily depending on the condition being treated, as a single dose after breakfast, as divided doses, or as a double dose on alternate days. The maintenance dose is usually 5mg to 20mg daily. The dose should be individualised according to the severity.

    Children: For children up to 18 months of age, dosage has not been established. For children over 18 months, initial dosage is 0.5mg/kg daily, this dosage can be doubled or trebled if necessary, continued until definitive remission occurs. Maintenance dose 0.125 to 0.25mg/kg daily.

    A single daily dose is preferable over divided doses, to reduce the likelihood of adrenal suppression. The dose should be taken prior to 9am, to closely mimic the body's own maximum corticosteriod secretion. Giving the dose, usually double pre-determined daily dose, on alternate mornings may also reduce the suppression of the HPA axis. This regimen is not recommended for treatment of haematologic disorders, malignancies, ulcerative colitis, or severe conditions.

  • Posted

    Thank you Eileen! You do hold this forum together. If my rhumatoligist disagrees with the quantity or amount I will update this note.

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