How long to stay at 15 mg
Posted , 10 users are following.
Hi,
Hope you are all as well as you can be.
I could do with some advise, diagnosed May 16, increased and decreased over the months.
I had got down to 10mg, the death of my father recently had my symptoms through the roof.
I was advised to increase to 15mg which I have done for 3weeks.
I am concerned this may be dangerous and when should I reduce.
The Dr will say reduce to 12.5 having done that before not inclined and to do that again.
Any advise would be appreciated.
Julia
1 like, 32 replies
lilian05079 julia85224
Posted
Perhaps you should stay on 15mg for the month. Since you reduced to 10mg before the death of your father.,,(my heartfelt condolences to you).....reduce to 10mg again. If your pain is managed ok at that dose then stay on 10mg for a month..but do consult with your doc or rheumy first before reducing further.....my best wishes to you.....
julia85224 lilian05079
Posted
Thank you for your kind words and advise.
I think for the moment I will stay at 15mg, due to see new rhematologist Dec 8th.
Hope you are well.
Poupe julia85224
Posted
Rimmy julia85224
Posted
Hi Julia
Sorry to hear about the recent loss of your father - it is no wonder you have had a flare. Don't worry too much that 15 mg is a 'dangerous' dose though - it is only a temporary place for you to be - but probably wise for you to sit on it a little longer as grief can really take a toll. Anyway considering you were diagnosed less than a year ago the fact you were already at 10 mg is a fairly fast taper (I think) - especially in the greater scheme of things which is about having to take Pred for at the very least another year or two - and often much much longer. Given that -why not taper down a little more slowly this time from the 15 mg - maybe in 1 mg decreases to be sure of controlling the inflammation. - and to be able to best 'pinpoint' about when it might rear up again. This after all IS the way to use Pred - to find that place where it best keeps the inflammation at bay at the lowest possible dose. I think many medicos STILL aren't very aware that fast tapering is often counterproductive and can in the long run result in a bigger cumulative dose which - it has been argued might be a more relevant marker.
Condolences and best wishes to you
julia85224 Rimmy
Posted
Hi, Rimmy,
Thank you for yours kind words.
Plan to stay on this dose until see new rhematologist early Dec, the last one said I hadn't reduced quickly enought.
Needless to say I won't be seeing him again.
Hope you are well.
Anhaga julia85224
Posted
I'm so sorry for your loss.
First off, I don't think 15 mg pred is likely to be dangerous. You can safely stay on it until your pain is as good as it was before your flare. If the symptoms have subsided I recommend a slow taper. Only you will know if your symptoms are being properly controlled. But if you had trouble with a 2.5 mg drop before (it is more than 10% of 15) then you may find the same thing happens this time so 1 mg is probably a better amount.
julia85224 Anhaga
Posted
Hi Anhaga,
Thank you for kind words.
I will stay on this dose until I see new rhematologist.
I am concerned 're higher dose as I have osteoporosis in back and hips and didn't want to make it worse.
Also at least with this dose of pred I am mobile, and try to keep busy.
Take care.
Anhaga julia85224
Posted
I hear your concern, having experienced some of the invisible side effects of pred when first starting. How are you "managing" your OP? If you haven't started taking a vitamin K2 supplement yet I do advise you to look into it. I had a DXA scan several months after starting pred (so no pre-treatment baseline unfortunately) and was diagnosed with osteopenia. Taking supplements, trying to eat right, and get as much appropriate exercise as I can manage has actually improved my t-score.
julia85224 Anhaga
Posted
Hi,
I often see you comments on the osteoporosis site.
I refused the acid tabs ( can't spell, then they suggested an infusion, that was a definite no no.
I am not managing it really I asked my Dr for vitamin K2 after reading you're posts and he said I didn't need it.
So trying to eat a reasonable diet, head in the sand and hope it won't get worse.
Dex scan was back L1-4 -3.7
Hips -2.9.
I do take a lot of pain killers.
Take care
Anhaga julia85224
Posted
Thing about Vitamin K2 is information about it hasn't filtered through to the medical practitioners. The only rheumatologist I've encountered told me when I asked at the workshop I was attending that four studies had shown Vitamin K doesn't work. I checked internet when I got home and indeed found four studies which, however, didn't seem to differentiate between K1 and K2. There were other studies, however, which do show K2 is effective. Even my daughter, a registered dietitian of fairly recent vintage, was unaware of K2 until I told her about it and she was interested enough to ask me about it and get the book I recommended. If you google the words vitamin K2 calcium kate you should find it. Japanese researchers have studied the effects of K2 and are convinced, through their research, that it is protective against osteoporosis.
Western diet severely deficient in Vitamin K2 nowadays.
julia85224 Anhaga
Posted
lilian05079 julia85224
Posted
If you eat 2 portions of fresh green leafy veggies,natto-fermented soy, spring onions, brussel sprouts, cabbage, romaine lettuce, fermented dairy such as edam cheese et al, prunes, cucumber and dried basil all of which contain vit K2 and this will provide a daily intake of K2..if we follow this regime daily we will not need K2 supplements.....my wishes to you julia85224 and bon appetite....
Michdonn Anhaga
Posted
Anhaga, I agree and have been taking it since the spring. 🙂
julia85224 lilian05079
Posted
Many thanks,
I will certainly get the food cupboard stocked up.
EileenH lilian05079
Posted
I'm quite surprised at your list as most of them are high in vit K1 - not the same at all:
"Vitamin K was initially discovered as a nutrient involved in blood clotting. There are two forms, K1 (plants) and K2 (animal foods). ...
... Humans can partly convert vitamin K1 to K2 in the body. This is useful because the amount of vitamin K1 in a typical diet is ten times that of vitamin K2.
However, current evidence indicates that the conversion process is inefficient, because we benefit much more from eating vitamin K2 directly.
Vitamin K2 is also produced by gut bacteria in the large intestine, and there is some evidence that broad-spectrum antibiotics can contribute to K2 deficiency (27, 28).
Unfortunately, the average intake of this important nutrient is incredibly low in the modern diet.
Vitamin K2 is mainly found in certain animal foods and fermented foods, which most people don't eat much of.
Rich animal sources include high-fat dairy products from grass-fed cows, liver and other organs, as well as egg yolks (29).
Vitamin K is fat-soluble, which means low-fat and lean animal products don't contain much of it.
Animal foods contain the MK-4 subtype, while fermented foods like sauerkraut, natto and miso contain more of the longer subtypes, MK-5 to MK-14 (30)."
and
"Food sources of vitamin K2 vary by subtype.
One subtype, MK-4, is found in some animal products and is the only form not produced by bacteria. Chicken, egg yolks and butter are good sources of MK-4.
MK-5 through MK-15 are forms of vitamin K2 with longer side chains. They are produced by bacteria and often found in fermented foods.
Natto, a popular Japanese dish made from fermented soybeans, is particularly high in MK-7.
Certain hard and soft cheeses are also good sources of vitamin K2, in the form of MK-8 and MK-9. Additionally, a recent study discovered several pork products contain vitamin K2 as MK-10 and MK-11 (4).
The vitamin K2 content for 3.5 ounces (100 grams) of several foods is listed below (4, 5, 6).
Natto: 1,062 mcg
Pork sausage: 383 mcg
Hard cheeses: 76 mcg
Pork chop (with bone): 75 mcg
Chicken (leg/thigh): 60 mcg
Soft cheeses: 57 mcg
Egg yolk: 32 mcg"