Is prednisolone still classed as immunosuppressant at 8mg
Posted , 16 users are following.
Obviously, prednisolone is an immunosuppressant and people who are immunosuppressed are classed as 'vulnerable' as far as covid 19 is concerned. My question is, does the dose make a big difference? I am a health care worker and currently have reached 8mg, almost at 7.5, using dsns. I only work 2 days a week but am planning to continue doing so. I wonder if I should be staying at home - I just don't like to let others down. 8 mgs is almost the same as my body would produce so maybe I am not immunosuppressed??? Any thoughts please?
0 likes, 15 replies
TheRaven lbh
Edited
I've read so many posts lately that I can't give the exact details of what I read, but in the last couple days I saw that a highly-placed rheumy in England spoke of 10 mg as being the dose to be below. Above that and your immune system is compromised, best as I can recall. However, remember that your immune system is already a train wreck from the PMR which is still in you. Your immune system is compromised - it's just a matter of how severely.
Hopefully someone else can respond with better clarity than I have.
Stay safe.
Tinapoly1 lbh
Edited
Yes ,It is an immunosuppressant & I'm down to 4.5mgs.after going down very slowly for 2.5 years. I got the 2 worst flu viruses of my life in Oct. & in early Jan. along with a strange illness that attacked my nerves for 33 days with excruciating ,electrical shock like stabbing pains in my chest,back,& then up in my head & at times it was shocking me every 5 seconds.The E.R.doctor said he had heard of other patients with the same thing but they don't know what it is. When I got the 2 flu viruses my lungs were filling up so fast that I thought I was going to drown & the antibiotics worked for only a few days at the end of the week that I was on them & the infection in my lungs came back within 2 to 3 days both times & lasted for 2 months each.I was on 4 other medications during this time also. I got several skin cancers burned off my arms & one on my leg last year & they all got so infected which isn't the norm for my arms. My rheumatologist & primary dr. both said that even though I'm down to 4.5mgs that I have little immune system left . SO SCARY ! Iwould never survive the corona virus since I thought I wasn't going to make it with 2 regular flu viruses that almost took me out & corona covid 19 is 10 times stronger. Best wishes ! Tina
rocketman42 Tinapoly1
Edited
How do you know you didn't have COVID-19 instead of what your calling the "regular flu" ? It was about that time that it started and the way you are describing it there certainly is the possibility that you had it then.
Only way to know for sure is to be tested to see if you have the antibodies for it.
Boone Tinapoly1
Posted
Jeez, don't you get flu shots? As Rocket says, that one in January could have been Covid19!
Sounds similar to what my dad was experiencing when he had shingles.
I don't know if it would have helped, but there is also a vaccine for pneumonia now, too.
Take care!
Tinapoly1 rocketman42
Posted
The 2 flu viruses that I got were in late Oct. & the 1 week in January . I think it was around New Years Eve that it was 1st announced to the World that there was a virus killing people in China. I stay home most of the time unless it's to my doctors offices. It wasn't in the U.S. or most other countries at that time. I did get the flu shot in early January since I thought I was finally over the Oct. flu but that night my granddaughters came over with a runny nose,& sore throat which I told my daughter to never so that to me again since I think the combo of the flu shot that day, where you can not take it if you are ill, & my granddaughters giving me their fresh colds on top of the flu shot that made me so sick. As far as Shingles with that 33 day illness with the worst stabbing pains , it was on both sides of my chest ,back,& then up to my head . Shingles always attacks only one side of the body.
Boone Tinapoly1
Posted
Yeah, I've gotten slightly ill after a flu shot. Fortunately, it usually lasts only a day...
EileenH lbh
Posted
The official advice from rheumatologists is that above 10mg/day is high risk, PMR itself is is increased risk if you were to develop Covid19. Do you have any other comorbidities? And where do you work? They are both significant factors.
In some regions they are looking for nurses and doctors to staff the Hub to support 111. It is probably something to discuss with your manager and find out if there is a role that keeps you well away from the front-line. But it is difficult isn't it - one of my daughters has had her "highly vulnerable" message so should be isolating despite working in the ED. Haven't heard from the other but she must be the same with asthma - but she is in Scotland so I don't know if she gets the same consideration. OTOH - there will be a role for you all once this is over to replace exhausted staff.
patricia43291 lbh
Posted
Ibh, I wouldn't worry about letting others down. Just don't let yourself down by going to work. Stay home!
barrie62598 lbh
Edited
There is so much they don’t know about the medications they prescribe and a lot more they don’t tell us. I went from 15mls down to zero of PREDNISONE and PREDNISOLONE. I got conflicting answers on the difference between the two and why rheumatologist and GP kept changing from one to the other and back. With the Covid-19 now I wonder if the PMR or medication has affected my immune system now both have ceased. I am a 77 y/o male with Type2 diabetes, elevated BP and long-term congestion issues. My daily medications include twice the standard dose of Lercanidipine (Zanidip) = 20mg I received advice from a GP that BP medications especially Lercanidipine act as a receptor for Covid-19 and substantially increase the risk of infection. My GP has received no advice in this regard. The disparity between Corona’s severity between age groups could have more to do with our medications than just our age. We don’t know how any of our medications affect our immune system now or down the track. Our individual system is a work in progress for each of us. Covid-19 once in our system will likely leave an immunity against re-infection but possibly for a short time. Like the common cold it could keep happening with these more serious ramifications.
I took Duodart, with a possible PCa risk and ended up with severe prostate cancer. Am now on Trulicity (dulaglutide)with a possible thyroid cancer risk and Lercanidipine with a possible increased risk of Covid-19 infection. The PMR is likely still an issue as could be the Preds I took back then for it. All my medications have a list of side-effects as long as my arm. It’s a difficult path we follow with so much unknown or withheld information but we just have to go along with it and hope.
Barrie
Boone barrie62598
Posted
That seems to be the case with PMR itself. They don't know the cause! It's hard to treat something when you don't know what's causing it.
Hoping for the best, Barrie!
EileenH barrie62598
Posted
The doses are equivalent so it shouldn't have made much difference switching from one to the other.
Personally I would be doubtful that anyone has any evidence that any particular BP medication acts as a receptor for Covid, it is far too new - it also seems a very dodgy theory.
What is fairly certain is that your PMR plus diabetes and raised BP and age would increase risks but if you are no longer on pred that improves the risk of contracting CV in the first place. But the other risk factors do require you should self-isolate and are consistent about avoiding other people. Your age and comorbidities will make management more difficult if you were to get it. So you should be concentrating on avoiding contracting Covid 19
Michdonn EileenH
Edited
EileenH, I think you are 100% correct, practice avoiding Covid-19 is the intelligent thing to do. 🙂
barrie62598 Boone
Posted
Yes! PMR is so mysterious yet they prescribe immune suppressing treatment and now there’s covid-19 and our already declining, with just age, immunity. Post Radical Prostatectomy + complications it took almost a year for new symptoms to result in Rheumatologist referral. Two visits to the first one and another 2 to the second. Cost a bit and the second replied to GP with “I agree that he most likely has polymyalgia rheumatica. Not too encouraging. My bloodwork was ESR/CRPs were Aug’2009 36/9.9Nov’2016 54/18.8Dec’2017 34/41.5.My initial diagnosis was 12 December 2017. Pathology was probably low in comparisons.
Preds went from 15mg 12/12/2017 to 0.5mg 1/4/2019 to 21/04/2019 and seemingly cure. My muscle pain had initially been lower back (either side of spine) then later hands, glutes and minor knees+shoulder where I already had joint issues. I believe shoulders are the main source for diagnosis which likely led to the protracted PMR decision. The only comparisons I had were from the internet with ESR of 88 and CRP of 242. I have no way of knowing if I even had PMR. During investigation into the initial back problem they discovered a minor crack in spine and inactivity was prescribed for cure. The lack of exercise exacerbated the issue and heated pool exercising and pilates formed a good part of the recovery. During covid-19 isolation, for the second time in my life, I became aware of the muscle structure of the glutes which again begun to cramp and I now make a point of exercising. I always knew old age would have its problems and I have already exceeded my father’s lifespan by a decade but this virus on top of all the rest seems so unfair. Our 20 year olds (Australia) are still partying and we’re locked in if we want to survive at all.
Barrie
EileenH barrie62598
Posted
If your 20-30s are still partying you have a problem: the general opinion here is that it is that age-group who are the problem. They are infected, not displaying significant symptoms or any at all and spreading it all round their peers. Who go home and infect the rest of their family...
Pred isn't used in PMR as an immunosuppressant - it is being used for its anti-inflammatory properties and then adjusted to the lowest effective dose which is often low enough to no longer be immunosuppressant. Tocilizumab is used for its specific action on the production of IL-6, the cytokine that causes the inflammation.
Boone
Posted
I should clarify. Of course, we do have a treatment. It treats the symptoms and not the (unknown) cause, but certainly it's better than nothing!