Night Dose Prednisone
Posted , 6 users are following.
After a suggestion by Nick to help control my blood sugar, I'm migrating my prednisone dose from my usual 7:30AM dose of 10 MG to taking the entire thing at night. Prednisone elevates blood sugar somewhat, but the worst thing it does is impede muscles and organs from taking up excess sugar. So the plan is to take my 10 MG at night at say, 10:30 PM, and then by approximately 9 AM the following morning the bulk of the effect will be over with, and controlling my blood sugar during the day could become a trivial thing.
Issues: Possibly even more difficulty sleeping at night, and what if it stimulates the liver to produce yet more sugar during the night? I'm also concerned that while I'm moving about I might get a lesser amount of protection from the pred given that I took it the previous night before. If it works, and side effects are minimal, I can control my blood sugar more easily, and have a more normal life.
To try this out, I'm moving my dose 1 hour earlier each night. Tonight I'll be woken at 4 AM for my dose. At this rate it will take me 6 nights more to get to 10:30 PM at night. I could have staggered the dose in the other direction, but as you'll see below I'm starting in on a nice and slow DSNS to 9 MG, and thought under the circumstances that a sooner and stronger dose while I'm moving the time is better than a longer an weaker dose.
So as I've said, I've also started a DSNS reduction from 10 to 9 MG, and I'm using exactly the one posted online here, so lowering 1 mg is going to take more than a month. Hopefully slow and sure wins the race.
Mark
A Harmless Drudge
0 likes, 16 replies
nick67069 mark9992
Posted
Mark, good luck with experiment. As you probably know, cytokines peak in a body is about 4-4:30AM and 9AM... so ideal time to take prednisone ( uncoated) is 2-4 hours before the first peak. Since your time adjustment is going "thru the night" time, you may want to try 12-1AM as a target.
Just a side note, when I switched to split dose, I have noticed that my body seems to use prednisone more efficently so I could lower my dose another notch ( in my case was 12.5 --> 10mg).
mark9992 nick67069
Posted
Hey Nick, although I've been studying this for awhile, I know bugger all about cytokines. Midnight could be a good compromise if there's an advantage, but I don't usually stay up that late. It could be done though.
mark9992 nick67069
Posted
lodgerUK_NE mark9992
Posted
Cytokines, Inflammation and Pain - NCBI - National Institutes of Health
worth putting in search engine and reading up on.
Bowen Therapy helps to break them up for many people with PMR and a whole load of other ailments and it seems to work It got me out of a wheelchair, stopped using zimmer frame and then walking stick.
There is a thread on here discussing Bowen, put the 'Bowen Therapy' in the search box top right hand corner.
One thing, the Bowen Therapist will tell you after three one hour sessions (one a week for three weeks) and you will know also, whether it works for you or not.
lodgerUK_NE mark9992
Posted
on the 1 October 2010
Lodotra is a modified-release preparation of prednisone licensed for the treatment of moderate to severe active rheumatoid arthritis (RA), particularly with morning stiffness.
It is not currently licensend for use for PMR, so I am given to understand. Use you search engine to read up about it.
ptolemy lodgerUK_NE
Posted
lodgerUK_NE mark9992
Posted
Mark
I suggest a chat with your friendly pharmacist.
This does not mean you don't try it out, but running your idea past someone who knows drugs like the back of their hand is always worth 15 minutes of your time and they never ever mind.
I depended on Lara (who worked at my little local Boots) all the time I had GCA. I was sorry when she left - but the next person is equally helpful and always makes time to talk.
mark9992 lodgerUK_NE
Posted
Friendly pharmacist...in the U.S.? I suppose its theoretically possible, but most of them are a couple of bricks short of a load.
I took my dose at 4 AM and immediately measured at 98. Come 9 AM I knew I was in the middle of a peak, and sure enough I was at 132. These are all US measurements, but suffice to say normal fast is under 100 (well under if you ask me) and post prandials should be 120 or less, although anything under 140 is considered to be non damaging.
Why 132 when I hadn't eaten? Because I had eaten: prednisone. Its like a big long meal. As soon as I get to my midnight dose, I should be able to have good control during the day...works in theory.
mark9992
Posted
Today turned out to be quite an ugly show sugar wise. I'm afraid Midnight isn't going to work. In the AM I've got a huge dose of pred and morning affect, so that if I so much as have a single morsel of any food sends my sugar thru the roof. OTOH, 12 hours after my 4 am dose (and a 40 minute walk) my sugar is back in the normal range. 10:30 PM will let me have breakfast by 9:30, exercise 40 minutes and I should be able to keep my sugar under the instant stroke level. So my cytokines are going to have to get a bit of short shrift. If fact its clear that for my own good I'm going to have to accellerate my push back to the evening, so 2 AM tonight, midnight thurs, and then friday night is my first 10:30. Wish me luck, this has been a bumpy ride.
Anhaga mark9992
Posted
Can't remember, have you tried splitting the dose? Would that make things better or worse?
I doubt if the time shift will be any worse than what people experience when they fly across a few time zones, and most of us can cope with that fairly easily.
Good luck!
mark9992 Anhaga
Posted
The reason I haven't considered splitting the dose is that the idea is to get the relief of prednisone in the night time, and the prickly sugar spike isolated while I'm sleeping, because pred doesn't raise my sugar to dangerous levels unless I do something foolish like eat something...anything. So, let pred have the sleep period, and my sugar should be easier to control in the daytime. Will it work? Turn the page.
Anhaga mark9992
Posted
Just wondered if your sugar spike was dose dependent and it might not be so drastic if more spread out. Curious really, I'm sure you've been trying everything!
nick67069 mark9992
Posted
Mark, maybe you are one of the guys that takes longer for prednisone to peak ( closer to 4 hr), so just maybe you will see better results when you take pred before midnight.
What Anhaga suggests about sugar spike being related to dose makes sense to me. Not to spoil this experiment, but keep in mind that spliting dose may work as well... The good thing about PMR, it last so long you will have plenty of time to experiment
.
As I mentioned before, I take half late at night ( after midnight) and half first thing in the morning. The idea being that I try to "hit" both cytokines peaks with pred. As you probably read by now, they are the reason for muscle pain.
mark9992 nick67069
Posted
The reason split dose will be a last resort with me is that to the extent I split dose, I'll simply have twin sugar peaks instead of one. Also, it seems to me that from what you've said, a dose at 10:30 will be closer to the cytokine's peak that my initial dosing at 7:30 AM. right now I'm going through a bit of havoc, but I'm planning to wind the thing up by Friday and then giving it a week of trials. If it doesn't work, then I'll think again because as you say PMR won't be going anywhere for awhile! Also, as disasterous as the AM has been, its been interesting to watch my blood sugar act almost normal in the evening. If I can back up the dose so I don't combine morning effect with prednisone peak, this could work!
mark
lodgerUK_NE mark9992
Posted
Anhaga mark9992
Posted
You sound like the sort of person who will be keeping written track of this, so I hope you are, and can do a little write up once you've found the sweet (or hopefully in your case not sweet) spot.