Weight lifting with PMR to minimize muscle loss

As I understand it - even if you are a competitive athlete/body builder eating too much protein will achieve what you don't want:  building flab as you gain weight. That amount of protein is also pretty risky for good renal function - and however much I might want nice abs, I'd far rather have healthy kidneys!

More than a needed amount of protein also tends to elevate insulin levels, and usually that's not good either.

A lot has been written about the need to balance one's dietary proportions of fat, protein and carbohydrate. Weight lifters who actually experience a lot of muscle tissue breakdown during efforts that are continued to the point of muscular contraction failure can utilize a higher protein intake, and for the rest of us there are benefits to higher protein intake only in proportion to how much muscle repair is needed after hard work or exercise. Aerobic exercise doesn't much increrase one's protein requirement, though protein can be a useful source of fuel/calories during extended endurance activities.

I had wondered how high of a dose of pred that it takes to noticeably impair muscle development in response to training efforts.

"Weight lifters who actually experience a lot of muscle tissue breakdown during efforts that are continued to the point of muscular contraction failure can utilize a higher protein intake, and for the rest of us there are benefits to higher protein intake only in proportion to how much muscle repair is needed after hard work or exercise."

But you can't do that in PMR - because if you do you are at a massive risk of those muscles not repairing at all or taking months which has been known. Part of the problem in PMR is that the muscle tissue is unable to repair itself in the same way as normal. It isn't a risk I'd want to take if I was really so keen on that particular activity. 

never mind about protein intake, prednisone blocks muscle repair (rebuilding) in particular to fast twitch muscle (which you mobilize for maximal effort). If the "body building" is intense enough it will accelerate muscle loss.  On the other side, endurance exercise mobilizes slow twitch muscle and counters the effect of prednisone blocking the muscle rebuilding. This is the only kind of exercise that we can do ( with PMR) while on prednisone.

If I consume only 100 g of protein daily, I lose about a pound a day. In addition, I periodically lose muscle mass in a specific area - for example, I lost almost 1 inch in my right arm in one week.  Pain is almost totally under control (except for "normal" old age pains), but ongoing muscle loss is my problem. I am on 15mg of Pred at this point. How long/far are your riding each day, how much Pred, and have you stopped losing muscle? Did you ever have rapid, significant muscle loss?

Shelley, I try to ride 20-30 miles per day, but average only 20 miles due to busy days or bad weather.  In the winter it might be a little less, but I will jog 2-4 miles a couple of times a week in addition to cycling.

I lost 15 pounds of both muscle and fat during the first four months that was mostly unmedicated.  I went from 155 lbs to just under 140lbs and have stayed there to this day, after three full years with pmr, even as I rebuilt at least half of my lost muscle.

I tapered within the first few months of pred from 15mg to 10mg, during which I got most of my strength back and could exercise with great intensity on the bike.  I took a little time off due to local forest fires and resulting air quality, which was enough time for my symptoms to return as I tapered from 10mg to 5mg over the next five months. I should not have tapered so fast at that point, just followed doctor's orders, so I ended up stuck at 5mg for the following 12 months.

After that 12 months, I again reduced, this time to 3.5mg over a very short time, which correlated to an increase in my regular daily bike riding. I again relapsed to 5mg after the winter weather curtailed my exercise by 50%, and othen reduced again after six months at 5mg (this time down to 2mg, then up to 2.5mg). I am alternating between 2 and 2.5mg after a few months at 2.5mg, doing well but still experiencing limited range of motion in my shoulders.

I will say that in my case, I was able to build muscle/strength while at 10mg/day for my 138lb mass, so the ability of pred to block muscle gain and repair is not much of an issue at that dosage level. I have aged from 53 to 56 in the same time period so I may never have all of the muscle that I once had, though I haven't really put much effort into this other than to maintain the strength to do a set of pull-ups.

I find it very interesting that I can do many strength-building efforts with no aggravation to my pmr symptoms, while lifting weighted things over-head is still not possible. I can do a lot of exercises and urge others to experiment and really keep track of what does and doesn't aggravate their pmr condition.  I advise to be imaginative in coming up with exercises that are still possible in their present condition, as some exercises seem to go extremely well. Patients who were non-exercisers before pmr will probably have more trouble with this than those who routinely exercised before having pmr, so a strong will and enthusiasm need to be cultivated toward building muscle strength and getting aerobic/anaerobic exercise, starting slowly. For example, my shoulders also still don't like doing push-ups, but I did figure out that I can lean forward and push against the kitchen counter to simulate the muscle effort of real push-ups. So I do several sets of 30 such push-offs when I am feeling energetic, especially when the weather is bad. Oh, and I cushion my palms with sponges, forgot to mention that!

Dan, thanks - really good info. BTW, even though my name is Shelley, I am a guy, 73, extremely active. I am still at the 15mg level of Pred, but the tapering has not created issues so far. Your reply definitely gives me hope and some things to try.  It is encouraging to know that you started to rebuild mass at the 10mg level. I recently returned to my Skier's Edge trainer to get ready for a ski trip, and do not seem to be losing any more muscle in my legs, which is also encouraging. I am going to try your push-up idea. Thanks for the info and for giving me a better attitude about the future!

Dan, this question goes WAY back. I am now off of Pred (2 months), but cannot regain muscle, and may still be losing some in my upper arms. My reflexes are terrible. My body fat is at rock bottom.  Obviously you are an active guy and I am curious about a couple of things, assuming you are in the U.S.     Have you tried PRESCRIPTION GH or  GH stimulator or any PRESCRIPTION anabolic steroid to rebuild the lost muscle?  I am absolutely talking LEGAL prescriptions and NOT over the internet. This question is for Dan only please, unless you have actual experience with the items mentioned.