Prednisone without side effects?

[UnXmas]

I've been on prednisone for over a couple of weeks now. Started at 50mg, so not a low dose. I was wondering if it's normal to NOT get side effects? I realise some - like the skin problems - may take a little while to come on. But I was looking forward to feeling hunger.

Due to being ill, I need to gain weight. But I don't feel hungry at all. I have delayed gastric emptying. Would this cancel out the hunger-enducing effects of pred? Does it mean there's something else wrong with my hunger-signals or hormones if I don't feel hungry on pred?

I had a tiny bit more trouble sleeping, but no effects on my mood or any other noticable side effects. No water-weight gain/bloating. It's not making my symptoms much better either. For a moment I even wondered if I'd been given a placebo.

Has anyone else experienced this, and does anyone know anything about the mechanisms by which pred is supposed to cause increased appetite?

 

[Jennifer]

You say you started at 50mg. How long were you on 50mg for and what is your current dose? Your posts reads as if you've already begun tapering.

As for the appetite increase I'll have to look it up on the main cause but I know its listed as a "possible" side effect. I don't believe everyone becomes extremely hungry from it.

Besides the lack in appetite and the need for weight gain has it done anything for your symptoms at all? Also what were/are your symptoms? Also what is your diagnosis?

Welcome to the forum! Would you like to share your story in the Your Story section?

 

[CrohnsChicago]

Oddly enough I had more side effects the first time around being treated with prednisone than I did the 2nd time.

***The first time I did a prednisone taper (2 months taper of 35mg) I had constipation (the first 2 weeks), insomnia, was hyper-active, SUPER hungry, mild acne, slightly irritable. At the end of the taper I came down with a yeast infection and 2 weeks of joint pain/stiffness in my knees. I did not gain weight as I was very mindful of my salt and water intake.

***The 2nd time I did a prednisone taper (1.5months taper of 30mg) I only had constipation (the first 2 weeks), insomnia (the first few weeks), and hunger. At the end of the taper I did not experience joint pain again, but I DID get another yeast infection. I only gained 3lbs (which I have since dropped) by not being as active as the 1st prednisone taper and not being as mindful of my salt and water intake I assume.

I guess everyone responds to it differently and we won't always react the same way to it. Definitely worth discussing with whoever is treating you with the prednisone. I make sure my GI knows all my side effects and I follow up with him weekly or bi-weekly over the phone to let him know how the taper is going.

 

[Hope345]

It is a love hate relationship with Prednisone. Each time my daughter took it, the side effects were terrible: round face, large belly, increased appetite, irritable and symptoms came back as we tapered. Second time around the side effects were worse but it did not seem to be as effective in eliminating inflammation. We will do all that we can to avoid our 13 year old daughter using Prednisone again.
Having said that, you are fortunate to not have the side effects. That is truly a blessing. For some, it can put you in remission, but most importantly stop the damage that Crohns is doing to your body. If you have a mod/severe case, it can stop it quickly and seems to be the only option at this point.
Our doctor has put our daughter on Remicade and it along with removing lactose from her diet is working.
The best to you and keep us all informed of how you are doing.
:ysmile: take care

 

[CrohnsChicago]

I would agree julie, I am moderate/severe crohn's and each time I have taken pred, it stopped the bleeding, inflammation, cramping within two to three days.

I am only on Asacol right now along with supplements and am trying desperately to find a diet that will be beneficial to me so that I can do my best avoid/prolong the need for the next level of treatment which would be imuran or humira in my case.

 

[UnXmas]

You say you started at 50mg. How long were you on 50mg for and what is your current dose? Your posts reads as if you've already begun tapering.

As for the appetite increase I'll have to look it up on the main cause but I know its listed as a "possible" side effect. I don't believe everyone becomes extremely hungry from it.

Besides the lack in appetite and the need for weight gain has it done anything for your symptoms at all? Also what were/are your symptoms? Also what is your diagnosis?

Welcome to the forum! Would you like to share your story in the Your Story section?

Sorry for being unclear - I'm still on 50mg. I see the specialist again in December. The idea was for me to not be on the high dose too long precisely because of the supposed side effects. They were more concerned about my bones though - I already have osteoporosis due to another health problem. How quickly does pred begin to affect your bones? Is that a guaranteed side effect, or again the luck of the draw?

My story is too muddled to put down in words still, I think. First I was told I had "inflammation" in my stomach, after an endoscopy. Then I was told Crohn's based on biopies, but this news was delivered to me second hand from my GP, I haven't discussed it with the specialist yet. They gave me so many diagnoses that were then withdrawn (I was told I definitely had Irritable Bowel Syndrome - of course that turned out to be wrong. I was told I was anorexic - I KNEW that was wrong) so I'm still reluctant to trust in my diagnosis completely. It seems diagnoses are a matter of each doctor's opinion. :sign0085: I'm also not sure if there's disease lower down in my digestive system or not. My symptoms are weight loss, bloating and diarrhoea.

I read horror stories about pred. I guess people are more likely to post online if they have problems with it than if they get along fine though. I'd read so much about it being this powerful drug, it's disconcerting to find that my attempts to prepare myself for it did no good at all really. I just wondered if there's a specific reason why I would not feel hunger from pred. I know from a gastric empyting study that my stomach empties too slowly, hence no hunger, and believe this is probably a seperate issue from Crohn's. Though maybe not it the Crohn's is in my stomach? I had read that pred causes hunger through hormonal mechanisms, so I thought I may get some craving for food inspite of the bloating. But I guess not.

 

[CrohnsChicago]

Your GI will probably give you a colonoscopy which will determine if there is anything going on down below. I know crohn's can happen anywhere along the digestive tract (upper and lower). So maybe a colonoscopy can get you closer to an answer especially if you experience diarrhea and if you have never had this procedure done before....

I can definitely see how you would be confused about your response to the pred because it is such a strong medication. I don't think everyone who has ever been on pred (for whatever illness) experiences extreme hunger, but it is one of the more common side effects for sure.

It could very well be a combination of conditions you are dealing with, but again crohn's is not a very linear disease so everyone shows symptoms differently and responds to treatment differently (frustrating, I know!). That's definitely why you need to discuss with your GI to determine if the prednisone is even working for you.

Wishing you the best!

 

[tots]

This is my third round (or fourth) round of Prednisone. I am hoping because I am also taking Remicade it will be a short course. Each time I have taken it I have reacted differently- diff sleeping is always a problem. This time I feel like a friggin humming bird at work! Good lord ita a good thing I work retail and need to be on my feet and moving all the time.


Good luck to you!


lauren

 

[DustyKat]

My son never had side effects with oral Pred and the only time his face even looked a little roundish was when he was on his third round of IV Hydrocortisone, his appetite did increase a little at this time too but the minute he went back to oral the side effects went away too. I do firmly believe the steroids helped stabilise his acute condition but I don't think they did any more than that and I often wonder if lack of side effects equates with how well your response is.

Dusty. xxx

 

[hawkeye]

I have been hit and miss with side effects. The increased appetitie has been there every time I've been on pred but insomina has occured sometimes and not others.

 

[UnXmas]

Well my diarrhoea does seem to be slowing a little. Though I couldn't say for certain yet it's not coincidence. And I'm notcing facial hair growth now - already! Unless I just noticed because I'm now looking for it - it's only a tiny bit so far. :frown:

But no hunger, no mood swings, no changes in energy, no weight gain. And still far from normal bowels.

 

[Jennifer]

Sorry for being unclear - I'm still on 50mg. I see the specialist again in December. The idea was for me to not be on the high dose too long precisely because of the supposed side effects. They were more concerned about my bones though - I already have osteoporosis due to another health problem. How quickly does pred begin to affect your bones? Is that a guaranteed side effect, or again the luck of the draw?

"Prednisone does result in bone loss, both by increasing the excretion of calcium from the body and causing it to be lost from bones. While there is no truly "safe dose" of prednisone, doses of > 7.5 mg daily are associated with more complications. Typically, ongoing use of 3-6 months or more in duration is when we begin to see prednisone impacting bone density and increasing fracture risk. There are several ways to get around this. First of all, the disease modifying drug regimen (MTX, etc.) should be adjusted to control the disease as well as possible so that less or possibly no prednisone is needed. Secondly, checking a bone density test (known as a DEXA) is essential to determine the baseline bone density. Depending on your estimated fracture risk, strategies to prevent bone loss while on prednisone could include as little as calcium and Vitamin D supplementation or as much as some potent prescription drugs we have to prevent bone loss, and in some cases improve bone density." http://rheummd.org/question/prednisone-dangerous-bone-loss

Since you haven't noticed much improvement then its more than likely that Prednisone alone isn't enough. Hopefully with further testing and a proper diagnosis you'll be able to get the treatment you need and soon.

 

[Jer]

Being very hungry is one of the only sides I get with Pred. I do get oily skin, hold some water and get slightly moody at times too.

This is probably my 6-7th round, the first time was miserable, but after that, not too bad.......plus it's the only thing that gets my symptoms to subside ATM.

 

[UnXmas]

I've concluded that I am immune to hunger.

Not to facial hair, unfortuneately. Seriously, that's started coming on quickly, hasn't it? Will it just get worse now as long as I'm on it?

I am sleeping a little less, and have a little more energy - a good thing - so it's clearly not that pred is without influence. Just the hunger that I really seem to have bypassed so far (of the more short-term side effects I mean, I realise it's still early days for some of the others to make themselves noticable). Oh well, perhaps the next person who's scared of gaining weight on pred will take some comfort in the fact it doesn't always happen!

Edit to add: I've never had any problems with my skin previously, and I'm hoping not to get acne from pred. I realise it's just a cosmetic thing but still, it's one less problem I need. How long would acne take to develop after starting a high dose of pred? If I've been on it a few weeks and no sign of it yet does that mean it likely won't happen even when I end up (probably) tapering over several months or maybe on a lower maintenence dose?

 

[Jennifer]

I never got acne from Prednisone (took up to 60mg for almost a year). Never really had acne either though. Just good genes in that department I guess.

Being on steroids long term and on higher doses does lead to weight gain although its water weight and will start to come off quickly once you're off the steroids. I believe that's one side effect that cannot be avoided. The amount depends on the person, the dosage and the length of time you're on steroids. Its best to avoid salty foods as they tend to make you retain more water.

 

[CrohnsChicago]

I avoided the weight gain when on pred. I cut back on salty, processed foods, focused on clean eating diet and made it a point to do cardio interval exercises for at least 20 min. each day. I actually lost a little weight and gained a tiny bit of muscle during my first prednisone treatment because of that. Like I said before I only gained 3lbs on my last taper because I wasn't as committed to physical exercise and diet as I was the first time around.

I also found working out seemed to distract my mind from the hunger and irritability.

So it's possible for some people to curtail the whole weight gain side effect if you are willing to put in the work.

 

[Jer]

I tend to get a little acne when I taper off of the pred.

 

[Jennifer]

I avoided the weight gain when on pred. I cut back on salty, processed foods, focused on clean eating diet and made it a point to do cardio interval exercises for at least 20 min. each day. I actually lost a little weight and gained a tiny bit of muscle during my first prednisone treatment because of that. Like I said before I only gained 3lbs on my last taper because I wasn't as committed to physical exercise and diet as I was the first time around.

I also found working out seemed to distract my mind from the hunger and irritability.

So it's possible for some people to curtail the whole weight gain side effect if you are willing to put in the work.

I'm talking about fluid retention in general, not eating more or not moving around enough.

"Prednisone causes the body to retain sodium (salt) and lose potassium. This combination can result in fluid retention, weight gain, and bloating." http://ibdcrohns.about.com/od/prednisone/f/predweight.htm

You can try reducing sodium and increasing potassium to try and avoid retaining any fluid but this is not guaranteed (many people with IBD have absorption issues so you may still not get enough potassium).

 

[UnXmas]

So far I have put on no water weight at all either...

Perhaps I should add that I'm the opposite type to worry about some of the pred side effects in the first place - underweight even before IBD, low blood pressure, young age, never had sodium retention or high blood sugar in my life as far as I know. But I'm definitely not puffing up at all - no moon face either - and on the scales I'm exactly the same weight as before pred - I checked today.

 

[Clash]

C was on 40mg for probably 6 weeks before starting to taper and although the crazy energy, restlessness showed up then the water retention/moonface and acne showed up when we were on the taper around 25mg. Being 16, C is in no hurry to ever go back on pred. The weight gain looked decent on him and it was around 30 lbs but still put him below average for his age and height and he lost all but about 6 lbs of it within 3 months of finishing the taper.

 

[katiesue1506]

I never got the bad side effects till I got in the 35mg-20mg range. Those were always the up and down moods, weight gain, eating a ton, moon face, oily skin, and anger issues.

Anything higher than 30 mg I was generally happy go lucky, talkative, and full of energy. My house was always very clean too.

I've been on pred for the better part of this year (sat at around 15mg for most of it though) and I'm currently tapering from 12.5 to 10 today. I have some extra weight but I've been noticing my face has been slowly losing the moon face. Still have a pretty decent appetite too, and minor moodiness (I'm usually pretty good at realizing my moodiness from years of pred tapers).

I would hazard a guess and go ahead and say no one can take pred without side effects. I will also go ahead and say that as long as you realize the side effects, you can easily control a lot of them (not the moon face though). Usually I will notice I'm angry and I ask myself if there's a reason, if its a valid reason, or if its just random. Generally I deduce that its just a Pred side effect and I remind myself not to take my anger out on others. Its WAY more trying to do this while you're on pred AND menstruating though

 

[UnXmas]

I never got the bad side effects till I got in the 35mg-20mg range. Those were always the up and down moods, weight gain, eating a ton, moon face, oily skin, and anger issues.

Anything higher than 30 mg I was generally happy go lucky, talkative, and full of energy. My house was always very clean too.

I've been on pred for the better part of this year (sat at around 15mg for most of it though) and I'm currently tapering from 12.5 to 10 today. I have some extra weight but I've been noticing my face has been slowly losing the moon face. Still have a pretty decent appetite too, and minor moodiness (I'm usually pretty good at realizing my moodiness from years of pred tapers).

I would hazard a guess and go ahead and say no one can take pred without side effects. I will also go ahead and say that as long as you realize the side effects, you can easily control a lot of them (not the moon face though). Usually I will notice I'm angry and I ask myself if there's a reason, if its a valid reason, or if its just random. Generally I deduce that its just a Pred side effect and I remind myself not to take my anger out on others. Its WAY more trying to do this while you're on pred AND menstruating though

If you get symptoms on a lower dose/while tapering, that would be because of the "withdrawal syndrome" rather than the med itself, wouldn't it? The result of the adrenal gland struggling to work on its own after the pred has caused it to shut down, once you're no longer on a high enough pred dose to do all the work of the adrenal gland?

So maybe there'll be more problems to come on a lower dose.

You're right it helps to remind ourselves that something's a result of the meds - and hopefully temporary. I'm telling myself that about the hair growth. It makes me feel less gross to think of it as a med side effect as oppose to part of me. And I can remember that I could make it go away, if I stopped taking the pred.

 

[katiesue1506]

I don't think it would be a result of the tapering just because the human body stops making its own cortisol at levels of 7.5 mg of pred and higher, which is why people tend to have trouble in the taper schedule around there or 5ish mg (cause the body is trying to wake up the adrenal gland again).

At 30-20 mg all of your cortisol is still coming from the pill only. I'm not sure why the Bad Pred Beast tends to rear (tee hee) its ugly head in the mid doses whereas Happy Pred Beast is 40mg or higher. Of course experiences may vary.

 

[UnXmas]

So reaching the taper without certain side effects doesn't necessarily mean you've escaped them? More might come on with longer term use even at a lower dose? :frown:

That's depressing. The hair growth is depressing me. I only started this med earlier this month, and there is definitely hair on my face where there was none before. Is it going to get worse? It's only a little so far. Would taking anti-androgens (like women are prescribed for excess hair growth when they have polycystic ovary syndrome) stop the hair growth, or is it not a result of androgen excess when it's caused by prednisone?

Sorry for all the questions. I guess my thread title doesn't make much sense now: should be "prednisone with only some of it's side effects?"

The hunger/weight gain is non-existent for me still.

 

[lola99]

I feel like everyone is affected differently by meds and not all the side effects will happen if at all. I have no side effects with imuran but with the steriod i've had side effects. I was only on 25 mgs ( 130lbs) and after two months i had cushing symptoms (moon face,darkening body hair,sweating,buffalo neck,etc) i had to get off of it. Its been months since ive been off of it and im pretty much back to normal. I wouldn't stay on it long. Its a short term fix. If you notice getting symptoms of cushings call your doctor.

 

[Hobbes650]

I've been on prednisone for over a couple of weeks now. Started at 50mg, so not a low dose. I was wondering if it's normal to NOT get side effects? I realise some - like the skin problems - may take a little while to come on. But I was looking forward to feeling hunger.

Due to being ill, I need to gain weight. But I don't feel hungry at all. I have delayed gastric emptying. Would this cancel out the hunger-enducing effects of pred? Does it mean there's something else wrong with my hunger-signals or hormones if I don't feel hungry on pred?

I had a tiny bit more trouble sleeping, but no effects on my mood or any other noticable side effects. No water-weight gain/bloating. It's not making my symptoms much better either. For a moment I even wondered if I'd been given a placebo.

Has anyone else experienced this, and does anyone know anything about the mechanisms by which pred is supposed to cause increased appetite?

Weight gain and other side effects are all subjective. After I was diagnosed with Ulcerative Colitis in 1986 I started on 60mg a day. I had tons of side effects, but not weight gain. I actually lost 20 pounds in the first three months, but some of that was due to being in the hospital for 2 weeks. Once home, I only gained about 10 of those pounds back before relapsing and needing surgery. This year I've gone back to Prednisone due to Crohn's flare up. However, it took a few months before I started feeling the full force of the side effects, including weight gain. Never heard of anyone so anxious about Pred side effects before- be careful what you wish for.

 

[UnXmas]

Weight gain and other side effects are all subjective. After I was diagnosed with Ulcerative Colitis in 1986 I started on 60mg a day. I had tons of side effects, but not weight gain. I actually lost 20 pounds in the first three months, but some of that was due to being in the hospital for 2 weeks. Once home, I only gained about 10 of those pounds back before relapsing and needing surgery. This year I've gone back to Prednisone due to Crohn's flare up. However, it took a few months before I started feeling the full force of the side effects, including weight gain. Never heard of anyone so anxious about Pred side effects before- be careful what you wish for.

Lol well gaining weight has been a big issue for me for a while, so when I heard about pred I was hopeful. Now I'm beginning to be more anxious over the side effects I am getting. I wonder if excessive posting on forums is a side effect? It's not like me to write about my medical problems online like I've been doing here the last few days. I've no idea what prednisone-induced mania is like (nevel had any mental symptom of that kind before) - I wouldn't say I feel manic but I do feel like posting and talking a lot. :shifty-t:

 

[UnXmas]

So the verdict on side effects. I hope it's helpful for other people to read, even though your own experience will probably be totally different:

Facial hair growth
Skin is a little more greasy
Sleeping a lot less
Have more energy

That's it. I've been getting a lot of mood swings but there are so many other factors I couldn't confidently say that's down to prednisone.

My stomach is better but not completely. But I have more issues with my digestion than IBD which the pred was never intended to address so I wasn't expecting to be back to normal.

I have had no hunger, weight gain, moon face or water retention whatsoever. I made no alterations to my diet (didn't cut down salt; didn't add potassium - nothing). And no acne either. Edit: Reading my information leaflet, it says pred can also cause heartburn and indigestion. That's something I'm prone to already, but it hasn't been any worse on prednisone.

I had thought that once tapering no new side effects would appear, but it seems there's a possibility they might either as a result of reducing the dose or just from being on it longer term.

Now it seems like the aim is always to get patients off this drug as soon as possible. But then I read about some people being on it for years - and sometimes at high doses. And the most dangerous thing to do is to stop it too suddenly. Finding it hard to get my head around. :confused2:

 

[katiesue1506]

Just make sure you are taking it with Calcium and Vitamin D. They don't want people on it long term because of the effects on bone density but if you gotta be on it for any length of time, you should be supplementing to help.

Also my doc said if you are on it for any amount of time that adds up to a year, you need a DEXA bone scan to get a benchmark on your normal density. Then they can watch it over the years.

 

[UnXmas]

Just make sure you are taking it with Calcium and Vitamin D. They don't want people on it long term because of the effects on bone density but if you gotta be on it for any length of time, you should be supplementing to help.

Also my doc said if you are on it for any amount of time that adds up to a year, you need a DEXA bone scan to get a benchmark on your normal density. Then they can watch it over the years.

I already have osteoporosis due to an unrelated condition. So I have had scans and am on treatments already, including calcium and vitamin D. I don't think I'm supposed to be on pred long enough for it to have a chance to worsen my bones - my doctor was wary of pred long term for me for that reason. Thanks for replying. xx

 

[UnXmas]

I feel like everyone is affected differently by meds and not all the side effects will happen if at all. I have no side effects with imuran but with the steriod i've had side effects. I was only on 25 mgs ( 130lbs) and after two months i had cushing symptoms (moon face,darkening body hair,sweating,buffalo neck,etc) i had to get off of it. Its been months since ive been off of it and im pretty much back to normal. I wouldn't stay on it long. Its a short term fix. If you notice getting symptoms of cushings call your doctor.

Does getting a bit of facial hair growth and having skin a bit more greasy indicate Cushing's? I was told to expect side effects like that. I'm supposed to be on it as short a time as possible.