What is Prednisone?
Are you dreading the PRED?!
It was the best of times, it was the worst of times – if you know, then you have most certainly been prescribed the steroid, Prednisone before.
Prednisone is a steroid, from the drug class of glucocorticoids, that is used to help decrease inflammation for many conditions like arthritis, rashes, and autoimmune diseases like inflammatory bowel disease (IBD).
Prednisone is systemic which means that it works on the entire body and is not just limited to the gastrointestinal tract. Prednisone is known to be extremely helpful in lowering inflammation in the body, and provide side effects to the brain, bones, skin, muscles, and other organs.
When are steroids used?
- Short-term solution – 6-12 weeks with a taper is appropriate
- Tapering allows for a gradual weaning off of the drug to help prevent complications from abruptly stopping
- The body makes about 5-7 mg of prednisone daily in the adrenal glands and when you take steroids it sends the signal to your adrenal glands to stop steroid production, since there is enough being made already. Without a taper period, the body wouldn’t have enough time to produce more prednisone naturally and it could cause a withdrawal syndrome. Symptoms of withdrawal would be lightheadedness, dizziness, weakness, headaches, and feeling faint.
- To bring about remission when there is active inflammation in the bowel, typically used in a flare
- They should not be used in remission or maintenance because of the side effects they cause
- They are not helpful for preventing symptoms from returning in the long-term
Note: When in a flare, your doctor may prescribe a steroid alongside other maintenance medications to reduce the inflammation. But, you can’t keep returning to steroids every time you flare. If you are receiving steroid prescriptions more than 2-3 times per year or becoming steroid dependent, a conversation with your doctor about stepping up therapy and using more potent drugs is appropriate. Sometimes even surgery is considered a better option than staying on steroids too long.
Short term side effects can include:
- Weight gain
- Facial swelling (often referred to as moon face)
- Mood swings
- Trouble sleeping
- Acne
- Increase in appetite
- High blood glucose (high blood sugar)
- Headache
If on steroids longer than 6 weeks, additional symptoms you may experience include:
- Easy bruising of the skin
- Thinning of skin
- Osteoporosis (weakening of bones)
- Diabetes
- High blood pressure
- Cataracts
- Cushing’s syndrome
- Infections
- Muscle weakness
- Fatty Liver
- Depression
- Growth problems in children
What can you do to decrease Prednisone Side Effects?
- Take your medication (Prednisone) as soon as you wake up so it’s less likely to interfere with your sleep
- Prednisone can contribute to fluid retention and increase blood pressure, so decreasing salt intake can be helpful to prevent/decrease this from happening (exception: please do not decrease salt intake if you have an ostomy, unless your doctor states otherwise)
- Keep up with movement. Going for a light walk can help lighten your mood (and decrease the chance of mood swings), decrease stress, and help contribute to a more restful sleep
- Eat balanced meals to help control blood sugar highs and help decrease that insatiable appetite that can occasionally happen when taking Prednisone. You can do this by including a source of protein, fat, and fibrous carbohydrate. An example of this is a tuna salad (protein) sandwich on whole grain bread (fibrous carbohydrate) with avocado (fat)
Nutrients to consider when taking Prednisone:
- Calcium can help prevent weakening of the bones.
- When taking Prednisone it is a good goal to shoot for 1000-1500 mg calcium/day unless otherwise stated by a healthcare provider (1). Calcium rich foods include spinach (260 mg in 1 cup) canned salmon with bones (170 mg in 3 ounces), broccoli (100 mg in 1 cup)
- Vitamin D to help with calcium absorption.
- Vitamin D can be synthesized from the sun, and is found in salmon, mushrooms, and fortified milk and orange juice. Vitamin D can be difficult to obtain from food alone and supplementation is often recommended.
- Magnesium also helps maintain healthy bones.
- Magnesium can be found in legumes, dark leafy greens, nuts and seeds, oatmeal, salmon, and 70% dark chocolate
- Potassium is an essential component to heart health and it also helps play a role in fluid balance and blood pressure
- Potassium can reduce fluid retention/swelling by removing excess sodium (salt) from the body and helps relax blood vessels
- Potassium can be found in avocado, potatoes, bananas, beans, lentils, and cantaloupe
- Melatonin to help with sleep if you feel it is appropriate for you.
Reminder:
Always check with your doctor, pharmacist, or dietitian to see which options are most appropriate for you before starting any supplements.
References:
Flesher, M. (2020, April 1). Prednisone and Diet. Gastrointestinal Society. https://badgut.org/information-centre/health-nutrition/prednisone-and-diet/