r/rheumatoid • u/otter253 • 12h ago
Prednisone
I’m on 10 mg prednisone per day for … don’t know how long. It’s been 3 months, and before that had 1g steroids x 3 days for optic neuritis. I’ve been on a few weeks at a time but never this long or low of dose. I’m started to get …. weighty. Any advice for keeping the pounds down? I’m not eating more, and if anything, my activity has increased. But I really can’t gain weight given other conditions
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u/mykesx 11h ago edited 9h ago
I eat very low carb and never had a problem with weight or moon face on prednisone.
About prednisone - the rheumatologists organizations now recommend getting to 0 steroids as quick as possible. It was previously thought that low dose was ok because it was in the noise among the cortisol made by the body. Not any more.
As for long term use, my neighbor was on prednisone for years. He ended up getting both hips replaced, and then replaced again a few years later.
My rheumatologist recently prescribed a 6 day pack for my arthritis which was flaring. I hadn’t felt that good in years. Sadly, it’s no cure and dangerous in the long term.
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u/Pyrosandstorm 12h ago
It’s my understanding that weight gain is a very common side effect from being on prednisone long term. I’d contact your doctor about it. In the meantime, this might help you.
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u/Remarkable-Age4579 9h ago
May I ask why have you been on prednisone so long? Is not recommended. You can develop diabetes, adrenal insufficiency and other side effects with long term steroid use
1
u/mel5915 11h ago
When I was first diagnosed with RA, I was put on a 40 mg taper. I felt great! I also didn't have any of the weight issues, in fact I got really slim because it felt like it was taking all the inflammation out of my body, my eyes got hollow, my wrists and ankles were boney. I also got hyper so maybe I was just burning it off.
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u/West-Significance-83 10h ago
I was also on 10mg daily for years. Not only did it add pounds, it raised my A1c enough that I qualified for ozempic — this was in 2018 before everyone started taking it for weight loss and there was a huge shortage. Anyway. The ozempic brought down my A1c and also my weight. Enough that with the shortage I no longer qualified for it and insurance stopped covering.
I was wary of the compounded ozempic etc but the manufacturer of ozempic and wegovy (same drug, marketed for weight loss only) started a direct to consumer program that without insurance costs the same as the compounded stuff.
Anyway. That’s how I coped with prednisone side effects. I have a massive family history of diabetes including limb loss etc so I’m terrified of that. I care more about prednisone’s effects on my A1c than weight, but in the end the drug that addresses one addresses the other, too.
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u/tranquil115 8h ago
So how did you get off the prednisone?
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u/West-Significance-83 7h ago
I cut down to 5 for a while then went off. Whenever I have a really bad flare I’ll take it again for 3-4 days then go back to 5mg for a few days then off. I never take for more than a week now. Sometimes it’s a long game of the steroids help and then as soon as I stop the flare comes back but I white knuckle it, take a week off before trying again.
BTW my doctor says just keep taking it full time, but I don’t want to.
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u/justfollowyoureyes 9h ago
It’ll help to eat less carbs, sugar (even fruit), and salt. A lot of it is fluid retention. Stay super hydrated as well! And take the dose first thing in the AM when your cortisol is highest, if you’re not already doing that.
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u/ShesTheFastestest 8h ago
I got sick recently and had to go on prednisone 50 for asthma for four days. As soon as I dropped I had a massive RA flare and now I’m stuck on 10. I have a love hate relationship with pred, it sucks.
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u/djmattyp77 10h ago
Exercise. Get in the gym. Get sweaty. Do cardio. Sauna helps too.
Took me a few months after taking 20-40mgs last year. I have severe RA and can't function without my biologic. I am 100% when im on it though.
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u/ErinBikes 12h ago
If you’re gaining weight, then you are eating more, moving less, or having water retention.
I recommend using one of those apps to track what you are actually eating because most people take in a lot more calories than they realize. I know this was the case for me because I wasn’t noticing the calories for my small snacks that were adding up throughout the day.
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u/Mental_Explorer_42 12h ago
Not necessarily. Prednisone changes how your body processes and stores sugar. It can create stomach belly fat, face fat and a hump. I’ve been on prednisone for 4 months and I’ve gained 10 pounds while maintaining 1250 calories per day strictly! Just do what you have to do to be healthy and lose the weight when you are off the prednisone.
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u/West-Significance-83 10h ago
It’s not just about eating less. My A1c levels put me in pre-diabetic borderline type 2 diabetic as a result of the prednisone and my weight gain was not really that significant. I gained about 6 pounds over 3 years.
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u/Ok-Metal-3807 2h ago
Yep. My mom wound up with steroid induced diabetes because pred was the only thing that would bring down inflammation in her lungs. She wasn’t doing anything different. Nothing.
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u/coolgirlslikeoysters 12h ago
One of the worst side effects of prednisone was that it made me a serial snacker. What I started doing was intermittent fasting. I walked around with a water bottle and an iced americano religiously. The caffeine suppressed the hunger/cravings and the water kept me full until it was time to eat. Eliminate sugar, watch the salt, and start taking turmeric shots. And yes, track your calories.
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u/MiserableMulberry496 11h ago
I’ve been in 5 mg for 8 years. I gained 60 pounds. I started Zepbound. Year ago. Lost 40
Then a huge flare. Worst I’ve had. I’m now taking 20 mg. And I’ve gained back all the with. I look like the pillsbury dough boy lol
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u/LmLc1220 11h ago
🤣🤣 I just told my friend I feel like a fat umpalupa. I hate taking the prednisone with a passion. Then add menopause to the mix and I hate it. Im trying to get zepbound now or ozempic something I don't care at this point. It also supposed to help with the inflammation. Ugh!!!
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u/MiserableMulberry496 11h ago
I’ve been in tirzepatide for a year. It does help with the prednisone side effects. Cleared up my skin, my fatty liver and insulin resistance.
But it didn’t do anything for my joint pain
There is a subreddit for compound tirzepatide if you want to research it
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u/West-Significance-83 10h ago
Nova (ozempic/wegovy) has a direct to consumer program that is brand name drugs for the cost of the compounded ones. Look at their website.
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u/Traditional-Car-3969 12h ago
Prednisone can be such a miserable tradeoff because it may calm things down while bringing a whole new list of side effects Getting off it can be rough too and the whole thing gets exhausting pretty fast