Is it possible to develop a resistance to Prednisolone so it doesn't work as well?
As my consultant said to me today, in the past, upping the Prednisolone has worked really well for me, got me well again, substantially helped my peak flows. At the moment however (last couple of months whilst I've been having problems with asthma) it isn't having the same effect and I'm really struggling with symptoms and low peak flow - and it's not picking up.
The pred is obviously doing something because when they've tried to wean me my asthma has crashed, but it doesn't seem to be doing as much as it was.
Is it just that my asthma's worse or is the Pred not doing such a good job?
I don't actually know the answer but I just thought I'd say that I'd be really interested to know, as I just don't seem to respond to steroids properly anymore. I've ended up on ITU while on steroids and my peak flows don't really pick up like they used to anymore.
Prednisone resistance
Prednisone could definitely still be helping but it could be that your asthma is really getting out of control/severe. I used to take Prednisone as a regular part of my daily asthma medication regimen. this lasted for years. I was up and down with my asthma. Prednisone would help more sometimes than others. I think my body became too dependant on them - the doctor even told me that this was true. Regular administration of steroids is not good for your immune system and your immune system is linked directly with asthma. Steroids give an automatic boost to your immune system but, then lowers your immune system in the long run, leaving you more vulnerable to asthma and many other issues. you should try to build your immune system while you are taking the steroids. You will give your body a better chance at fighting off asthma attacks with a reduced dependency on Prednisone. I use Traditional Chinese Medicine and this helps me. I find that I am more in control of my asthma than when I had to be constantly taking steroids. Diet also affects your immune system, so make sure you are eating plenty of whole grains, veggies and fruits at every meal and cut out the processed food. Good luck
Resistance
Hi Ratty
Urgh...steorids. lol. Well, before my asthma turned brittle, I used to be prescribed Pred and felt like I could run a marathon! Nowadays, it has NO affect on me whatsoever. Not even IV hydrocortisone when in an attack. I have had a Synacthen test done at Royal Bromtpon to test my adrenal gland (as this is where the body produces corticosteroid naturally) and due to Pred use, surprise surprise, its function has decreased. Now the only option is.....to take more Pred!!!
I know refuse to take Pred as it has no affect, like you and the side effects are horrific, considering I am so young too. So I know how you feel. I try and tell the Drs that Pred has no affect but I tihnk they think I am lying and just don't want to take it due to moon face etc etc.
I do believe you can build up a resistance even though the medical profession say you can't. Think we know our own bodies by now and whats not working!!!
I know how you feel
hi ratty
i am in exactly the same boat!!!!
before being diagnosed as brittle asthmatic, i just needed the odd pick me up course of pred and i was fine - i rarely even checked my pf - very naughty in the begining when i was first diagnosed - 9 years ago and up until bout 5 yrs ago... then needed more and more courses :S
then since past year, since being diagnosed brittle - 13 months now - been on continuous daily pred and now cons wants me on it long term. everytime i try reduce/ stop it pf plummets and symptomatic + i would end up in resus / hdu and one even in itu cos of severe attacks - obviously other factors too...
at same time, been started on bone protection tabs and multivits, and also, cons keeping check on me every 2 weeks cos of side effects.
however.... last few weeks as you have seen from posts i have been to heel and back, and over the last week i am not managing to even respond to high dose pred / iv hydro either even now and peak flow not picking up either :S which is worrying...
so i defo think my body has built up resistanct to pred and even iv hydro, only question is now - where to go from here - got consultant next week to ask same question. seriously considering finishing the pred altogether and starting afresh - but what ?
in resus, only things respond to ;
nebs , mag repeated doses, amino, if failes - bipap then intubation
hmmmm.....
x x x
Thanks everyone for your replies. It's comforting to know that others are experiencing the same, even though it's really hard to live with. I do question what the point of staying on the Pred is as it's not mending me, though I crash if I come off it - it's a no-win situation.
My consultant's just told me there's nothing more they can do, having a seriously weepy day as I'm really not coping with that news. It feels like there must be another option, but he's supposed to be the person who knows what he's doing, so I have to trust him.
sorry to hear ur consultant has told u there is nothing more they can do for u. thats awful. surely there must be something ? second opinion ?
i understand why ur having a weepy day, had many of them over past few weeks, joining in with u today too....
keep ur chin up and dont give up hope
x x x
Thanks Snowygirl, I dunno, normally I have a bit of weep but can kick myself out of it and just get on with stuff (not that that actually helps because then I get the ""but you look so well..."" line - grr!!) but struggling today - I think it's because of all the other stuff going on with uni, plus my GP has picked the worst time possible to go on holiday - I'm going to insist that she only goes away when I'm stable and fine in future!!
When my GP is back I'm going to ask her about where I go next, because there has to be something.
Ratty:
I don't know if this might make you a bit more hopeful, but I was told the same thing pretty much, but my GP did some researching (lovely woman) and came up with some ideas to suggest to my consultant that he's now considering. So, it might be possible that they can try something a bit more unusual to try to manage your asthma a bit better, in the absence of pred working so well.
It can't be easy with uni stuff going on too. I can definitely sympathise with the ""you look fine attitude"", I have to keep explaining that that's because of the sort of asthma I have grrr. I really hope things pick up for you.
yeah defo think cons shud only go on hols when we do!!
just got off phone with asthma nurse who been on hols til today - thats y cudnt get hold of her...
got lots of things to think bout for now....
i have used that line many many times - 'i feel fine!' probably why i self discharged a few times...
x x x
I have something similar to this
Pred used to work amazingly well on me and was on it for ages over the summer and it never really made a difference. No-one really listened and were convinced it did. Anyway i'm now in the brompton and one of their standard tests is exhaled nitric oxide, and my score is right at the bottom of the normal range. This means my asthma is not caused by inflammation but by hypersensitivity. So pred wouldn't have worked, but he reckons towards the begining it was inflammation.
Something to think about maybe?
My asthma has not started to improve with my steroids yet and taking lots of reliever.
pf is 250 and creeps up to 300 only to go back down.
Hope next few days start to pick up as this year been hell of a lot worse gggrrr!!!!
edit- had lots of high dose pred and then my doc put me on 10mg daily to see if would help
me but my consultant said he wanted try wean me off them so he could see how i got on with out them.
So 1mg reduction after a 40 day plan and they ended up faxing my doc with 40mg and 40 day plan again 2 week after last lot.
getting worried a little that the pred could stop working as not responding well this time as quick.
Some people have steroid resistant asthma. There are now newer drugs that are just beginning to be available to treat people with this type of Asthma. Ask your G/P for a referral to a Tertiary level consultant if possible. You may have to wait sometime for this. They will do tests, that can Phenotype your asthma. (Although these tests are not perfect yet). In the meantime do take the pred and everything else you are told to do. Also keep a really good Asthma diary of levels of peak flow and steroids you are taking to show the consultant if you get an appointment.
I am assuming here that you have tried all the usual non steroid add on treatments and had your sinus's checked and acid reflux checked.
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Going to see the asthma doctor on Friday again
To Pred or not to Pred?
