Steroids

[Buckybri]

When taking a course of steroids why is it that each week u reduce yr dose ? also do the steroids work with each dose , so say I didn’t take them for two days would the pain come straight back

[helixhelix]

You reduce week on week because it is dangerous to stop suddenly if you have been on a dose of about 5mg for a while. Under that it is just better for you body to go gently.

Everybody’s sensitivity to steroids is different. With some people the pain would be back in 24 hours. With others if they have slowly decreased dose and the inflammation has been controlled then the pain might never return.

[Hidden]

As HelixHelix says, it is very dangerous to even stop them for two days'

From Medicine.net

"Synthetic cortisone medications (corticosteroids) simulate cortisol, a naturally occurring, anti-inflammatory hormone produced by the adrenal glands. Such drugs (for example, prednisone) have since benefited many, but are not without potential side effects.

The two major problems related to continuous steroid treatment are

drug side effects and

symptoms due to changes in the balance of normal hormone secretion (withdrawal symptoms).

The production of corticosteroids is controlled by a "feedback mechanism," involving the adrenal glands, the pituitary gland, and brain, known as the "hypothalamic-pituitary-adrenal axis" (HPAA).

Using large doses for a few days, or smaller doses for more than two weeks, leads to a prolonged decrease in HPAA function.

Steroid use cannot be stopped abruptly; tapering the drug gives the adrenal glands time to return to their normal patterns of secretion."

[lilyak]

Steroids mimic the action of your bodies natural corticosteroids. When you take externmal steroids, your body may reduce its own ability to produce steroids. MAY. It very much depends on the time you've been taking steroids, and the dose. But unless the course was very short (under two weeks), it is always safer to taper. The length of the taper, and the increments that your drop by are completely individual and dependent on how long you've been taking them and at what dose.

If you stop taking them suddenly, and your body has stopped producing its own corticosteroids, then you risk an adrenal crisis, which can be fatal. This is why you taper, you reduce the exogenous steroid slowly, which allows your adrenal glands to 'wake up' and start producing steroids your own natural steroids again. Sometimes they don't wake up, and you wind up with secondary Adrenal Insufficiency, which can be a very difficult disease to manage.

If you've been taking steroids less than 2 weeks, you are generally fine, no taper required.

No one but your doctor can give you a proper tapering schedule. There are posts here quite often that are just plain wrong. This can be very dangerous, so always consult with your doctor.

Also, don't be afraid of steroids, they are an essential and life saving medicine, they just need to be used exactly as prescribed.

[Buckybri in reply to lilyak]

That’s taught me something, it’s amazing how some of these medicines work and take for granted .

[medway-lady]

Good replies I tapered from 60 to 0 over months. I think coming off to quick affects so many things and yes the pain does come back fairly quickly.

[Troygirl]

Took me over a year & half to get down to 5mg per day from 20! Need to go really slow when on them for a long time! Soon I will be on 4.5mgs. Waiting to go to Dr to get new prescription of 1mg. Hard to cut 2.5 mg into 1mg properly and consistently. My medicine cabinet has all the sizes except 1mg. lol

[Wobbies]

Beware, I made myself very ill by reducing steroids too quickly. In the end, had to reduce by 0.5mgs per month to avoid feeling very ill. Of course pain returned, but I would only take steroids again if it was that or death, after the withdrawal problems I had.