I have no idea if this link will work, I'm not the best at pc's
But found this article on adrenal health, I've given it a quick read at seems to be a sensible approach and one I thought might be if interest to some.
Magnesium supplements are a good idea when taking pred and it definitely helps to avoid cramps - it is the first line of attack used by mainstream doctors in most of mainland Europe when patients complain of cramp. Vit C will do you no harm, it is water soluble and excess is excreted easily - but there are no scientific studies that show it does what is claimed here.
HOWEVER - if you have PMR or GCA and are taking prednisolone DO NOT take ASHWAGHANDA. It is a form of ginseng and taking it alongside pred can lead to drug interactions, potentially severe.
If you are taking pred NEVER take any supplements of this sort without checking with a pharmacist. It is even a good idea to check with the pharmacist before taking OTC (over the counter) medications of any sort and sometimes even the prescription your doctor gave you! I was given an antibiotic that should never be used alongside any corticosteroid and especially the one I was taking. It can lead to an inflamed achilles tendon, which can rupture. If it does you face a major operation to sort it out. I was on crutches for 9 months.
Thanks for the tip about Ashwaghanda I was all ready to buy some from Neals Yard only they were out of stock. After six years of up and down doses of prednisoline I was willing to try anything. I already take VitC, magnesium and VitD3.so back to the drawing board until someone does research into this terrible condition we are stuck with it.
Are your ups and downs with pred possibly due to trying to force reductions or reducing in too big steps? When you reduce in very small chunks or spread the reduction over a few weeks it can make a big difference. I always got stuck at just under 10 until I used the "dead slow and nearly stop" reduction I have posted elsewhere and have got to 4mg for the first time in well over 5 years. I feel so well at that I'm perfectly happy to stick here - I felt the same at 5mg and my GP was happy to leave it there. I screwed up the courage to try again and it was fine but an attempt at 3mg was OK for a couple of months but then aching muscles reappeared - just a bit but enough so I went back to 4mg where the aches disappeared again.
You are taking calcium with that D3 aren't you? It is important alongside pred to reduce the risk of osteoporosis unless you eat a diet that is very high in calcium.
I was diagnosed with PMR in August and am currently moving from 10 to 9 ml prednisolone by PMRpro's slow method ie 1ml in 26 days as distinct from the very slow method. I understand that Korean ginseng can stimulate the adrenal glands and I have some Korean ginseng teabags which I was thinking of using when moving from 8 to 7 ml, which, I think is when the adrenals have to start working again. Seeing PMRpro's comment about Ashwaghanda has made me think twice about this. I have consulted my GP and my local pharmacist and they didn't advise against it but I had the impression that they may not be very knowledgeable about it. The teabags are 14% red ginseng extract per 3gram sachet. Do you have any advice?
Sorry - I only know I have seen the statement that mixing ginseng and pred is not a good idea - one place at least is on the livestrong site.
But a quick search also found that the University of Maryland Medical Centre has an information site where they say that ginseng should not be taken by patients with autoimmune disorders and that it may interact badly with prednis(ol)one.
Intuitively, if you are taking ANY medication that suppresses or modulates immune function then it is questionable what might happen if you use any of the natural supplements that stimulate immune function in any way, whether it is via the adrenal glands or by any other means.
some of what is said applies to many such supplements - like be careful where you source it. Analysis has shown that often something sold as a particular substance has never seen any of it in its life! And there can be some very dubious substances in the packs!
Thanks PMRpro. I think I'll leave the ginseng tea until I'm better. My gp's a bit bemused by your slow tapering method but she's cooperative. I'm between 10 and 9 mg at present, taking roughly 1 month to go from 10 to 9 and OK so far.
What is she bemused about? If you had told her you had dropped 1mg overnight I trust she wouldn't expect you to then immediately drop another 1mg. Some people can manage dropping the dose from one day to the next, others can't and it is better for you to spread a drop in dose over a month and not find out if you are the person who can't do it - since sometimes it means a return to a higher dose to sort it out.
Keep it up - there is a sort of feeling of satisfaction when you get into single figures isn't there?
Yes. I should be into single figures by the end of December. I am quite nervous about getting lower and coming up against things like my adrenal glands needing to start functioning again. Wondering if that's going to make it harder than ever to get physical jobs done. As it is I take things fairly slowly and can feel my body heating up if I do anything a little bit strenuous so I'm aware that the illness is lurking there just under the surface. It is like a dragon as it starts spouting fire if its disturbed or upset.
I think my doctor was just bemused at the calculations I'd made to show her what to prescribe as they took up quite a lot of space. I find the slow tapering easy to organise though as I just put the days dose in my diary for the month ahead.
With thanks to you and everyone on Health Unlocked for your invaluable help. I'd feel quite lost without you.
If you are having signs/symptoms then slow down a bit. The reduction is never a relentless progression to zero - you are looking for the lowest dose that controls the symptoms. If you don't take that then you might as well decide to stop taking pred. It is a balance of the benefits and problems and taking too little is pointless.
The Bristol group keeps their PMR patients at 10mg for a year, in fact they keep all patients at 10mg for a year before reducing further because they start GCA patients higher, taken them down to 15mg and then put them on the same reduction as PMR patients. 10mg is just above where the adrenals have to "wake up" - it lets your body catch up.
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