Pred and high cholesterol

[Lochy]

Just wondering if anyone can shed any light on a link between high cholesterol and prednisolone. I started taking Pred March 2016 and in a year my cholesterol has increased to now being in the 'concerned' category. I feel my diet has improved because of all the things I've changed since starting steroids so just curious. Thanks

[SheffieldJane]

I wonder if this is similar to my Diabetes 2 warning in that steroids alter the way the body deals with sugar/ fats? I too lead a very wholesome healthy life. All the downsides and none of the fun. Roll on the day we can do without this wonderful, terrible drug!

[venezia1]

I've been on steroids for several years for GCA. After a long standing excellent record of cholesterol, I've recently been told it is raised. This is ironic as my Rheumy is wanting to put me on Actemra instead of pred, but now can't until my cholesterol comes down!

[PMRpro Ambassador in reply to venezia1]

That sounds like the chicken and the egg - won't happen until your pred dose goes down, which is most likely to happen if you are on Actemra!!!!

[venezia1 in reply to PMRpro]

Exactly!

[PMRpro Ambassador]

Pred affects liver function - and causes increases in cholesterol level and blood sugar levels in some people.

[venezia1]

Interesting- liver function has been down too.

[Lochy]

I have always had extremely elevated liver function tests since my PMR diagnosis, such as my rheumatologist has never seen before. Might this make it more likely my cholesterol has risen or is it just me and i have to address it with lifestyle changes. Not sure how best other than eating loads more vegetables as I'm already trying to eliminate carbs - good and bad!

[PMRandRA in reply to Lochy]

Not a good idea to eliminate good carbs. We need them to survive.

Just kick out potatoes, bread, rice, pasta, cereals and grains and of course, sugar.

Then add full fat yoghurt, milk, cream etc and mushrooms, cheese, butter, mediterranean salads, lentils ( yes) some local fruits and berries - apples, pears, strawberries, blackberries etc. And keep below 1000 calories a day.

That will do the trick. I lost 2 stone that way.

[Marie1479 in reply to PMRandRA]

Yup that's how I did it. I was also normal until taking steroids. In 2 months my cholesterol jumped to 268 and sugar 100! I was advised by my dr to adopt a low carb diet. No bread, rice or pasta. 1 peice of fruit a day (strawberries because low in sugar). Nothing processed and eliminated cow milk products because they bother my gut. Lost 22lbs and my cholesterol is under 200 and sugar is normal. I am on Actemra and Rayos (time released Prednisone).

[PMRpro Ambassador in reply to PMRandRA]

I'm afraid it is an old wives tale that we need carbs to survive. The good lord (or whoever invented mammals) made sure that if carbs were not available that the body could readjust and live off either dietary fat or its fat stores. Which is exactly what your body needs to do to lose weight. It takes a few days - and doesn't happen until you get below a certain level of carbs. So if you think you are eating low carb but include fruit and stuff and you aren't losing weight - that is probably why.

[PMRandRA in reply to PMRpro]

I did not stop eating vegetables and local, in season, fruits.

[Lochy in reply to PMRpro]

So it's avoiding bread rice pasta. I have raspberries rhubarb and sometimes bananas. I love eggs and eat them often to fill me up! Also enjoy my wine.

Perhaps I just eat too much but it's working out what reduces cholesterol?

I assume any increased cholesterol even caused by pred is still concerning and needs to be addressed. I definitely don't want statins!!

[HeronNS in reply to PMRpro]

cbc.ca/news/canada/nova-sco...

livestrong.com/article/7012...

[kezzybabes]

Hi lochy. I have just been told my cholesterol is high (7) yesterday so your post is timely. I too have been on a low carb diet ( lots of cheese, butter and cream!) so wonder if this is the culprit or whether it's pred. I will now change my diet again to Mediterranean way of eating.

[PMRandRA in reply to kezzybabes]

it is not the diet. but take out potatoes, bread, pasta, rice, cereals and sugar.

[PMRandRA in reply to kezzybabes]

Keep eatingbthe full fats though. Keep cheese to a match box sized piece a day or have Tesco cream cheese. not Philly, it has too many additives.

[PMRpro Ambassador in reply to kezzybabes]

Diet makes very little contribution to a raised cholesterol - 85% of your blood cholesterol is made by the liver. It is the effect of the pred on the liver.

[Lochy in reply to PMRpro]

So if the liver is responsible is there much I can do? Presumably raised cholesterol is still a concern although they did say my risk of heart/stroke was 6% which sounds ok to me!

All my side affects of the pred seem to be liver related, I'm assuming it's very sensitive or something!

[PMRpro Ambassador in reply to Lochy]

My cholesterol is raised some - no idea what the level is though offhand. I was almost forcibly put on a statin after I developed severe atrial fibrillation 5 years ago - and in less than a week on half dose was almost in a wheelchair so I unilaterally decided no more. When I saw the cardiologist (as opposed to the physicians on the ward) a few weeks later she wasn't in the least bothered! She subscribes to the thought (as I do) that in women who have not had a cardiovascular event taking statins does not change the outcome. It DOES make a difference if you are female and have had an event or if you are male in either case. Atrial fibrillation does not count as a cardiovascular event (heart attack, stroke/TIA). It is not the lowered cholesterol that makes the difference though - that is a surrogate marker for what the statin is doing, it changes something that makes the difference and, as a side effect, it lowers cholesterol. Too low cholesterol is as bad as a high level and is being linked to a number of things (no proof yet).

If you can take a statin and not have side effects and you keep the cholesterol at a sensible level (not silly low) - fair enough. But since at least one includes PMR as an adverse effect on its data sheet - I'd rather take my chances.

[Koalajane]

Mine was 7 and now is 3.8 but I am now type 2 diabetic and have high blood pressure. I am on 9mg of prednisolone down from 15 originally and on a LCHF diet. I was put on statins to reduce the cholesterol.

[Maz48]

Hi Locky. I've had the same problem. However, after struggling to get it down my last blood test showed it was down by a massive 1.5.

[Amkoffee]

I can't speak for your concern because I don't know, but this I do know. Every time I have a new symptom come up I check the Prednisone side effect list and it is almost always on the list. Lol

[PMRandRA]

It just does, unfortunately. My docs want me on statins, but I refuse because I was on them pre PMR and they darned nearly killed me from the pain. tried 2 different types.

My reasoning is we know the cause, why treat with more dangerous drugs. Get rid of the cause.

On 11mg now. Getting there!

[Trixiechamp in reply to PMRandRA]

Aaah, I'm assuming this is why mine was 7.6 after being on 60mg for some time...Consultant has asked GP to 'discuss' with me, whatever that means!

[PMRpro Ambassador in reply to Trixiechamp]

See my reply to Lochy further up.

Cutting carbs not only improves risk of diabetes but also often lowers raised cholesterol - and there's the weight loss aspect as well.

[Trixiechamp in reply to PMRpro]

Yes I know you have given this very good advice to me a few times and now I am mentally in a more stable place I am going to put it into action, there is certainly enough compelling reasons for me to get focussed!