Keeping the cortisol down (diet and lifestyle)

[Vburris]

Hi there, I’m new here.

I was diagnosed with pmr and gca in April, started on 40 mg pred and currently at 25mg. I’m pretty certain (undiagnosed) shingles on my face led to the pmr and the gca and my doctors agree with that. I was diagnosed in the UK but live in the USA and am being treated there. I’m 55 and female.

Having read what I can do to help myself, both on this forum (so helpful, thank you all!) and on the internet, I think my non medical approach is focused on keeping my cortisol levels down. It sounds like this is best done by eliminating/reducing:

alcohol,

caffeine,

white carbs,

sugar,

Strenuous exercise and

stress

Does that sound right to you or are there any other dietary things I should consider?

Thanks so much!

[HeronNS]

I don't know why you are trying to keep your cortisol levels down. If you are taking prednisone it is suppressing your body's ability to make its own cortisol and acting as a replacement for this cortisol, which you need to maintain life.

That being said, your list is helpful because it will help to eliminate foods which increase inflammation (sweets, soft drinks for example) and help maintain healthy weight by reducing carbohydrate consumption. Getting sufficient exercise without stressing the muscles too much is an excellent idea. And definitely stress avoidance.

You need to make sure you are getting enough Vitamin D and Vitamin K2 (not K1) which are vital for proper calcium metabolism to avoid the bone-thinning effects of prednisone. You'll almost certainly need to get those two vitamins through supplements. Yoghurt is supposed to be a very good source of dairy calcium, better than liquid milk, as are some of the leafy greens.

[DorsetLady PMRGCAuk volunteer in reply to HeronNS]

My thoughts!

[Vburris in reply to HeronNS]

I’m hoping to keep the weight down mostly at this stage, but also to adjust my diet so when I get to tapering under 10, my status quo diet will support that as best it can and not be an additional stressor.

[Soraya_PMR in reply to HeronNS]

I’ve assumed (shouldn’t do that!) that Vburris is referring to her pred dose when saying ‘keeping the cortisone down’

[Vburris in reply to HeronNS]

Many Thanks for the info too. I hadn’t known about the k2. Am taking vit d daily. Dexa scan shows good bone density currently so hoping to manage calcium via diet, if possible. Yoghurt and tinned sardines high on the menu for me.

[Soraya_PMR]

Get plenty of sleep. Go for 8 hours at night and an afternoon nap as well if feasible. Sleep helps your physical body heal, and helps with memory which can go a bit skewiff with PMR and pred.

[Vburris in reply to Soraya_PMR]

Great point. Have had bouts of insomnia but as of now, I can’t identify a pattern or specific cause Why I have it at some times but not at others.

[Soraya_PMR in reply to Vburris]

No it’s a bit unpredictable, but it does improve with lower pred doses.

[PMRpro Ambassador]

Not sure strenuous exercise is a factor for most of us!!!!

But physiologically speaking - the fact you are taking pred keeps your cortisol level not just down but pretty much absent until you get down to about 10mg and below. But otherwise - you are eliminating pro-inflammatory things which can only be good. And low carb definitely helps with weight management.

[sondya]

I had a voracious appetite, ate everything in sight. Medics not worried. They said reducing steroids will also reduce appetite. Absolutely right. I have lost a lot of weight.

[PMRpro Ambassador in reply to sondya]

Lots of people are not so lucky and have to work at it! Low carb also reduces the risk of developing pred-induced diabetes. And I would be quite concerned about a medic who wasn't bothered about that.

[sondya in reply to PMRpro]

He would be bothered if I didn't show signs of weight reduction.

[Stella3]

Hi Vburris, I also got PMR/GCA after having shingles (for which I had the vaccine for by the way!). My doctor said there was no proof yet that the two are connected.....I am 73 and am pretty careful to eat healthily. I am English, but live in the States too and was diagnosed here. You sound like you eat a pretty good diet, don’t forget vegetables and whole grains. I assume you are taking calcium and Vitamin D, baby aspirin every day? Good luck.

[Vburris in reply to Stella3]

Hi Stella. Interesting the docs don’t think there’s a link. I’m taking the baby aspirin and vitamin d but aiming to not take a calcium supplement if I can get enough calcium via food. Was interested to see other posts on the amount of carbs in fruit, so probs should be bringing that down. Am eating a lot of raw veg and humus, nuts and seeds as my default and trying to re educate myself to not think i need to eat a different meal each day. Seems to help. Avoiding too much weight gain is so key to me feeling ok about all this.