Pred and constipation??

[3daysinjuly]

Since going on pred....what a difference. I never had this problem my entire life. So either it is all the calcium (milk, yogurt) that I take with it in the morning, the calcium supplements, the pred alone, or a combination of all three. I am looking to get back to, sort of, normal, in this area.

[SnazzyD]

I found the opposite until I got down below 10mg when things slowed down too much. calcium and stomach protecting drugs can cause disruption in either direction. A large increase in dairy can do this to susceptible people too and any sudden large change to what your gut is used to.

[3daysinjuly in reply to SnazzyD]

Yes. I had not been a milk drinker since I was a kid. But I have read that it is good to have with the pred so I do so.

[PMRpro Ambassador in reply to 3daysinjuly]

In what sense good to have with pred?

[3daysinjuly in reply to PMRpro]

Well, the instructions that come with the pred say take with milk or food. But since it is in the morning and I never was a big eater in the morning, milk and cereal seemed like a good way to go. But I am open to suggestions about what others consume when taking their a.m. pred. Thanks.

[PMRpro Ambassador in reply to 3daysinjuly]

It was never a problem for me - I was on enteric coated pred and simply swallowed it with water - and never eat breakfast anyway so I can't really help. Now I am on Lodotra which I take within 3 hours of my dinner, Lots of people use plain yoghurt - though that also has calcium in it if that is the problem.

[3daysinjuly in reply to PMRpro]

Are you in remission now? Off pred? Hope so. Thanks.

[PMRpro Ambassador in reply to 3daysinjuly]

No - I've recently had a flare and had to go up fro 8 to 15mg to manage the symptoms. I'm one of 5% or so who have PMR for a long time,..

[3daysinjuly in reply to PMRpro]

Sorry. I just read that Lodotra is a form of pred. Correct?

[PMRpro Ambassador in reply to 3daysinjuly]

Yes - it has a coating that breaks down after 4 hours in the right post-prandial conditions. So I take pred at 10pm and that is effectively 2am and the peak blood level is at 4am...

[PMRCanada in reply to PMRpro]

You are so lucky to have access to this form of pred! Not offered in Canada ☹️. Would be ideal for me given that I have to take my uncoated pred between 4-6am .

[3daysinjuly in reply to PMRCanada]

I guess we don’t have it either in the U.S.

[Linny3 in reply to 3daysinjuly]

I think in the US it is called Rayos?

[PMRCanada in reply to Linny3]

Yes it is approved in US, as is Actemra a steroid sparing medication.

[PMRpro Ambassador in reply to 3daysinjuly]

It is available in the US as Rayos but at an excruciating price!! It is covered by some insurance plans though.

[3daysinjuly in reply to 3daysinjuly]

You seem very well-informed and I think I know what your answer will be but I will throw this out there. When I showed the Rheumatologist my initial blood work——taken before diagnosis and when I could barely move my limbs and was in agony—-he saw my sed rate was 6. He kept coming back to that number, shaking his head. Finally he said you have the classic symptoms of PMR but then he would look down at the paper and say “but sed of six”. So I briefly thought not PMR. Well, I have been fantasizing that it is not but I guess that is wishful thinking. I have not a soul here to talk to and this helps me get things out.

[PMRpro Ambassador in reply to 3daysinjuly]

Up to 20% of patients with PMR do not have raised sed rate or CRP. I'm one. It is more common in younger patients - who also tend to be atypical in other things too. It is a clinical decision - the lab results are supporting evidence, not essential.

[3daysinjuly in reply to PMRpro]

So maybe atypical also in the intensity/duration?

[PMRpro Ambassador in reply to 3daysinjuly]

Possibly. I have heard people theorise it might be better or worse if you are younger or have low inflammation markers but no-one really knows. All I know is I was still just 51 when it started and still have it at 66. So young, normal blood markers much of the time single figures, they took a long time and severe illness to rise to the dizzy heights of 16-18 which were still in normal range so no-one remarked on them. And it has lasted well over the average time.

[Hidden in reply to 3daysinjuly]

Hi 3daysinjuly;

I have GCA 3.5 years and about a year ago had a bout of constipation that my doc had to help with. He gave me a plan : Lax A Day...a fibre and Senokot....a vegetable

laxative. Worked like a charm and I learned. The key is fibre and water.

What works for me is crushed Flaxseed. I take at 7.30 a.m. with pred: 1 tablespoon flaxseed topped with 2 tablespoons of thick Greek yoghurt ( no or 2% fat, low carbs no sugar additives). But do not like plain so I add 1 teaspoon dark chocolate pudding ( hey it's good for you!) The fibre absorbs the water that is needed to surround the stool and float it down the bay! Or two soft boiled eggs on odd days.

I also have a very sensitive stomach and this works. I no longer take a proton pump inhibitor (Pantaprazole) and if I feel any acid I take a Gaviscon.

Find the fibre that works for you, you may have to take a glass of Metamucil. Keep a journal. I keep watch carefully as I have a few stretched spots in my bowel.

I was in the store reading every yoghurt label to find the one for me!

Oh and breakfast an hour or two later. This is not my breakfast.

Tomorrow I add a sprinkle of......coconut!

Good Luck

[3daysinjuly in reply to Hidden]

Thanks Linda, I will try your suggestions. I hope you are doing well.

[Berylholley in reply to Hidden]

How Do you crush your flax seed please?

[Rugger in reply to Berylholley]

I use my spice mill attachment on my Kenwood Chef mixer.

[Berylholley in reply to Rugger]

Thanks I will get one. Beryl

[Hidden in reply to Berylholley]

I buy a big bag already crushed and keep it in the freezer.

[Berylholley in reply to Hidden]

Thank you lindanne I do all my shopping online so I hope I can get some. They are very good for constipation and lots of other things. Beryl

[Berylholley in reply to Hidden]

I have ordered some

[SnazzyD in reply to 3daysinjuly]

I have enteric coated pills so I can take it with just water. As such I’ve been able to avoid stomach protectors like Omeprazole which really bunged me up. On higher doses than 7/8mg I had to have Gaviscon at bed time. I tried the yoghurt thing but I’m too lacto intollerant and it just made things worse top and bottom.

[Qubbie]

Try magnesium. Not only for the fact it helps your bones while on prednisone but is a mild poop and go. My prednisone brain can not for the life of me recall the word

[Hellyowl in reply to Qubbie]

Hi, I started magnesium last year because I noticed on the paper in the omazaprole (PPI) that there is no conclusive study but it can cause Magnesium deficiency and I wondered if that was what I blamed a Pred Head. My recall and alertness improved enormously.

Re constipation I have the opposite, but as almost vegan I have a big veg and fibre intake.

[PMRpro Ambassador in reply to Hellyowl]

Pred increases loss of magnesium too.

[Judy211]

Hi. I always suffered slightly with constipation but after being diagnosed with GCA I cleaned up my diet enormously. Since diagnosis, I have eaten a bowl of porridge almost every morning with a dessert spoon of both crushed flaxseed and chia seeds...poured over a sliced banana and topped with yoghurt. I also add raw cacao sometimes to make it chocolatey. (Soak your oats in a little milk the night before to cut down cooking time.)

Anyway, works like magic...the only time I ever suffer from constipation now is when I’m away and there’s no oats. Might be worth a try? Best wishes