Concerned about infections

[Navion]

Hi,

I just started on prednisone 9 days ago. My rheumatologist put me on an extra low dose, 5 mg. , to see how I tolerated it. I went up to 7.5 yesterday. However I am concerned as I feel like I'm getting either a yeast infection or a genital herpes outbreak. I'm wondering if a person who has herpes and who tends to get yeast infections should be on this drug. My fear is I'll get an infection that won't be able to be stopped. Plus if I go up in dosage, which I suspect I'll have to do to control my symptoms, it's even more likely. I have a message into my doctor but I'd like to hear any opinion you might have.

[Pongo13]

On high doses of Pred I got lots of yeast infections and tweaked my diet (no sugar etc etc) - plus meds from dr for oral thrush. I get recurring shingles and take acciclovar quickly (if I miss the window of opportunity I’ve had it!). Poor you having genital herpes - and how brave as no remedy. Your doctor will best advise plus the medical experts on the forum. Suffice to say my own immune system has been on holiday and I have had more than my fair share of infections. But.... with PMR I get on with it, as life without Pred would be unmanageable! Good luck Navion, life does get better. Just seems a bit sh*t right now no doubt x

[Navion in reply to Pongo13]

Yes, it does indeed seem like sh#$t. I feel like I'm dammed if I do and damned if I don't. Thanks for your response.

[PMRpro Ambassador]

Beyond my experience I fear - I assume your doctor knows your history. Certainly pred tends to make people more likely to develop thrush. But any of the medications used in rheumatology are likely to increase the risk as they suppress the immune system. Many people have found probiotics have helped.

[Marilyn1959]

Hi Navion. I hear your concerns. We are all very different and you are wise to consider your options carefully. However pred is the only option to manage PMR and unmanaged inflammation can lead to GCA, so it certainly is a risky business.

Recurrent infections are the bane of my life, but were present pre PMR and pred. In fact my Rheumy thinks three infections in one week triggered my PMR!

Having had 4 UTIS, herpes of the eye, boils in the groin and a gum infection since Christmas I feel I have formed my view based on experience. Without pred I would be pretty much immobile and very dependent on others. I would not be able to do my part time job. With pred I can take care of my own care needs and do activities such as light gardening, a bit of housework, enjpy my time with grandchild etc albeit at a slower pace. There are days when extreme fatigue sets in and all I can do is rest and sleep.

At Christmas I had an accident that required a replacement ball joint in my shoulder. Once again I was totally reliant on my OH for my care needs. It reminded me of how I was pre diagnosis of PMR and pre pred. For me loss of independence is the worst.

So really there is no choice for me as I wouldn't trade my good days made possible by pred for the world. (Started 15mgs pred June 2017, now at 7mgs.)

[PMRpro Ambassador in reply to Marilyn1959]

Amen!!!!!!

[Navion in reply to PMRpro]

That is helpful, thanks.