Hi it's me again, I'm just wondering if anyone can help , as I've said in my previous posts, unfortunately for me steroids make me constantly hungry !.I've been battling hunger pangs from almost day 1 .I'm now in week 5 of taking 15mgs of Pred.Hoping to drop down from next week. Does anyone know at what level you need to be on for the pangs to subside ? It's exhausting trying not to eat constantly. It really feels like it's an addiction !
Hunger !: Hi it's me again, I'm just wondering if... - PMRGCAuk
Cut your carbs drastically - the hunger attacks happen when your blood sugar has peaked, insulin has been secreted and the blood sugar level has plummeted to too low a level and it makes you crave carbs to bring it back up. Pred also makes your liver release random spikes of glucose into the blood - the body doesn't care where it came from, it sends in the cavalry in the form of insulin compounding the problem and creating a rollercoaster that self-perpetuated.
You can do nothing about the liver bit but you can reduce the dietary part - cut processed carbs and all added sugar. Don't do low fat, low fat products have sugar to make up the taste that removing the fat causes. Keep fruit down, berries aren't too bad but most have lots of fructose, still a carb. Above ground veg/salads, protein and good fats/oils will fill you up.
This is a good and simple introduction:
Lots of pictures so you can see what is good and what isn't in terms of carbs. Most is free - no need to pay for cooker books, just use your browser to find low carb things.
What are you eating?
Trying to follow SW, so porridge with banana ,blueberry s or bran with banana for breakfast. Soup ryvita etc lunch. Salmon chicken salad etc plus yoghurt low cal jelly, healthy food.But the hunger is insatiable !
Sounds like you’re one of those like me who gets uncontrollable sugar highs with any carb and over production of insulin as a result, including with sugar free sweet tasting foods. As Pro says, you are already getting sugar spikes from the liver and there’s nothing you can do about that. The problem with adding to it with foods that the body can turn easily into glucose is the insulin storm that plummets you into low blood sugar. Your body screams hunger so you eat and will be attracted by sweet tasting foods and carbs. Fats and protein don’t have this effect. So, my breakfast is nuts or cold meats and as PMRPro has said in the past, you need to reassess the conditioned ideas as to what is a breakfast food. If I needed banana for potassium I ate them on the unripe side.Now, this isn’t a magic bullet if you have this hunger thing but it’ll feel more like a road with lumps rather than a rollercoaster. I got to eat lots as long as it was veg or protein and I didn’t put on weight even on high doses of Pred. Once you get off this sweet/carb thing for a bit, it all starts to taste pretty horrible anyway.
We are all so different , trust me to get the hunger symptoms , thanks for your reply ,it has really helped me to investigate other goods !
One of the problems with SW for people like us is that it has too much carbohydrate - for US, Dietary management of the pred problems needs to work of reducing the carbs,
Snazzy and I both have to get down to 20-40g carbs. Your breakfast alone is probably more than 20g - bananas hide a LOT of carbs! Even an extra small one is the best part of 20g:
Then even a small portion of porridge, healthy though it is, has carbs.
Two slices of ryvita - 13g carbs, I could go on. It all adds up. Keeping a food diary and checking often makes it clear.
Wow !. I had no idea! Thanks for your help, as I've said to my other replies! Time to investigate !😊
Re porridge/carbs: when I was reading up this stuff a while back I came across something about how the fibre in oats doesn't 'count' in the carb calculation because you don't actually digest the fibre.
Whether true or not, that encouraged me to continue with my daily porridge* but using the more coarsely milled oats - which may not be labelled as porridge oats.
Do you know if it's true?
*made with coconut water and topped with anti-inflammatory red berries and plain yog.
Not as much as you might think - nutritional info will tell how much of each sort of carb is in a food. In the case of porridge:
Typical Values........... Per 100g Per 50g
Carbohydrate...............60.5g ............... 30.3g
Sugars ..............................1.1g ...................0.6g
Fibre .................................8.3g ...................4.2g
Protein........................... 10.3g ..................5.2g
So you can take the 4.2g from the 30.3g to get the utilisable carbs which is what counts for carb counting. In a typical bowl of porridge (depending on portion size obviously) you are still looking at 20+g carbs in a smallish bowl. 50g oats is a usual amount though I used less.
If you are like Snazzy and me - that bowl of porridge made with water not milk and no sugar, fruit or yoghurt is still our day's carb allowance! It is a good carb component for a low carb diet - but it is the total carbs in the day that counts.
I have a bowl of porridge every morning, since 1st January this year, l believe it’s the mainstay of the changes l’ve made to my diet to enable me to lose 2stone (28lbs) in six months.
I have traditional Quaker Oats with Full Fat Milk, l have Semi Skimmed in Tea/Coffee.
The porridge has enabled me to give up the ‘quick fix’ sandwich for my lunch.....
I’m about to review my diet as l want to lose another 7lbs
Best of Luck
Wow , thats fantastic, seems like im on the right track with my porridge . Thank you x
The rest of the day l don’t have Carbs but sometimes with my Evening Meal l may have a Spoonful of Rice, l don’t eat Pasta or bread & occasionally have a one small roast potato or half a dozen chips.
I’m not a zealot on No Carbs at all because l don’t want to make my life miserable, l use a lot of Recipes from Second Nature, l won’t join it’s way too expensive but l’ve picked up lots of really good tasty meals.
Hope that helps
Good for you with your new eating plan and resulting weight loss. Not an easy task while on pred.
I’m hoping to drop more weight as well and tried keto this week, but find it difficult to eat all the fat that is required. And keeping carbs down to 35g and sugar down to 27g is a challenge, mainly because I am a fruit lover. I tried only eating strawberries, raspberries and watermelon, in measured amounts this week. Previously a general low carb/sugar/salt did the trick, but I’ve been “stuck” with my weight as it levelled off for the last 7 months or so.
Despite being more active, I am finding it difficult to kick start the next phase of my weight loss journey. I am, however, in awe of anyone on pred who doesn’t gain weight, or who can lose weight.
Once again, congrats on your efforts and results.
Hi Thank You, it feels very worthwhile, new stretchy jeans & T-Shirts & not elastic waisted trousers with tunic tops! 👖👚
And, the dresses available to me now in my wardrobe are too many to count! I do feel like a different person, l’m still far from well but l like the look of the New Me 🥰
Hope you’re keeping OK?
If you’re following slimming world try increasing protein in place of carbohydrates, things like boiled eggs are free and should help you feel full. It worked for me.
I’ve been on the Slimming World regime since January and I’ve lost 2stone. I was like you always hungry and battling but I’m ok now. I do think you’ll lose the appetite craving as you get down. PMRPro is defo right about the carbs. I don’t eat many potatoes and have cut down drastically on bread. Good Luck!
Hi, thanks for your reply , its great to know there is someone that has had the same struggle !! im exhausted with it . I have done loads of research over the weekend into carbs etc, picked up some great tips on here ! Hoping to go back to SW , i dont like the virtual one. But having lost 15lbs and now put 10lbs back on due to hunger pangs it back to square one ! at least i have a lot of SW info. Im reducing my pred today from 15mgs to 12,5 . Fingers crossed it makes a difference . Love this site and the people ! Best wishes Viv x
When I started pred, I could have eaten a five course meal followed by another five course meal and a horse thrown in. I think it did start to reduce after my first pred reduction thank goodness.
Hi, thank goodness it's not just me !So glad it started to reduce.Fingers crossed and thanks😊
I did become a nutrition nerd when I got PMR particularly as I was taking steroids. I gave up simple carbs and gluten as I understood it would stop a moon face, which amazingly it did, could just have been luck though. More recently I got an App MyNetDiary which you can get for free. It measures all the basic nutrition, carbs, calories etc. and it often surprises me when I see the results. My protein is a lot lower than I think quite often. You can get an upgraded one with lots of charts and more nutrient measurements for nerds like me!
The carb cravings didn't ease up for me until I was down to 6.5 mg pred. Now am able to start working on shedding the quick 20 lbs I naively acquired 18 months ago when it all started. You're wise to try to avoid that if you can, but take heart from knowing that the cravings will mitigate eventually. Good luck!
Thanks so much ! this is me atm !! put on over a stone in a short space of time, after losing it with SW , so im back to where i started ! But your post gives my hope ! Today im going from 15mgs to 12.5 . So its a waiting game ! Trying hard, its the best i can do. Best wishes Viv x
Buy a Cucumber, wrap it in foil and keep it in the fridge. Hunger pangs, cut one inch off and eat it. You can cross a desert with just cucumbers. Full of vitamins and minerals.
There are just 16 calories in a cup of cucumber with its peel. You will get about 4 percent of your daily potassium, 3 percent of your daily fiber and 4 percent of your daily vitamin C. They also "provide small amounts of vitamin K, vitamin C, magnesium, potassium, manganese and vitamin A,"
Cucumbers are also natural anti-inflammatory...............just put Use of Cucmbers in your search engine...............they even clean mirrors and help bathroom mirrrors not to steam up.
PS Always eat the peel.
An ode to celery!! What next?
Who mentioned Celery?
I can't read.😂😂😂 Ended my rather boring day on a giggle. Thank you! xxx
Yuk!!!!!! Should be banned!!
Isn't it funny how people either love or hate celery? And those who hate it are so vehement about their loathing and in my experience are not general veg haters. One of my daughters who's vegan and eats tons of veg, loves them all except for celery which she hates with a vengeance. I think it's delicious, both raw and cooked and celeriac's even nicer.
Celeriac - now there you are talking! Fabulous mashed! But celery? I think it is the texture mostly - but maybe I'm really a bit allergic to it!! You know it is an allergen?
Celery - no way.
Coriander - tastes like soap to some people (me) because of a gene deficiency huffpost.com/entry/why-does...
It gets better as you reduce - I am on 6 mg now and ok with a low fat diet (cos of gallstones)
Hi Viv54. I've just read through all the responses and there's lots of really good, sound advice that I really wish I'd known 15mths ago when first diagnosed. I muddled through on my own, researching diet and how steroids changed the way I was metabolising food and obviously all roads led to that very same advice being discovered.
I personally have found that setting myself up with a good breakfast really helps...I have a bowl of porridge made with skimmed milk, and put blueberries and raspberries on top, followed by a chopped up orange with a teaspoon of local honey, pumpkin and sunflower seeds, tablespoon of puffed quinoa (high in protein) and 2 tablespoons of natural live yogurt. Lunch will probably be carrot, pepper and cucumber sticks with hummus followed by benecol yogurt with teaspoon of ground linseed mixed in, and dinner.....salmon/chicken with fresh salad comprised of spinach leaves, radishes, avocado, tomatoes, olives, etc. My one treat each day is something chocolatey like a couple of pieces of green and blacks dark chocolate. I do very occasionally have the odd packet of crisps or other such similar treat. Some of the things I eat are deemed to be absolutely avoided, but for me, this regime works and I've not put any weight on at all. I do exercise every day too....within my capability of course as fatigue is always a problem but I know even gentle exercise is better than no exercise. I'm also having to eat taking into account other conditions such as high cholesterol and osteoporosis.
I think all the advice given is solid, good advice and to be followed as much as is reasonably possible, but sometimes 'one size doesn't fit all' and our bodies are all reacting and responding to PMR in our own individual ways, so don't be disheartened...... life has to be enjoyable. Just be mindful of the good advice out there and learn and understand what your body's limits are and what it needs.
Hi Kendrew , got lots of advise so helpful, but yours rings a bell with me . I like the diet you follow and feel this is the one for me , to strict and i would falter ! Some of the things you suggest im already doing . So ill tweak a few things and give it a go . Thanks so much for your reply and help. Best wishes Viv x
Just a tip that I have read many times but only occasionally remembered to use: when your body is telling you that it needs nutrition (ie you feel hungry) but it doesn't actually need food - try having a glass, or more, of water - and, if you can, generally, keep up your water intake.
Really interesting reading this.I remember this well.
Why when the Doctors, prescribe the Pred , and then the tapering plan , do they not suggest or give you a diet sheet.?
They must surely be aware of the side effects Pred causes. Instead of being told your weight gain is a result of the tablets!, when you go back for a review.I had a Moon face for Months
Yep , these people are great.,& the sight is a godsend .
I think regarding the diet and weight gain, two things are going on when we take steroids. Firstly they alter the way we metabolise certain foods but secondly, they make us hungry, which in turn makes us eat more. If you eat more.....you'll gain weight! So need to be mindful of both issues.
But they are linked: the way we process carbs is affected and blood sugar levels rise. That triggers release of insulin - and the BS level falls to too low a level which leads to a craving for carbs to bring it back up. This is especially the case when the liver triggers a release of a spike of glucose - but because it is a single sharp spike with no food behind it to slow down the release of glucose the release of insulin is too much, the glucose spike is combatted very quickly and there is a lot of left-over insulin and the BS level plunges - creating hunger pangs. That happens each time there is a spike - and the left over unused insulin leads to deposition of excess sugar as fat deposits as well as making cells insulin resistent
That's completely correct. I was just trying to explain it in a simple way that could be understood a little better by someone who may not necessarily understand all the medical terminology and biological explanations.
Hi Kendrew , you explained it perfectly ! i will confess to my lack of knowledge about the whole PMR thing . I didnt research it the first time i had it last year a nd frankly i thought id take the Pred and that was the end of it !! You can imagine my shock when it came back with a vengeance a few weeks ago . Thats when i really looked into it .Its a huge learning curve , im getting there ,so i just wanted some straight forward advice. Im now on the right path.Once again thanks for your advice . So many kind people are taking the time to reply . Starting to feel not as overwhelmed by it . Best wishes Viv x
I really appreciate you saying that Viv54. The last thing I'd want to do is mislead or confuse anyone further. I've learnt so much about the condition over the past 15mths and now understand so much better how my dad must have felt....he had it for 7yrs up to his death, and I feel sad that I probably acted so dismissively because I just thought, "Oh, more aches and pains"! We're each on our own journey (to coin a phrase!) and will each experience different problems and discover our own ways of resolving them, but listening to others conversation helps us make more informed choices and that can only be a good thing.... particularly if we make new friends along the way.
Simple terms are better for me when it comes to this topic. I prefer your explanation. I'm just beginning to understand what happened to me from a dietary and metabolic point of view. I'm currently learning about insulin resistance and metabolism. The effects of long term corticosteroids on metabolism is starting to get interesting. It seems nothing functions normally when a person takes corticosteroids. The effects are truly widespread.
I definitely have metabolic syndrome. They say it takes years to develop. I maintain that it happened practically overnight.
Hi DadCue. For me, the steroids have definitely made me more unwell than the condition and at times I've had to stop reading about their possible effects on the body as it's been too overwhelming to process all at once. It's weird cos my body now reacts totally differently to all sorts of things.....exercise, gardening, diet, change in routine or sleep pattern. I at times have felt almost out of control, and still do sometimes!It would appear some people manage very well on them, but for many, they pose constant added complications that may be eased or eradicated, just to be replaced by a different set of complications. On a positive note, I haven't yet heard of anyone who has suffered ALL the possible side effects of long term steroid use, which is just as well, as the list is extensive. PMR can be an unforgiving condition, but support from people who understand is a huge help.
Yes , if they would alert people to the fact you could put on weight would help! But getting loads of good tips etc on here so very pleased . Thank you x
Drs rarely advise dietry advice. I had an intolerance to organic yoghurt without knowing it. Dr gave me anti sick pills. Took ages to work out the intolerance but as soon as I stopped it, no more nausea and no more pills 💊 I drink soya milk unsweetened and the odd soya yog and feel fine!
And one other thing: I discovered only very recently, that eating 'raw' nuts - ie not salted or added-to in any way - satisfied my 'appetite' for a surprising length of time. Unfortunately, some nuts can be pretty expensive but, in my experience, they are worth 'sacrificing' some less satisfying food for.
I love nuts too. I've read frequently that eating protein keeps you fuller for longer but I'm afraid I can't explain why. It definitely seems to be true so I eat some nuts daily for one of my snacks. I love eggs too and eat lots of white meat and fish, lentils and beans.........can make life a bit 'windy' though!! Haha!
Protein in the diet suppreses the secretion of the "hunger hormone" - grehlin - and boosts peptide YY, a hormone that makes you feel full/reduces appetite.
Protein also smoothes the absorption of glucose - blood levels remain lower than if you had just eaten simple carbs and so there is also less of a spike in insulin in response which means the blood sugar level doesn't plummet as low.
CHEESE!! Really satiates hunger pangs. Eggs are great too. Couldn't live without them.🧀🧀🧀
All this is making me hungry
I was eating a low carb diet before PMR and when I was put on Pred I had no hunger problems. I don't think that is a coincidence rather that I was already used to a diet regime that stopped those problems.
Very difficult, but as I have type 2 diabetes, have to control appetite. Strange though this may seem, keep up the fat in your diet. You we then feel full more quickly and take in less carbohydrates. Very few potatoes, rice, pasta. They are once a week treats.
Two things to add to all the helpful tips here. One is that when you do eat carbs (healthy ones only of course!) have protein at the same time as it helps prevent sugar spike. The other is this: consider when you eat you are feeding your gut microbiome. If your microbiome likes a lot of carbs or sugars then that's what you will crave. I think if you are very strict with yourself and eliminate all carbs from your diet for a few days you will start to rebalance your gut microbiome. I was astonished at how much wheat I'd been consuming when I had my early pred sugar scare. After replacing my carb-heavy diet with one including a lot of protein and vegetables (lots of salad) eventually I started to crave ... wait for it .... kale! This was in the winter of my first year on pred. I have no problems avoiding foods like cake. I do now eat some carbs, bread, the occasional cookie, a single square of extra dark chocolate. Presumably my gut microbiome now prefers leafy greens to breakfast cereal because consciously I certainly do ....
Initially I was told to just cut out all salt or I would put on weight. I went all out with that one .even found salt free bread and crackers ' I also felt continually hungry..and put on weight ' just a Greek yogurt for breakfast no bread low carbs made such a difference. I have not lost any of the 10 kilo's but IV stopped gaining am down to 15 mg pred per day and don't feel hungry that's a start for men very interesting information on this post thank you take care stay safe xx
Maybe a bit contrary to what others are saying, but this works for me. I even managed to actually lose 7 kilos while on 20mg! Firstly, if you are hungry - eat. It's miserable being hungry.
Low carbs - 2 slices of bread per day, no pasta or rice. No cereal. Potatoes occasionally but don't base your meal around them (jacket potato).
Unlimited salad, vegetables and fruit (yes, fruit). You'll soon regulate your intake because if you east too much, you'll have diarrhoea! Bananas are good.
Full fat is good - I can't take full cream milk so it's ss for me.
Eat protein at every meal/snack. Cheese, cottage cheese (full fat), nuts, fish including tinned, meat, eggs and Greek yoghurt. Fat helps to fill you up, so butter and mayo are ok. I like to use lighter butter to reduce saturated fat.
When I eat potatoes, I chose a moderate portion of roast or chips, to slow down the sugar reaching my bloodstream. Mashed cauliflower or root vegetables is a good substitute for mash.
It sounds like a scary diet, especially when your body is getting used to it and you're hungry all the time. My snack when the munchies appear is mashed banana, Greek yoghurt with a spoonful or 2 of sucralose.
It does work. I am diabetic and my sugars are consistently low. However, you cannot cheat. Sneak in a biscuit or two, chocolate or a cake and you will pile on the weight. You MUST keep all sources of sugar as near 0 as possible. Good luck!
Luckily, I did not get hunger pangs. Advice from GP and diabetic clinic is to eat more fat. Yes, you are allowed butter, proper cheese, full fat yoghurt, in sensible quantities. An egg for breakfast. Any toast to be wholemeal.
As someone who was diagnosed with PMR over 3 1/2 years ago (I don’t often post on here because I am in a very different place to most of you now) and went on to develop GCA, Rheumatoid arthritis ( very active and throughout my body) Lupus, type 2 diabetes, hypothyroidism, sjogrens, asthma, and 4 other nasty illnesses (hope you are all feeling sorry for me now) Starting on 69 mgs steroids and now on so many truly horrid meds and injections and having put on 4 stone and been extremely ill since then ....... I have found out 4 magic foods to help me: one is vegetable soup for lunch and on hot days gazpacho (chopped or liquidised) these both fill you up for a long time, both can be prepared whilst sitting down ( I no longer stand or walk). Another, as people have mentioned, mixed nuts - bought online - very good at staving off hunger pangs but don’t have too many and lastly for chocolate lovers, Heavenly Chocolate - nothing bad but delicious, again online. Good luck and I hope you all feel better soon.
Were all those other conditions diagnosed before or after PMR was diagnosed? You should post more often --- I'm sure you could contribute valuable information. Plus, it helps to talk about it.
All diagnosed within six months of being diagnosed with PMR. Prior to that I was slim, healthy, cycling, riding my horse, long walks, still working (67) and full of life. I don’t want to frighten other people.