Weight gain: Hi All, Been on 15mg Pred daily for... - PMRGCAuk

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Weight gain

Handler5
Handler5

Hi All,

Been on 15mg Pred daily for 2 months, about to reduce to 10mg. I have suddenly developed an insatiable appetite resulting in a 10 lb weight gain in as many days! Would it help to split my dosage, or can I take it all at night in an effort to sleep away the hunger pangs?...

50 Replies
oldestnewest

Hello, it probably won’t make much difference changing your times to be honest. Prednisolone causes the liver to convert some if it’s ‘energy’ stores into glucose. This causes random spikes in blood sugar which the body doesn’t like, so it puts out lots of insulin that clears it, which can make your blood sugar drop. This is before you even put anything into your mouth. When you have any carbohydrates you are helping to keep the blood sugar high and the insulin keeps pumping out so you can keep hitting sugar lows and we all know what that feels like. The tried and tested way to deal with it eat very very low carb diet. On 60mg Pred I had to cut out all pasta, potato, rice, maize, flours or any sort and of course sugar. The raging blood sugar swings calmed down so I didn’t feel dreadful and if I did feel hungry which was often, I ate as long as it was protein or veg. Fruit was moderate but I ate quite a few berries. Desert was 85% dark choc or berries and full fat yoghurt, in my case non-dairy. I had two small glasses of wine a week. Fats are fine, ideally plant based oils and you need a good amount of protein.

Eating merely healthily while taking Pred squally doesn’t cut it, but not being diabetic and facing a major reducing diet is a small price to pay.

Handler5
Handler5 in reply to SnazzyD

Hi Snazzy D,

Thank you for this info, very useful. I am a Type 2 Diabetic (non-insulin) and prior to this hunger surge was practicing a low carb diet and had managed to loose 10-12 pounds. This surge was overwhelming though and impossible to resist, despite my 'after this nothing else' resolutions! Have put your reply on my fridge as a memory aid! Was surprised this took so long to manifest itself I must say. Thanks again.

Regards,

Geoff

SnazzyD
SnazzyD in reply to Handler5

Do you mean you were low carb before diagnosis or since being on Pred?

Handler5
Handler5 in reply to SnazzyD

Before - had cut out what I identified as 'white' carbs (potato, (not sweet) bread and pasta. Eating lots more veg especially broccoli. This was working until this latest setback. Thank you.

SnazzyD
SnazzyD in reply to Handler5

I found that initially the Pred effect accumulated and at three months I felt very ‘preddy’ with all the effects on maximum. On that basis it doesn’t surprise me that it has taken a couple of months to be affected. We all differ but I found I could have very little carb indeed (sweet potato was right out) whereas others wouldn’t function on the same. How closely is your diabetes monitored by you or anybody else? The other thing I couldn’t cope with was salt which would cause massive fluid retention.

PMRpro
PMRproAmbassador in reply to Handler5

How about fruit?

Handler5
Handler5 in reply to PMRpro

Don't have a lot of fruit, re sugar content. Most common is bananas as they're filling. Love grapes and miss them so much !

PMRpro
PMRproAmbassador in reply to Handler5

Lots of carbs in a banana! Snazzy and I need to get down to 20g carbs to lose weight (easier to maintain though) - and one single banana can take you over that in one fell swoop! Lots of people are diappointed they don't lose weight - and when we ask, it turns out they are eating fruit. Healthy maybe, but lots of carbs ...

Once you get into proper low carb you do find you fill up better - at least I think you do. Lots of protein snacks instead of the usual stuff means you have fewer of the roller coaster highs and lows in terms of blood sugar levels.

Handler5
Handler5 in reply to PMRpro

Wow, noted, thank you.

diduck
diduck in reply to PMRpro

I get very stuck as I’m a a vegetarian and fine it difficulty to have no carbs

PMRpro
PMRproAmbassador in reply to diduck

No-one is talking about NO carbs, it is LOW carbs.

healthline.com/nutrition/lo....

PMRCanada
PMRCanada in reply to PMRpro

Yes I adopted LOW carb/sugar/salt which helps me sustain that eating plan over the long term. Cutting out carbs altogether is almost impossible and living without any sugar or salt would cause me likely sway off the path! Unless you have food sensitivities or allergies, my daughter (nutritionist) recommends not excluding completely certain foods groups.

Alchemy8
Alchemy8 in reply to PMRpro

But then there is fruit and fruit. Raspberries are the best but have had to cut out the blueberries largely and my daily papaya half or whole mango for breakfast. Continuing on the breakfast theme there seems to be a no no about dairy but yet yoghurt is recommended for taking pred if splitting. Is there a difference between live and "dead" yoghurt? I have Ewes milk because casein is lower there (not sure if I am intolerant but..breakingtheviciouscycle.inf...). I whack on hemp and linseed too.

PMRpro
PMRproAmbassador in reply to Alchemy8

There is no "no-no" about dairy except in the context of the sugars content - the same applies with fruit. Or anything else - you can eat something which has carbs - but it must be taken off the allowance for the rest of the day because even salad leaves have SOME carbs!

Yes, raspberries and other berries are relatively low in terms of carb content - bit for anyone who needs a low carb content eating the most common fruits soon adds up - apples and bananas can have 20 or more gms of carbs. If you are looking to be at 50g or below then you can arrive there with one banana and one apple.

DorsetLady
DorsetLadyPMRGCAuk volunteer

15mg to 10mg is a bit drop...is that what you've been advised.

You might initially dropping to 12.5mg better, then to 10mg.

Handler5
Handler5 in reply to DorsetLady

Good afternoon DorsetLady,

Apologies, I was trying to be brief. Was started on 15mg daily and am due to reduce to 12.5. As my symptoms have eased greatly I thought that (in view of my increased appetite) I would try a drop to 10mg in order to curb my weight gain - and/or split the dose. I have not run this through my GP as unavailable till Monday (and then on line only). She is very helpful but can give the impression that she is learning about PMR/Pred at only a slightly faster rate than myself! I will take your advice, and switch to a night time dosage at 12.5mg. Thank you, much appreciated.

Alchemy8
Alchemy8 in reply to Handler5

I know just what you mean!! Mine sugested dropping from 20mg to 15mg a few months ago! Now she is suggesting I stay on 19mg for a month now (and my CRP has dropped to 1!!). Good on her - she is begining to see that this is all rather more complex than at first thought.

Dydee
Dydee in reply to Handler5

I was so miserable before diagnosis and so thankful for the Prednisone relief that when I started tapering from 15mg to 10 I did it SLOWLY. I did 1mg taper every two weeks and have now been at 10mg for 3 days. Will stay here a couple weeks then go for the bloodwork doc wants. Depending on results I will begin another taper. Good news is NO recurrence of symptoms. Doc started me on 10 mg initially and it was just not enough. 15 worked great. But talk about weight gain. Hard to do low enough carb when I have to cook for hubby too.

PMRpro
PMRproAmbassador

Cutting carbs and salt might be more effective than splitting the dose - unless you need that to keep symptoms at bay as some do. With such a fast weight gain, I imagine there must be some water retention in there too (hence the salt).

Do be watchful with that sort of reduction step - it works in short term use of pred, a couple of weeks at a dose for example, I've done it. But it might be a different matter after a couple of months. Real experts suggest not more than 10% of the current dose - that is 33%!!!

Handler5
Handler5 in reply to PMRpro

Hi PMRpro,

Thank you for taking the trouble to respond. I will try taking the 12.5 dose at night and see how this works. Was only considering the drop to 10mg as this appetite thing has come on so quickly and soo strongly , much like the PMR itself. The hunger was all consuming and my will power was no match against it!! Interesting that no-one has suggested an alternative steroid... On the plus side, my psoriasis has cleared up 👍 Thanks again, much appreciated.

SnazzyD
SnazzyD in reply to Handler5

What you don’t want is to drop too fast just to try to get rid of the hunger only to have a flare up of PMR and to have to go back up the dose ladder again. Is it possible to restrict what food you have in the house, as in if you don’t buy it you can’t eat it? I wasn’t able to but had had some practice being gluten free and watching the family eat lovely things. Not being able to eat chips though was cruel. A steroid is a steroid and one of the effects of them is this blood sugar and appetite thing, so an alternative that is potent enough isn’t really an option.

Handler5
Handler5 in reply to SnazzyD

Yes, my wife has suggested editing our shopping list!

Love this forum and having the benefit of the expertise and experience of contributors such as yourself. Thank you to all for your advice and guidance. Keep up the good work. Stay safe.

PMRpro
PMRproAmbassador in reply to Handler5

There isn't much in the way of alternatives - both preds and methyl pred are used because they are effective and 1x daily dosing which improves compliance. A few people need to split but it isn't that common really.

Handler5
Handler5 in reply to PMRpro

I see. So much to learn.... I took 5 mg this morning with the intention of taking another 5 tonight (dropping from 12.5 to 10). In view of the advice received will now maintain at 12.5 mg.

Just taking the lower dose this morning has gone a long way to curbing my appetite/eating today. Will stick to one daily dose though, taken at night as this weight gain is causing me more problems then the PMR is currently. Thank you.

PMRpro
PMRproAmbassador in reply to Handler5

That is great - if it works split and stops you feeding your face, go for it! Everyone is different and a bit of experimentation really doesn't hurt.

Handler5
Handler5 in reply to PMRpro

Very encouraging, thank you once again PMRpro, and to all who took the trouble to respond. Love this site !!

It’s a long haul, my hca1c and weight went up quite a bit at first though I’m not dx diabetic, however as you taper down the increased weight will decrease so don’t get despondent. I weigh a bit less & hba1c is now 39, on 5mgm pred. Chin up !

Handler5
Handler5 in reply to 123mossie

Thanks 123mossie, very encouraging to hear that. 🙂

When I first started pred I was starving hungry, I could have eaten a five course dinner followed by another five course dinner and I would still be hungry!

Handler5
Handler5 in reply to piglette

That sounds familiar 😅

I was on 15mg for 3 weeks, then reduced to 10mg for 4 weeks and I'm now on 7.5mg where I'll stay for a while. We're all so different with regard to managing PMR symptoms because I am finding it difficult to put on weight while still eating very healthily. Having been a fan of low fat foods, I now eat full fat. I eat two small bananas a day with full fat yoghurt. I have a small piece of toast with cheese each day, a cheese and salad wrap at lunch-time and my main meal consists of meat (usually chicken), with a variety of fresh veg, and a small jacket potato. Definitely not keto! I had a fasting blood test a couple of weeks ago (sugar, cholesterol, etc etc). All normal. My blood pressure is also normal. I have no pain. I'm 77. I'm not bragging, honestly, because I remember how much pain I was in before diagnosis,just suggesting that many of us react very differently. Consider all the advice that's being offered on this excellent support site, do your own research and experiment obviously with a degree of caution. Oh, and some daily exercise. Even a 40 minute brisk walk a day (if you can manage it) will help tremendously. All the best to you.....

Handler5
Handler5 in reply to Pr0jection

Thank you, interesting to learn of your experience. Balancing the low carb/low sugar diet will require my close attention!

Agree with everything everyone has said. My own experience in terms of weight gain has been a journeyof exploration! I knew about the possible emergence of hunger pangs so always eat at regular intervals starting with a good breakfast. An average day would be.... Breakfast(about 8am):- porridge made with skimmed milk & few blueberries or raspberries on top, followed by chopped up orange, tsp local honey, sprinkled with sunflower & pumpkin seeds and puffed quinoa for extra protein & tbsp natural yogurt. So...a good breakfast that keeps me going till lunch time. Lunch (about 12pm):- hummus with fresh carrot, cucumber and pepper sticks & a handful of mixed nuts.....and dinner(about 5pm):- salmon, chicken or other protein with salad made from spinach leaves radishes, avocado, toms, etc or green veg. About 7pm I have a glass of skimmed milk and some 85%cs dark chocolate. I walk every day, as regular exercise (within your capability) is thought to promote more efficient digestion and metabolism of food, and in 2years I've put on 4lbs in weight. I know my regime wouldn't work for everyone and it's important to say that I don't have diabetes. I try and stay as low carb as I can but obviously carbs are a source of energy so I include some of the healthier ones but still avoid, pasta bread, white potatoes etc. (Although I have to own up to occasionally having some authentic sourdough bread and wholemeal pasta!🙄 Protein will keep you fuller for longer. Eating regularly seems to help minimise any hunger pangs, and in actual fact, I rarely feel hungry. I also drink lots of water throughout the day.....often we can mistake being hungry for thirst! Steroids effect everyone differently so I'm not saying my way is the right way by any means.....but it works for me at the moment and may just give you a few ideas to explore if you need some other options. Lots of protein and low carb is the key though.

Handler5
Handler5 in reply to Kendrew

Thank you Kendrew, a lot of sense here. 🙂

The weight gain is only more problematic than the PMR ! That’s because the Pred is working, reducing too fast will only put you back where you started, the Pred doesn’t cure PMR it merely dampens the symptoms, it’s not a race and for my part getting my head around that and that it could last years and years was the hardest part

Handler5
Handler5 in reply to Polymialgia

OK, thanks will take this onboard.

Just as a matter of interest, I had these 'must eat' feelings when on 15mg Pred. As soon as I was able to lower the dose (now on 5mg) these cravings just went.

Hi Francesbarbara, I knew I was taking a risk dropping down to 10mg but the weight gain was getting frightening.... With the benefit of the many wise responses I have had will remain on current dosage taken as a single dose at night. Due to Diabetes, and a family history of heart problems I am worried about weight gain and the wider implications of it. Also, scared of the intensity of my appetite increase, and where it would end? Many thanks - looking forward to getting down to 5mg daily...

Kendrew
Kendrew in reply to Handler5

I also have family history of heart problems and I'm on statins for hypercholesterolaemia and take propanol for ectopic beats. Also have osteoporosis induced by the steroids so lots of dietary considerations! All makes for some conflicts of interest dietary wise but you just have to figure out the options that will offer the most effective and positive outcomes.

Handler5
Handler5 in reply to Kendrew

Indeed, thank you.

It is possible to split the dose. I did fairly recently and find it much better. I don’t think it would affect appetite. My appetite gradually settled the longer I was on prednisolone but I did put on weight at first. I also feel warmer. The consultant said this was often the case.

Handler5
Handler5 in reply to Fireleigh

Good morning Fireleigh, that's interesting to know, thank you for your response.

Hi there I just could not loose weight until I was on 1 or 2mgs of pred. I am now off pred and in the recovering stage at the moment I hope. I have lost nearly 3stone on WW. I know weight gain is an issue but my experience has been focus on being or feeling well other issues resolve at some point. Good luck.

Handler5
Handler5 in reply to JulieR2

Thank you JulieR2, glad to hear of your experience which will be heartening for many I suspect. Best wishes for a full recovery.

Kendrew
Kendrew in reply to JulieR2

Very well done to you. What an amazing achievement.

Alchemy8
Alchemy8 in reply to JulieR2

I know what you mean. We have to work at so many aspects of ourselves as well - not just physical but psychological, energetic, relationships, how we would like our lives to be and most of all keeping positive as we know how much stress can impinge on our healing. Setting an intention with from the heart is always good. And of course looking at this brilliant forum which is such a support!

Thanks so much I never thought I would be able to loose weight but I think focussing on recovery helped. Your weight will come off when the time is right I am sure. I know how upsetting it is on top of everything else

From my own experience from being n Pred for 10 years plus, it will make no difference.Carbohydrates and pred are not the best of friends. Just keep track of calories and carbohydrates is my suggestion. I ballooned during lock down to 15st. It's taken me 120 days

to get to 13.7st, only by way of exercise and watching calories. The trick is to nip the weight increase in the bud! Not let run on like I did!

I gained 30 lbs. and after a year on prednisone (I am down to 1mg) I have only lost 10lbs. My doctor said that even if you are on a strict diet weight is slow to come down.

PMRpro
PMRproAmbassador in reply to baxternoni

Slow maybe but possible. However- that may be just an excuse as MrsNails lost a lot of weight since the New Year while on above 10mg pred:

healthunlocked.com/pmrgcauk...

That's 28lbs in under 9 months - hardly slow by anyone's standards ...

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