Naive question

[Rosina1871]

I know that a low carb diet is necessary when on steroids to avoid weight gain, but does the different dosage of steroids influence the amount of carbs you can eat? Ie if you are on 30mg are any carbs more likely to give weight gain than say if you are only on 5mg. Sorry if I haven’t worded that too well

[SnazzyD]

I suspect the answer is that boring one, depends on the person. High dose logically gives you more glucose spikes for the liver but some of us have to cut out carbs so much more than others to prevent blood sugars going up and weight gain. I also think the effect can hang on long after the dose drops. I found that at 5mg I couldn’t be much less strict than on 30mg and still on 0mg for 9 months I still can’t have any carb padding with my meal more than once a week. I have a biscuit a day with my elevensies and a couple of bits of choc for pud and a bit more fruit but still nowhere near my old carb intake. Interestingly I’m still pretty sensitive to salt as if I was still on Pred, though not the eye puffy bad as when on 30mg.

[HeronNS]

Not a weight question for me, but blood sugar. Definitely dose related. High blood sugar at beginning (15 mg) and I think "normal" by 3 mg, with a steady decline during that year, dose tapering from15 to 3. Blood tests every three months after the first month or two. So I suppose other effects of pred also decline. Certainly my eye pressure became normal again at about the same rate, although that's not related to diet.

[Rosina1871 in reply to HeronNS]

Thanks heron. Interesting

[HeronNS in reply to Rosina1871]

I've had to start eating carbs again because I was becoming dangerously thin so there is such a thing as too much (or in this case too little) of a good thing. It had just become such second nature not to eat in particular wheat products I had to force myself to start eating bread and cereal again. Mind you, I do enjoy a good pizza! For several years these good foods were rare treats and I'm still pretty abstemious. Been on pred for almost six years.

[Rosina1871 in reply to HeronNS]

Thanks. I’m eating very little carbs. Think the two glasses of red wine appear to affect me 🙈

[Carver63 in reply to Rosina1871]

been on low carbs intermittent fasting for 7 months to help control weight gain. i gained almost 30 lbs while on high doses of Prednisone. sugar and alcohol are the bad ones for me. off both now for 9 months. slowly adding some carbs now to help energy level. pred at 7 and i am finding i need some food to help the tiredness.

[PMRpro Ambassador]

Some people don't gain weight at all, some lose weight. Having gained weight with higher doses of pred, some people will start to lose at lower doses - but others won't lose an ounce until they have stopped pred altogether and then it may just melt away or you may have to actively aim to to lose it.

It really is as varied as that and I think it is more the person than the dose. Like Snazzy, I don't lose weight until I am at a very low carb level - but maintaining my weight is a lot easier.

[Rosina1871 in reply to PMRpro]

Thanks pmrpro

[Cosmos22Marigold]

Found i felt much better when on low carbs but since increasing them a little my weight has remained the same but i am more active so its one against the other for me. Good luckl