I recently had a consult with a Naturopath for general well-being health recommendations. I also spoke of my prednisone use and my difficulties with withdrawal symptoms during the taper. She suggested using a licorice herbal supplement (Mediherb Adrenco) to ease the symptoms. I questioned her about this, having read on HU to avoid licorice when on prednisone as it can increase the effects of the drug. She said licorice would help during tapering as I wouldn't feel the effects of the lower dose of prednisone as much - the licorice would "trick" my body into believing I had taken the higher dose.
Some information...I am currently on 3 mg Prednisone. Began GCA treatment in June 2019, Actemra added October 2019. Most recently, I tried a DSNS taper mid April (.5 mg reduction) but had to abandon the plan because of severe jaw and neck pain by week 3. This pain stopped when I went back to 3 mg. (I did not have jaw or neck pain when I was diagnosed...hoping this is not the start of something else...) My rheumatologist told me to stay on 3 mg until our next scheduled consult at the end of July.
I would appreciate thoughts on this recommendation by the Naturopath.
Many thanks, as always, for the continued support and "words of wisdom" by all.
Written by
GratefulBailey
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I don't think you got very good advice. Sounds good, but I think there are too many question marks around the use of licorice with medications. I myself have avoided using it despite several suggestions from alternative med folk over the years because of possible stroke risk and family history, never mind interaction with pred.
Not sure how they work that out. Eating licorice along with steroids will probably increase the level of pred in the blood (that's what it is supposed to do at least) - so that would have a negative impact on pred side effects but also reduce the stimulation of the adrenal glands which will only wake up if the feedback set-up in the body is triggered by the lowered blood level of pred.
It sounds to me more that the GCA isn't entirely gone - and TCZ/Actemra only works 100% for about half of patients. That's probably because there are 3 known mechanisms of inflammation production in GCA and TCZ only works on one of them, the IL-6 part. For the other patients pred is still required for the other inflammatory bits but at a much lower level which is a major gain.
Again, didn’t think of the impact on the adrenals...and believe me, my adrenals don’t need any additional encouragement to continue their sluggishness...
Slowly - a really slow reduction, 1/2mg in a couple of months, is the best way to go. You have really done well so far - and Prof Dasgupta, the UK GCA guru, told us last summer that he often keeps patients at 2-3mg indefinitely as it reduces the risk of relapses.
Yes, have to remind myself to go even slower next time I try to taper again. Thanks for saying I’ve done well so far - doesn’t always feel like it - what a difficult journey!
I do agree with others. I would be very sceptical about anything that would 'trick' the body into thinking it had taken a higher dose of Pred. How will this help you to eventually taper off? Maybe I'm missing something but my thoughts are that you should follow your rheumy's advice. By the way, I love licquorice but on advice found here I've not had even a nibble.
It is usual here to give direct links for such citations - not just the general website. However - since the whole point of the original post is based on the result of the interaction between glycyrrhizin and steroids, using red licorice sweets would be rather pointless.
Of course - if it is just the taste of licorice you want, it's fine if you are happy with artificial flavourings .
When the general recommendation is to avoid taking one thing with another, then don't do that. No, you're not going to think of every possible reason for that recommendation, and no, with a chronic illness, you shouldn't be relying on a naturopath who is not also a full-fledged medical doctor.
when I was reducing really struggled round the last few mgs of pred and so tried 2.5mg for 6 days 2mg for one day and the following week 2.5mg for 5 days and 2mg for 2 days, 2.5kg for 4 days and 2mg for 3 days etc and carried on until was down to 2mg a day for a week - held it there for a week and then started the next very very slow reduction. Worked for me in the end but it was a long haul!
just posted a question about licorice. How many drops a day have you been advised?says on the bottle that 1 drop is 1.05 ml but suggests 8-10 drops a day once or twice.. which seems a lot!
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