Joints if you pardon the pun

[Dog-11]

Sorry I haven't posted before. Not good with this tinternet thingy. Hope this isn't a touchy subject. Anyway I smoke a couple of small joints in the evening. Have been OFF IT for 5 days or so . The pains in the back off my legs felt so much better. Had one small joint this evening and within the hour I could feel the pain returning. I'm wondering if the joints are working against the pred ? John

[PMRpro Ambassador]

I think many things are trial and error - and when you identify something that makes things worse it is a good idea to consider whether you should be doing them - whether it is activities or things you eat or drink.

pubmed.ncbi.nlm.nih.gov/165...

seems to suggest that THC can have an agonist effect on corticosteroid receptors. That means that the receptors on cells in the body that would normally bind with the pred can bind with the THC. Pred has to bind with the receptors to be able to have an effect but if THC is already occupying them, pred can't get in to have its effect and THC doesn't have any effect on the inflammation. So it reduces the effect the pred would have. Have I put that clearly??? I know what i mean - need a pen and paper ...

[PMRCanada]

I consumed cannabis for years in the evenings to help with sleep when I had PTSD. When I was diagnosed with PMR 4+ years ago and started pred at 20mg it helped with calming my mood swings/anxiety at the higher pred dose, and with the side effect of insomnia. The pred worked really well to address my pain/inflammation but I didn’t notice any impact from the THC one way or the other. Of note I usually chose cannabis strains that had no, or very little CBD for the exact reason PMRPro highlighted (receptor blockage).

More recently I’ve had a bad bout of bronchitis that resulted in having to take puffers and antibiotics, so I stopped smoking or vaping any cannabis for about 6 weeks now. I haven’t noticed any change in my PMR symptoms or pain levels (not that I was having much pain except from pred withdrawal when I first begin a new step down in my pred dose taper), but my lungs feel much better. Given that I’m also on Methotrexate as a steroid sparer which can make me more vulnerable to respiratory infections taking off, I think I’ll just avoid it for now. Besides I also have to stop my weekly MTX each time I take antibiotics which means I also delay my taper.

[darkred in reply to PMRCanada]

I have been studying P450 inducers vs P450 inhibitors. Prednisone is an inducer, CBD is an inhibitor. In my opinion, that supports what you said about choosing a strain with no or very little CBD. It appears they cancel each other.