auto immunity

[Meggs01]

Is there a point when tapering that your natural immunity returns?

[piglette]

When you stop taking the steroids. When a person stops taking prednisone, the body cannot immediately produce enough cortisol to make up for the missing drug, so it could take even up to a year to recover.

prednisonepharmacist.com/ed...

[Meggs01 in reply to piglette]

thank you for your reply.

[PMRpro Ambassador]

Sorry, not quite clear what you mean. Autoimmunity is not a loss of immunity - it is a state where the immune system isn't able to recognise body tissues as self and so attacks various tissues as if they were foreign bodies, like invading viruses, bacteria or foreign bodies like a prosthesis or transplanted organ,

I have been on pred for a very long time but I really can't say that I am any more liable to catch infections than I was pre-pred.

In autoimmune disorders the immune system isn't working normally in some respects but in the case of PMR and GCA this derangement of its function burns out and it goes into remission, returns to normal, stops attacking body tissues and creating inflammation. At that point patients will be able to stop taking pred as there is no inflammation to deal with. PMR/GCA are unusual in that respect - the vast majority of autoimmune disorders don't burn out and go into remission long term.

[Meggs01 in reply to PMRpro]

I’m sorry for not being clear but I’m not too sure myself 🤣 When I was first diagnosed with PMR and put on 20mg steroids I was told I wouldn’t have immunity against infections. I was just wondering as I come down on my steroids if I would start to have some immunity?

[HeronNS in reply to Meggs01]

Pred does reduce the activity of the immune system, because the whole idea is to stop the immune system from being too active and attacking ones own tissues. My experience: First winter, when my dose was still over 5 mg (started at 15 mg) I did catch a couple of colds, which was a bit unusual for me. Also noted that if I had a scratch or a mosquito bite (the first summer) or some other minor injury it seemed to take longer to heal. As I've aged I can't say that the healing of skin contusions has returned to my pre-pred state but I certainly regained my resistance to colds quite rapidly. This, to be clear, was long before covid and masking. My lowest best dose since the end of the second year on pred appears to have been at or about 2 mg. I'm currently at 1.5. Am sure that my normal immunity to common cold etc has been perfectly operational since achieving a dose below 5. I was at 2 mg by the second winter (2016-17).

[Meggs01 in reply to HeronNS]

very reassuring, thank you.

[PMRpro Ambassador in reply to Meggs01]

I'm really not at all convinced by the suggested lack of normal immunity just because we're on pred - as I say, I have had absolutely no issues with infections or any sort of healing. I think it may well be a personal thing - how many colds or whatever have you had since being on pred? Though if that is the last few years, masking not only protects from Covid but a lot of other things.

[Meggs01 in reply to PMRpro]

I agree the masking has had a great benefit. I was also hoping my thin skin might have improved by now but the slightest knock just tears my skin, I always carry a selection of plasters around 🤣

[diana1998 in reply to Meggs01]

I didn't have a cold for 7 years on pred and caught nothing, not even my husband's odd cold/cough. Then had covid last December and had a terrible cold with cough, big shock but stayed in and rested up. Made a complete recovery after 10 days. So now hoping for another 7 years cold free!

[Meggs01 in reply to diana1998]

thank you for your reply, glad you are fully recovered.

[agingfeminist]

I have had probs on pred with infections ...never had them before. A fungal infection (horrible drugs) and a year later a bout of cellulitis requiring iv antibiotics. I hadn't had antibiotics for over 30 years. I am now extremely careful to avoid scratches. Others have had UTIs...so perhaps extra liquids might help.

[Meggs01 in reply to agingfeminist]

thank you for your reply, these steroids certainly have a lot of unwelcome side effects!

[agingfeminist]

but they have made it possible for me to move without pain...I was paralysed for hours in the morning until I had steroids...all the collateral damage I can live with...the pain was impossible

[Meggs01 in reply to agingfeminist]

so pleased for you.