Prednisolone weight issues

[Linbin1]

I have been on prednisolone for about 2 years now, starting at 25mg . I have reduced this down to 3mg but have a lot of pain. I have put on 2 stone, mostly around my waist and stomach and was hoping I would lose it by now. Can anyone help with weight issues.

[DorsetLady PMRGCAuk volunteer]

Now you have posted, plenty of related posts, but only way really is to cut carbs….

But am a more concerned that you say you have a lot of pain at 3mg… what in particular? You don’t have anything on your profile….

[Linbin1 in reply to DorsetLady]

PMR has been diagnosed but haven't had a consultation with anyone other than my local GP and that was well over a year ago.

[DorsetLady PMRGCAuk volunteer in reply to Linbin1]

So what did GP do - just give you steroids and told you to get on with it…..or similar. Most GPs are capable of dealing with PMR, but they do need some input to check how the patient is…. After all they are signing off your prescription each month, so for that reason alone they need to monitor you.

Sounds as if you have reduce below the level of Pred your illness actually requires.

If you haven’t already seen, you might like a read of this -

healthunlocked.com/pmrgcauk...

[SnazzyD]

I totally agree with DL about the diet and pain. A few people lose the weight with the Pred dose going down but not all. I think if you gained an appreciable amount there needs to be a change in diet not just hoping it’ll just disappear, partly because there will no doubt be other factors at play such as change in exercise, deconditioning, other medications, metabolic changes and dare I say it ageing. I went on very low carb from the start of 60mg, didn’t put on weight but still had to be pretty vigilant even when off Pred for a few months.

[Linbin1 in reply to SnazzyD]

I have tried to restrict the amount I eat since starting on prednisolone but it hasn't helped. I haven't tried low carb though so I may give it a go.

[SnazzyD in reply to Linbin1]

A normal healthy diet, even with portion control doesn’t usually help with Pred because of the way it changes your metabolism and blood glucose. Pred causes spikes in glucose and then a spike in insulin which converts the excess sugar into fat. It can make people end up either insulin resistant or diabetic too which is why we try so hard to avoid carbs. Out of interest have you had any glucose blood tests recently, ie HbA1c?

The Pred also has the ability to shove any fat you have around your waist, face and neck. As I dropped down, my face went down first. I had to cut out all potato, pasta, rice, maize and flours at one point. Watch out for fruit (berries are best) and root veg but don’t cut out all carbs. Fats (ideally lots of plant based oil) and protein were kept the same and I found I could eat masses as long as it wasn’t carbs as the bulk of the meal. You are on a low dose of Pred so don’t have to go really hard but you are trying to lose weight.I recommend a food diary for a normal week because it can be surprising how much carbohydrate is getting in. It’s trying to find the right level for you as we are all different.

[Loyd in reply to Linbin1]

I put on a lot of weight in the first two years of PMR then decided something must be done!! I have dropped from 84 kilos to 60 kilos by just refusing all carbohydrates - all! I now have the odd treat of a quarter pizza or a tiny helping of pasta. I wish I’d done it 30 years ago! Good luck it really does work! And I still have a glass of wine in the evening!

[sidra1968 in reply to Loyd]

Hello, could you give me an example of your typical daily diet please? I gotta do something!

[PMRpro Ambassador in reply to sidra1968]

Look at the diet doctor site I recommend and see what NOT to eat - which Loyd has listed really. Then look at what you CAN eat and find what YOU like amongst it.

dietdoctor.com/low-carb

They have suggested meals and advice. Recipes too.

First start by banning processed foods - ready prepared meals and baked goods. Cook from scratch using no flour, pasta, rice, potatoes of any sort. But that leaves LOADS of lovely things and the money you aren't spending on carbs can go towards what you are allowed.

But don't go hell for leather at it to start with - first identify the very processed stuff and cut it by at least half. After a couple of weeks, cut the rest and added sugar. Maybe you will be losing weight by then - lots of people only have to do that. Keep cutting the carby stuff until you ARE losing weight.

You can eat meat, fish, eggs, cheese - no carbs in that at all. Above ground veg and salads are also fine. But root veg and fruit you have to be careful about. Breakfast shouldn't be cereal or toast, yoghurt and berries with no sugar is OK - use plain Greek yoghurt and add something if you must - no ready flavoured yogs, they have a load of sugar in them.

Google suggested low carb breakfasts, lunches, dinners, it is so easy these days.

[sidra1968 in reply to PMRpro]

Thanks! Also, was going to update you, but wanted to wait until more time had passed, so as not to jinx myself. BUT, so far this taper has been ok..I get the bloods done next week (again) . Thank goodness on that second day the neck pain only lasted a little while (a few hours).

[Loyd in reply to sidra1968]

Well I don’t eat anything sweet ever. (No sugar) I have never eaten breakfast and only have a cup of tea. Most lunches I have a very small salad with maybe cooked ham or chicken, tomatoes and lettuce and olive oil and vinegar. At night we do a steak on the BBQ or maybe fish in tin foil with a salad. Maybe sounds bleak but it’s delicious! I used to eat heaps of take away curries or mince and tatties or huge Sunday roasts with Yorkshire puddings - all in the past! I love being slim for the first time since I was a child! It can be done and so worth it! New clothes look great. Wishing you the best. 👍👍

[sidra1968 in reply to Loyd]

Thanks for your reply. Really, I guess I know how to do it..I just love cooking so many different dishes from all different countries and my collected spices - that is my downfall. I am not a sweets eater, so that will help. I will give it a go starting tomorrow! God knows I have enough tomatoes to last years in my garden.

[Loyd in reply to sidra1968]

You can do it! Good luck. 👍👍👍👍

[PMRpro Ambassador]

Cut your carbs! Drastically but above all processed carbs and added sugar, limit fruit. Healthy diet in the normal sense and calorie cutting don't cut it with pred, must be the carbs, How much varies from person to person, a few of us have to get to almost keto to lose, maintenance is a lot easier.

I find this site very useful to get the information, it is European so not full of inaccessible items

dietdoctor.com/low-carb

The pictures of how much carbohydrate is in various foods are clear and easy to understand.

The problem of your pain has been mentioned - at what dose did you last have an acceptable pain level? You aren't reducing relentlessly to zero, you are looking for the lowest effective dose, the lowest dose that gives the same level of relief as the starting dose did. Any less, and there is left-over inflammation each day which will build up over time until you are back in as much pain as you were originally, It is like a dripping tap over a bucket - eventually it will fill up and overflow.

[Linbin1 in reply to PMRpro]

Thank you for your help

[tangocharlie]

I endorse all the advice on low carbs, it has worked for me. I also think that possibly one of the reasons you're in pain is that it has only been 2 years, your PMR is probably still there and you're not on a high enough dose to control it. The PMR goes when it is ready, steroids don't cure it, they only take away the inflammation in the meantime.

[Sueloucam]

I feel your pain, both physically and psychologically regarding weight gain. In the 1st instance it sounds like your pred is too low if you are feeling the physical symptoms, As much as you will hate the idea of increasing your steroids, you are not helping your body by being on too low a dose. 2 years is quite a short time in the whole disease journey. I am nearly 5 years now and it took me over 2 years to go from 7mg to below 3mg this year, I am now on 1mg reducing 0.5mg every 2-3 weeks. I finally feel that my disease has gone, for the moment. You cannot rush it , I wanted to exercise and like to do so, but constantly had flare ups that stopped me exercising and eventually retired from work too. Regarding the weight loss, my initial weight loss was through the Keto diet, drastically cutting carbs. It worked but not maintainable long term. I slowly increased my exercise level as PMR permitted. Even though I have put weight on, lost it and put a bit more on, I am now 3 stone lighter, it changes your mood and whole outlook on life. It is a struggle and requires consistency plus determination like I never imagined. I am currently on a local weight loss programme that I have managed long distance as still travelling, with lots of support and a closed Facebook group for questions, recipies etc., which led me the 3 stone weight loss. Best of luck and make contact if you wish.

[Linbin1 in reply to Sueloucam]

Thank you for your advice. Is the diet you follow skimmers world?

[Sueloucam in reply to Linbin1]

Hi, no it’s a SHRED programme run by a local fitness instructor, it lasts 8 weeks with menu and exercise programmes.

[agingfeminist]

just cut carbs...and keep cutting until you don't put on any weight. Out with anything that has flour or sugar in it...no bread, cakes, pasta, pizza...no rice. Check on a diabetes website for fruits with low glycemic index. No fruit juices, You can eat loads of vegetables, fish, meat, eggs. I found beans were fine and small amounts of nuts. Only eat potatoes that have been cooked and then allowed to go cold ...the starch in them changes so you can make them part of your diet. The diet becomes a way of life. Good luck

[Loyd in reply to agingfeminist]

Agree agree! No flour! No sugar! For me me no potatoes. Also only a tiny bit of rice once a week (I love curry!)