Why does Pred need to be taken with food? Do they... - PMRGCAuk

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Why does Pred need to be taken with food? Do they cause water retention and weight gain?

Motida profile image
22 Replies

Just wondered how much and the kind of food has to be taken with the cheaper Pred and why? If you can get the coated tablets do they need to be taken with food? Do they stop indigestion burping?

If Pred really causes water retention i.e. weight gain, what medication/OT counter can one take to drain off the water safely and which would not provoke bad night cramps?

Pronoun She/her 80 uk

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Motida profile image
Motida
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22 Replies
SnazzyD profile image
SnazzyD

Enteric coated Pred does have a less harsh impact on the stomach. I found it helped me after uncoated and stomach protecting meds didn’t help. The main thing about non-coated is to have it with a meal. Some people get away with a snack or yoghurt but we’re all different.

On the subject of side effects, the dose makes a difference and they should reduce as the dose lowers. Yes, Pred causes retention of sodium and fluid retention. I had this quite badly and had to go on a super low salt diet until I was under 10mg. Cramps can be caused by low potassium and magnesium, both of which are depleted by Pred. Potassium is best found via diet rather than supplements because over doing it can be dangerous. If you have kidney problems you need to speak to a doctor first. Magnesium supplements are commonly taken by those on Pred.

As for weight gain, Pred causes the liver to release its glycogen stores to become glucose. This is before you eat anything, so if you then eat carbohydrates, especially refined one, it adds to the glucose load. You then get a spike of insulin that makes your glucose drop and you’re hungry again. In the end you can become insulin resistant or diabetic. This can happen without Pred but with it, even a standard healthy diet can contain too much carbs. Again, it varies from person to person as to how much they need to cut out. I had to cut out all rice, pasta, flours, potato and maize until I got low enough in dose.

SheffieldJane profile image
SheffieldJane in reply toSnazzyD

Snazzy, can I pick your brains please?

I have borderline high blood sugar which is within normal levels sometimes. It seems that once you are identified as such you are in a system like a rolling train. I am bombarded with diabetes information and receive telephone consultations from a diabetes nurse. I was previously congratulated on having reduced my blood sugar levels to normal by a GP. I was tapering.

The latest advice is a medication ( unnamed) that enables you to “ pee out “ ( quote) excess glucose.

Can anyone advise on this? Will it cause further problems? Should I try it? My blood sugar levels correlate with my Pred dose. My diet is sensible apart from evening sugar cravings. I do not want to invite urinary problems and abdominal pain which I struggle with.

Getting you on a drug seems to be a “ score” for the diabetes team - very nice women but working to a plan. Thank you!

PMRpro profile image
PMRproAmbassador in reply toSheffieldJane

The drug that makes you pee the glucose out has - surprise surprise - a major adverse effect of UTIs since glucose feeds the little beggars. And yes - you ticked a box!

When are the "borderline highs"? Is this with random finger pricks? Or how do they establish them?

SheffieldJane profile image
SheffieldJane in reply toPMRpro

Ordinary blood tests highest reading 5 if I remember correctly, ages ago. They are more interested in treating than diagnosing.

I knew it! Some instinct of self preservation knew that I would be entering the portals of h*ll. Sorry happy Halloween. 🎃

PMRpro profile image
PMRproAmbassador in reply toSheffieldJane

Was that fasting or random? Are you SURE only 5?

SheffieldJane profile image
SheffieldJane in reply toPMRpro

Random and I am not 100% sure. I was sucked into the vortex ages ago.

PMRpro profile image
PMRproAmbassador in reply toSheffieldJane

Check - if that is the highest they've registered, tell them to get a reality check ...

SheffieldJane profile image
SheffieldJane in reply toPMRpro

Will do, she is ringing soon with this life ruining wonder drug. Thanks!

PMRpro profile image
PMRproAmbassador in reply toSheffieldJane

I really would want to see their claimed evidence.

SheffieldJane profile image
SheffieldJane in reply toPMRpro

I will ask if I can have definitive tests before I agree to drugs. Thanks.

PMRnewbie2017 profile image
PMRnewbie2017 in reply toSheffieldJane

Hmm. My understanding is that random blood sugars are not how diabetes is managed these days. Surely you should have an HbA1c? Is the SGLT2 drug being given as first line? Usually it comes further down the list as an option. My OH takes Metformin and Dapagliflozin. No side effects other than he pees for England. His HbA1c is now much reduced and he's borderline T2 again. His diabetic nurse said she prefers Dapa to the other SGLT2's but didn't say why.

SheffieldJane profile image
SheffieldJane in reply toPMRnewbie2017

It is as if long ago - I mean years - when I was on over 10 mgs of Pred a blood test that didn’t seen unusual showed raised blood sugars. Since then I have been stuck in a programme for diabetes 2. In spite of my lowering my blood sugars to normal levels within a short period of time and being congratulated by my GP for it. This coincided with my lowering my Pred dose. It seems that I cannot resign from this special measures programme. No more tests are administered. I am bombarded with dietary advice and phone calls from a diabetes nurse. I have explained all this but it falls on deaf ears. I will have to ask for HbA1c test. They act as if once your test results have been high ( once) that’s you locked in. Maybe that is the case. At their worst they were called borderline. The reading I remember is 5 but I am wondering if it was 6 then 5 then 4. Due to nothing but lowering Pred.

PMRpro profile image
PMRproAmbassador in reply toSheffieldJane

I'd have a paddy at the GP - because it is wasting resources that could be better directed at someone or something else.

Sophiestree profile image
Sophiestree in reply toSheffieldJane

5 isn't that high. You need to know the LDL and HDL. Pretty sure mine is that but but would need to check

SnazzyD profile image
SnazzyD in reply toSheffieldJane

PMRPro has replied. Yes, I’d be wanting a more solid basis for diagnosis to take this drug or any that might tip me the wrong way. It doesn’t sound like a bundle of laughs

diabetes.co.uk/diabetes-med...

SheffieldJane profile image
SheffieldJane in reply toSnazzyD

Thank you. That’s the drug. I am on BP meds and am prone to UTI’s. So it would be no good anyway.

Motida profile image
Motida in reply toSnazzyD

Thank you very much everyone for the information. I eat the same diet now, as before PMR was diagnosed and yet 10 kgs has gone on. I do take salt but never more than the 6 mg because I have crippling feet, shin and groin cramps at night if I don't. They make me cry with the pains otherwise.

I will check out diuretic herbs and veg rather than ask for water tablets.

BTW I flagged up breathlessness and blurred vision earlier. Heart and lungs checked out and are okay so it must be the Pred.

I have been put on the waiting list for cataracts this week because the Pred has made them worse. I have to use the camera on my phone to see road signs and bus numbers and then enlarge them in Pictures to see. I did it in an art gallery in Dresden last week and got to see some of the paintings. My Mantra is "it can/must be managed somehow"

Enjoy what the weekend has to offer. For us an extra hour in bed on Sunday!d

PMRpro profile image
PMRproAmbassador in reply toMotida

Try cutting carbs, especially processed ones and added sugar and limit fruit - helps with the weight problem.

And try magnesium supplements for the cramps.

Mfaepink1973 profile image
Mfaepink1973 in reply toMotida

I take dandelion root capsules to relieve bloating from water retention but only use them occasionally.

Missus835 profile image
Missus835 in reply toMotida

Yay us! I get to see Ophthalmology Surgeon in November and his assistant is saving me a surgery spot in December. She felt bad as I've been on bed 4 months with now 8 vertebral fragility fractures and I mostly read. My eyes in some aspects are better. Only need my glasses for reading. Distance not. Computer unsure, but this prescription doesn't work. Went back 2 sets of eyeglasses. Can't wait to see if syrgery improves vision even more.

PMRpro profile image
PMRproAmbassador

Snazzy has covered most of it, Taking pred with food is just to mop up the acid while the pred is in the stomach as some doctors think the main irritant is the pred's presence in the stomach - others think it is the presence in the blood. Either way, acid without food isn't good.

In terms of fluid retention - I don't usually have a problem as I use no salt in cooking and almost no processed foods, However, if I eat out I immediately develop puffy ankles - even one very salty meal can do it and 3 consecutive days is guaranteed to do it! Our advice to cut carbs also helps because carbs also lead to fluid retention in the muscles. And since the main approach is to cut processed carbs - it also cuts salt intake at the same time.

agingfeminist profile image
agingfeminist

you have already received great advice. I have followed the wise advce here, Just summarizing.

1. pred taken with greek yogurt meant I didn't have to take ppi (e.g. omeprazole)

2. no added salt (stopped swelling) also keeping feet elevated when possible. I work with my computer on my lap on a recliner chair.

3. Almost totally elminating carbs stopped weight gain and moved from edge of diabetes to normal range (absolutely no sugar (or sweetners), flour, rice...only berries ..no other fruit and no fruit juices),

BTW You can eat potatoes but only if you let them get cold (changes the starches)

My doctor told me none of this. All learned here.

Good luck!

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