Inflammatory reaction to sugar and carbohydrate ?

[Seekingasolution]

did I read somewhere on this site that people with PMR and or on prednisolone can develop a reaction to carbohydrate ? One of the first things I recall about this journey was feeling very dodgey after sucking some butterscotch sweets on an empty tummy. That was before I was diagnosed and given steroids. I’ve now tried coming off steroids for about 3 weeks and I’m finding that sugar and carbohydrate can make me feel fluey after about 20 minutes. Food like marmalade on brown toast, maybe a little too much honey on yoghurt. More recently I made some flat breads with Greek yoghurt and flour and didn’t feel great after that either. I believe I’ve become more sensitive to carbohydrate but a banana this morning was ok, more complex I assume. I am missing my prednisolone! I do feel somewhat achey in the hips and tired but I’m now wondering if that’s osteoarthritis as the groin pains I used to have, have gone. I assume pred would help with arthritis too ? My mood isn’t down either as it was before pred. I used to feel fluey a lot but I didn’t keep a food diary so I can’t recall if I felt odd all the time or after I’d eaten. Any thoughts on the above ? Perhaps it’s time I went back to my rheumy for a review.

[PMRpro Ambassador]

Not that I know of.

What we do say about carbs is that it is a good idea to cut the amount you eat when on pred as that will help reduce weight gain and the risk of developing steroid induced diabetes. If you cut carbs a lot, particularly processed ones and added sugar, and then suddenly eat a lot of carbs or sugar many people find it makes them feel unwell - sugar is pro-inflammatory and all carbs turn to sugar in the body.

[Seekingasolution in reply to PMRpro]

Hmmm I have had a blood test recently and it didn’t show any pre diabetes markers. I’m puzzled then.

[PMRpro Ambassador in reply to Seekingasolution]

No - not pre-diabetes at all, just a rush of sugar that you haven't been used to. Not everyone becomes pre-diabetic, but most people do gain some weight. But you can't tell in advance who will suffer which side effect - and cutting carbs serves 2 purposes.

[Gimme]

I had read that sugar can be inflammatory. I try to avoid any added sugar because of the increased risk of developing diabetes on pred and I don't want to put on any more weight. However, I have noticed that if I lapse (very rare) and have a bit of a binge on either sugary treats or crisps, my aches and pains really kick off the next day and for about 48 hours. I've never found anything in the literature to confirm that that is a recognised thing, but it happens to me. But then, I am wheat intolerant, probably an undiagnosed celiac and follow a gluten free diet, and I have some other food intolerances, so there may be some other reason, in my case.

Your GI symptoms make me wonder if you might be a fructose or lactose malabsorber. Though I am reluctant to send anyone off down that journey after my own experience. It is a real pain. Do your symptoms worsen after foods that contain a lot of added whey. Could it be related to wheat? Do you react to apples and pears, for example? Has anyone (medical) every suggested to you that you might have IBS? It might be worth keeping a food diary for 2 or 3 weeks and recording your symptoms, before discussing with your doctor. A food diary will soon show if there is any kind of pattern. Btw, if I accidentally eat wheat, it gives me exactly PMR symptoms in addition to the GI symptoms.

[Seekingasolution in reply to Gimme]

I think keeping a food diary is a good idea. Fruit seems to be ok. Dates although sweet are ok. Dairy ok. I think. .. don’t get any other IBS type symptoms just feel fluey and tired and I was just thinking Oh No !! Re brown toast and marmalade! Gawds sake !! I don’t want to be any more faddy than I am already ! I just like a lot of veg and some fish. Not too much animal protein. A kind host made me paella last weekend thinking they were cooking a perfect meal which I obvs ate gratefully but actually paella has no veg at all, a lot of carb and wriggly stuff !! I hate to sound ungrateful!! 😂 ‘ What would you like for breakfast ? Bacon? Eggs? Pain au chocolat? No thank you

[Gimme in reply to Seekingasolution]

I've just read your OP again and initially, I had homed in on the dietary aspect, but on second reading, it was the fluey symptoms that stood out. The dose reduction and re-emergence of PMR symptoms could easily do that. Pre-pred, I used to get fluey symptoms now and again quite regularly and it is listed as one of the symptoms of PMR. But if you are linking it to sugar/carb intake, I really think you should explain this to your GP and ask if you should have your Hba1c checked (if you haven't had it checked in the last 2 or 3 months). They should be monitoring your bloods periodically anyway, if you are on pred long term, though they don't always check blood sugar.

[Seekingasolution in reply to Gimme]

I’ve had bloods done in the last couple of months and was ok. The fluey thing has started again now I’ve stopped steroids. I ll have to see if I can get an appointment. Thanks for your input Gimme