I came across this
ncbi.nlm.nih.gov/pmc/articl...
Nutritional recommendations for patients undergoing prolonged glucocorticoid therapy
I do wonder if there should be a leaflet on nutrition that docs hand out when they start us on high doses of daily pred (including reducing carbs, increasing protein etc.)
I am forever grateful for the low carbs advice on this forum, which stopped my prediabetes from deteriorating.
it looks like I do this. A few months after my PMR diagnosis I was diagnosed with type 2 diabetes. I was put on medication but changed my diet. No processed food, low carb and I walk over 10,000 steps a day. My diabetes went into remission. I have kept going with this diet and over 6 years later I am still on the diet.
I believe in France they give out dietary advice - very unpopular because it limits carbs and they can't have their baguettes!! In the UK of course they are very scathing about the role of diet and many doctors and nurses are still churning out the old fashioned advice about diet in diabetes. Not recently, but I still remember the dietician I was sent to by the GP for weight loss - she lost me when she informed me my food pyramid should include 6 slices of bread a day - SIX!!!!! I didn't eat bread even then. If I ate 6 slices of bread spaced through the day, I'd eat nothing else.
I was talking to Prof Sarah Mackie about the low carb experiences on the forum and even she wondered aloud whether more dietary prescription was called for.
More? I don't recall any! Even when I asked whether there were anything I could do. Was also not told that calcium and pred should not be taken together.
Brits are notoriously non-believers in the role of diet! And most doctors don't know the calcium/pred fact - many pharmacists do write it on the label but not all.
I'm afraid I do wonder whether the pharmacy students who graduate with high marks often end up in little corner-shop pharmacies... I'm happy to be corrected on that.
Depends what they want to do. Some choose to go into hospital pharmacies - they have to have really good results to be allocated in that direction. Others choose community pharmacies. My grandson loves both. He graduates soon - not sure where he is going but loved both. Think the power they have in hospital to correct errors made by medics appeals!! And then there is always rsearch.
You might like this: One of my son's friends, was asked by a local man what he was going to study at university. 'Pharmacology', he replied. 'So you want to be a farmer then?' said the man.
😳… 😂🤣
Sorry to interrupt on a small point but can you remind me what the Pred/calcium advice should be? Is it a minimum of 3hours between the two? Or longer? And why? Is it coz calcium interferes with/decreases effect of Pred?
Two is supposed to be enough. Calcium is thought to coat the pred tablets and interfere with their breakdown and absorption. Pred also interferes with absorption of calcium in the gut so to some extent it is a two-way problem.
Thank you very much. Is the two way effect mitigated at all ( or timing different) if you’re taking e/c Pred?
That isn't absorbed until after it has passed through the stomach, However, the lower gut effect of pred on calcium will probably still apply. I would think that given the approx 4-5 hour delay in absorption of e/c pred, a 2 hour gap between taking pred and calcium is likely to work either way. But who really knows!!!!
I find it a problem when eating out in UK. Menus now show the amount of calories for each meal but none show carbs!
I have to ask for a salad instead of chips!
but you can easily recognise the carbs...bread, rice , pasta, chips, cakes! A few hidden carbs ...flour in a sauce won't matter...you can just avoid the biggies.
yes but the littlest add up when it is important.
I know the major ones as I have been carb watching for 7 years now. It would also be nice to have more low carb meals on menus. I asked a waitress about low carb food once and her reply was “we do jacket potatoes”
About right for a waitress in the UK! At least here the waitresses have mostly done a proper qualification. One of the mountain huts in a local high valley offers gluten-free which is clearly marked on the menu but the waitress went through every dish and where she wasn't entirely convinced, she went into the kitchen to ask the cook. My daughter is gluten-free AND vegan (nightmare!) and they were so helpful when assembling her food.
The things pred does to blood sugar & weight – oh joy…
5 mg Pred when to taper again
PRED advice
Back on pred 6 months after coming off actemera 
