Another question

[LittleJane]

I have read that Prednisolone should not be taken with laxatives due to effects of lowering potassium levels? I take Movicol for chronic constipation due to sluggish bowel. Of course this has now worried me (health anxiety). Can anyone reassure me or am I worrying needlessly (as I do 😔)

[PMRpro Ambassador]

It is possible that using both together over a long period could lead to hypokalaemia, low potassium. Obviously you need both long term so the best thing for you to do is speak to your GP and request blood checks every so often to monitor your blood levels to be sure.

From your side, make sure you have plenty of potassium rich foods and consider using a LoSalt type product instead of normal table salt as they contain potassium salts instead of sodium. However - do check with your GP first to be sure that is OK for you.

uk.losalt.com/

[LittleJane in reply to PMRpro]

Thank you, yes. I am making notes to take to my GP review after my holiday

[LittleJane in reply to LittleJane]

My GP has sent me a message to point out that the aim is for me to be on the lowest dose of P. for as short a time as possible by following the reducing programme I have been given, and to be off it completely in a few months. This is not what I have read here and now I am confused. Symptoms don't seem to go away after only a few months 🤔

[DorsetLady PMRGCAuk volunteer in reply to LittleJane]

Oh really - what fairy tale have they been reading?…think they need to read the Life and times of PMR, as told by those that have been there! . 😳

[LittleJane in reply to DorsetLady]

Would you like to tell them or shall I? 😂I should add that the GP I spoke to last week didn't say this, so I will quietly carry on as I am 🙄

[DorsetLady PMRGCAuk volunteer in reply to LittleJane]

Maybe send this link - or better still just ignore -

healthunlocked.com/pmrgcauk...

[PMRpro Ambassador in reply to LittleJane]

It may be his aim but I fear that it is NOT in line with the medical literature - they at least say it lasts 2 years and even that is now being disputed. Professor Sarah Mackie, probably the leading PMR expert in the UK, has recently initiated a campaign to discredit the 2 year myth!

GPs are offered the opportunity to become members of the charity with no cost to them. He might learn something. Pred is not a cure for PMR, it is a management strategy. You start with a higher dose than you expect to need, clear out the accumulated inflammation and then titrate the dose to find the lowest effective dose, the lowest dose that achieves the same level of symptoms control that was achieved with the starting dose. And you may need that dose over a period of many months, often year.

He needs to do some homework.

And you need to stick with a GP who knows what they are talking about - since that one doesn't!!!!

ard.bmj.com/content/83/1/48

says in Recommendation 5

"Once remission is reached, it should be maintained with the minimal effective dose of medication; drug-free remission may be achieved in a proportion of patients. ...

The task force further emphasised that patients should not be pushed to taper-off medication too quickly, a strategy that often results in relapse of disease. "

In Recommendation 6 they say

"Disease activity in GCA and PMR should be monitored regularly, as frequently as every 1–4 weeks until remission has been achieved, and at longer monitoring intervals (eg, between 3 and 6 months) in patients in stable remission on therapy; monitoring of patients off therapy should be discussed on an individual basis. ...

Once stable remission has been achieved, monitoring intervals may become longer; however, disease activity and particularly adverse consequences of treatment should be checked regularly. "

Which makes it abundantly clear that it lasts more than a "few months". Where on earth did he get that idea?

[piglette]

You could always eat a few bananas!

[LittleJane in reply to piglette]

I love bananas but sadly they don't like me 🥴

[piglette in reply to LittleJane]

What a bummer

[winfong]

I have IBS-C and diverticular disease, and take 2 laxatives every day. First I've heard of the connection, from my rheumo, gastro or endo. I do take multi vitamins, though, so maybe that takes care of it.