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Crohn's Disease Forum » Treatment » Prednisone/Entocort » When Prednisone begin to be dangerous?


03-04-2014, 09:15 AM   #1
gianlu
 
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When Prednisone begin to be dangerous?

Hi, I've been diagnosed Crohn's one year ago. Since then I didn't follow any maintenance treatment except Prednisolone when it flare up.

I don't wanna take Remicade because I'm trying to keep the remission with LDN, paleo diet and organo oil. On December my CRP was 46, on January 54 and tomorrow I will know how high it's now. The doctor always said that was an acceptable value for a Crohn's (I don't think so, and I don't know if she's familiar with this kind of diseases, she's my new general doctor). Now I barely have any symptons, no pain, no diarrhea, only little blood every now and then.

Now the doctor wants to put me on Prednisolone again, with a dose of 100mg in the morning, and 50mg in the evening for the first 2 days, then tapering down.

I've been diagnosed one year ago and I had a relapse on september and so far I never heard those high doses... do you think she's wrong?

So far I have resorted to Prednisolone twice (first diagnose, first flare), do you think it's dangerous to be again, for the 3rd time taking Prednisolone?
03-04-2014, 12:03 PM   #2
sfmreb2
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Yes I think she is wrong. 150mg in one day. Wow, do you have a GI Dr you can check with? Maybe this is a new treatment. How quick of a taper are you going to have? I have taken up to 50mg a day and that was not fun.
03-04-2014, 12:10 PM   #3
gianlu
 
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I have taken 80mg the first time and the day after I went down to 70, because I had hallucinations... I'm sure she is wrong. The dosage should be 1mg x kg or more under clinical control. The last relapse I've taken 100mg for the first two days, but I was inpatient.
50mg few days for me could be ok. How many times have you been under Prednisone?
03-04-2014, 12:36 PM   #4
sfmreb2
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I have had crohns or colitis for over 40 years. I couldn't even try to remember how many times I have taken prednisone. I could see taking the 100mg in the hospital. I'm not sure more is better with prednisone. I'm only 125 lbs and 40 mg has always been a good starting place for me. I think you need to ask that Dr a lot more questions. Like how many crohns patients she has successfuly treated. You said earlier that you were not having a lot of symptoms, then why the big hit with prednisone? Good luck and remember it is your body she is treating.
03-04-2014, 12:40 PM   #5
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That's a crazy amount of pred, the side effects would be horrific. If you're not really sick I can't imagine how she would justify it.
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03-04-2014, 12:59 PM   #6
gianlu
 
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Yes, tomorrow I'm gonna ask if she's familiar with prednisone & IBD. I think she didn't understand me, because she's German, I'm not and we communicate in english. I'm pretty sure about what she said and I also got written instruction about the tapering from her.

When I had the opportunity to talk with specialists, they always said that I should start Remicade, because it's effective and the Prednisone it's dangerous to be taken so many times. I agree with them about the side effects in the short time, not so much about the long term and the risk of taking serious diseases like lupus, skin cancer and so on.

Do you think is too much to be on Prednisone for the 3rd time?
03-04-2014, 02:33 PM   #7
lsgs
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Gianlu I was on steroids for a year. I started off with an IM injection of 80mg kenalog then went onto 50mg pred. I rarely got below 20mg for a year. As far as I know I have no complications except being fat. You have to weigh up whether the risks are worth it. I wasn't sleeping, eating and quite frankly was in nervous breakdown territory. I could justify taking steroids. You have to weigh up, with a doctor you're comfortable with, if it's the right thing for you.

Remicade is not without side effects too.

Is LDN no longer working for you? I'm on LDN and I keep a weeks supply of pred (suggested by GP) on hand to take if things are getting out of control. A weeks dose is generally a lot safer, and for me it has nipped any flares in the bud.
03-04-2014, 03:13 PM   #8
highlandsrock
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I was on Prednisolone from 1979 to 1997. The highest dose I ever took in all that time was 60mg/day. As others have said 150mg just sounds too much.

In the end I asked to come off of prednisolone because of possible side effects and was put on Azathioprine, starting at 200mg/day (based on body weight). That worked for another 10 years or so.

I have had one further brush with steroids in 2012 - a drug called Dexamethasone - a sort of steroid on steroids. Never again. It was the equivalent of 200mg Pred per day for 4 days. The side effects were really bad so I imagine 150mg of Pred would be similar.
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03-05-2014, 09:10 AM   #9
gianlu
 
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I'm take LDN 4.5 since 2,5 months and I had no improvements. During the last weeks I had some problem of meteorism, then I think that the non success of the LDN could be due to a gastrointestinal Candida or SIBO, because as soon I begin taking Oregano Oil, the flatulence finished.

Today I got the blood test results and I have a CRP at 59,9 mg/l, more less the same of december and january. What do you think? Should I consider this value as flare? On december, my old general doctor, said that this value was acceptable because I was coming right after a relapse. A part the last week, where I found some blood in the stools (since 3 days not anymore), I have no symptoms of a flare. Now no blood, no diarrhea, perfect color and consistence of the stools... I don't know what to think, I should see a gastroenterologist but I can't get an appointment for the next weeks, because saturday I'm gonna fly to NYC for a trip.
03-05-2014, 03:56 PM   #10
sfmreb2
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Have a good trip.
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