Crohn's Disease Forum » Treatment » Prednisone/Entocort » Tips for avoiding weight gain and roid rage on Prednisone


04-20-2012, 12:55 PM   #1
Samantha Coral
 
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Tips for avoiding weight gain and roid rage on Prednisone

Hey everybody,

So my doctor put me on pred again, while we wait to see if Methotrexate will work. I did not want to go on Prednisone because I gain huge amounts of weight and get huge moon face.

This time though, I'm already fat to start with. So in an effort to avoid turning into Free Willy, does anyone have some tips (other than eating healthy and exercising) that might help keep the weight off? Should I be hitting the gym as soon as I feel well enough?

Also, this time I'm getting intense 'roid rage! Does anyone else get this? I freaked out on my boyfriend this morning for stirring eggs.

Happy Friday
04-23-2012, 03:23 PM   #2
David
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Hi Samantha! I'm sorry you haven't received any responses. I see you requested additional support. While I don't have any good insight, I have changed the title of your thread to be a little more descriptive so others might be more likely to click and respond. I hope you don't mind! In addition, free bump so others see your thread
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04-23-2012, 03:26 PM   #3
Jennifer
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lol, yes I get the roid rage. Haven't taken Pred in a while (I take Entocort instead as Pred messes with my heart too much). All you can do is explain to them that you're likely to have mood swings and to try not to take it personally.

As far as food and exercise, its always good to try and be healthy no matter what but for Pred try to stay away from salty items as they make you retain water and the Pred is doing that plenty already. Just do your best with exercise and don't push it too much. Remind yourself that it'll be over soon and the water weight will go away.
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04-23-2012, 04:07 PM   #4
archie
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Yes I had definite roid rage I nearly killed my husband and that was for breathing, I'm actually quite placid, i was always worse in the morning my family just avoided me!! anyways I avoided weight gain by religiously drinking loads of water to prevent fluid retention avoiding salt and walked every day. Hope this helps
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04-23-2012, 05:29 PM   #5
tiloah
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Sorry the Prednisone affects you so significantly. The reason most people gain weight on Prednisone (other than water retention in the short term) is that it makes you hungry. I wouldn't worry too much about the temporary weight gain of water retention, it will go away when you're off of the Pred. If you are able to eat the same amount as you did before, the weight gain effects shouldn't be long term. This is probably easier said than done, however! I would imagine all of the usual tips for avoiding eating when you are hungry or staving off hunger come in to play here. Get enough sleep, drink lots of water (or if you drink too much water, add some low calorie sports drinks to keep your electrolytes balanced), eat low calorie snacks in between meals if you can tolerate them (carrots, celery, etc.) Move around more (use a small glass for your water so you have to fill it frequently).

If you are well enough to exercise that's a good idea (for your health in general), but remember that cardio just burns a bit more calories. Building muscle helps you burn more calories all the time (although this is a delayed reaction and takes work).

In the end, you may need to accept that weight gain is just going to come with the territory. Your health is more important that the number on the scale! It will be easier to lose the weight/keep it off when you are off of the steroids again.

I don't have any personal experience with "roid rage," but if you find yourself aware of it happening, take a time out. Go for a walk or go to a room with nobody else in it and beat up some pillows. Whatever stress relief works for you. Let people know that it's happening ahead of time, so when you snap at them they know it's not you, but the medication you're on.
04-23-2012, 10:25 PM   #6
tots
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Roid rage- yes yes yes!! Once Josh asked for a glass of milk and I flipped out. My 10 year old looked at me and asked my where the broom was I rode in on! At 22 he still has the ability to make me laugh in the worst of times.

I lauughed so hard! It was great!

Put things into perspective.


Lauren
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04-24-2012, 06:18 PM   #7
Samantha Coral
 
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Thanks for the info, guys! It's good to know that I'm not the only one screaming at my partner for no reason.

Does anyone know if potassium would help with the sodium and water retention? I don't know much about it, but I just remembered the sodium-potassium pump thing from biology.

Is entocort as effective as prednisone? I wonder why they wouldn't prescribe that before prednisone since the latter has so many nasty side effects
04-24-2012, 06:28 PM   #8
chrisnsteph1022
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Entocort does nothing for me (side effects or symptom improvement). I cannot tolerate pred, though. The mood swings and weight gain are detrimental to my mental health. I'd rather suffer the Crohn's symptoms.
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04-24-2012, 11:34 PM   #9
Aura
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I know the roid rage, I can feel it. I try so hard not to snap - and I don't mean to. My hubby knows its the meds - but its still hard for everyone. I do like those beany pillows - cuddly buddlys - you can kick the shit out of them and punch them and squeeze them and they are ok with it. Also when I kick it it does not go too far for me to then go and pick them up. A stack of kush kush balls are also good to through at the wall - not at your partner
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04-25-2012, 12:33 AM   #10
tots
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Aura- I would thank you more if I could. It was a very good description of how we feel on prednisone!


Lauren
06-03-2012, 08:03 AM   #11
ellie
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Having struggled with the waistline since childhood, I was a bit nonplussed when I was handed leaflets " you and your nutritional status" when the CD was diagnosed..
6 months on prednisone largely undid the weight loss of 10 years dietary care (8kg back on!)
Fortunately have been off the oral pred for 18 months, and the spare tyre is slowly coming off.
I certainly sympathise with the problem! For me, if the Crohn's flares, then iritis is the major issue.
My main approach to weight management has been lots of steamed veges - my old dietary technique of a big bowl of leafy salad greens can precipitate a flight back to prednisone again!
06-03-2012, 08:28 AM   #12
nikimazur
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The sodium potassium pump thing has nothing to do with it. The sodium potassium pump is critical in muscle twitches and movement, which is why you need a certain amount of sodium in your body without going into too many details. Prednisone effects your hormone levels, contributing to the "rid rage", and also signals your kidneys to absorb more sodium, which in turn your body retains more water to balance out the sodium levels in your body.

The only and best advice is to keep hydrated, stay away from processed food, and try to eat foods with high water content such as cucumbers, watermelon, though it seems counterintuitive to consume water, it will help balance out the sodium levels in your kidneys.


I could go way more into the science aspect haha but hope this helps
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06-03-2012, 08:14 PM   #13
David
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I could go way more into the science aspect
Please do.
06-03-2012, 09:25 PM   #14
nikimazur
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Gluocorticoids act to inhibit-feedback of both the hypothalamus, decreasing corticotropin-releasing hormone [CRH], and corticotrophs in the anterior pituitary gland, decreasing the amount of adrenocorticotropic hormone [ACTH]. For this reason, glucocorticoid analogue drugs such as prednisone down-regulate the natural synthesis of glucocorticoids. One of the steroids produced by the outer portion of the adrenal glands is called cortisone. It normally helps regulate the body's salt and water balance and reduces inflammation. Introduced in 1955, prednisone is a man-made replica of cortisone. The adrenal glands normally produces an amount of steroids equivalent to about 5 mg. of prednisone a day. Since cortisone is produced in the adrenal glands, there is a biological relationship to the kidneys. The adrenal glands are situated right above the kidneys. The kidneys then are highly affected by the adrenal glands, and the hormones that the adrenal glands produce. They are chiefly responsible for releasing hormones in response to stress through the synthesis of corticosteroids such as cortisol and catecholamines such as epinephrine. The adrenal glands affect kidney function through the secretion of aldosterone, a hormone involved in regulating the osmolarity of blood plasma. Aldosterone,acts mainly on the distal tubules and collecting ducts of the nephron, the functional unit of the kidney, to cause the conservation of sodium, secretion of potassium, increased water retention, and increased blood pressure. The overall effect of aldosterone is to increase reabsorption of ions and water in the kidney -- increasing blood volume and, therefore, increasing blood pressure.

Water retention, sodium secretion, potassiam secretion, and even blood pressure are all dependent on the hormone of aldosterone. Prednisone indirectly affects the aldosterone hormone, causing an entire imbalance and disrupting homeostasis in the body.

Admin edit: Sources: http://en.wikipedia.org/wiki/Prednisone
http://en.wikipedia.org/wiki/Adrenal_gland
http://www.gihealth.com/html/educati...rednisone.html
http://en.wikipedia.org/wiki/Aldosterone


I can add more if need be

If it helps, I have my Master's in Public Health (Epidemiology- The study of diseases), my Bachelors in Health Sciences and am finishing my RN. I have done clinical research in Nutrition and Obesity in Children haha so I have lots of random knowledge stuck in my brain!
06-04-2012, 12:52 AM   #15
archie
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That's all very Interesting, I didn't know the relationship between steroids and blood pressure so thanks for that. I drank loads of water every day, ate reasonably sensible and I avoided the water retention and moon face. I still gained a few pounds but I think it was due to feeling better.
06-04-2012, 08:18 AM   #16
StarGirrrrl
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That is really interesting, thanks!
I'm 2 days in (30mg) and can feel the mood swings and hunger- but as i'm aware both are due to the Pred, I am trying my best with self-control, biting my lip and not increasing what I eat- I need to lose weight, not gain it.
That's the only effects of the Pred so far, no improvement in health (apart from slightly better joint pain at times, but it's still bad enough to take pain pills) which is dissapointing because I was sort of told it was instant. But my inflammation markers are high so maybe it needs time to start working, I start tapering in 12 days.
And I will have more bloods post Pred (I had some pre) so will see what it did to the inflammation numbers.
I was very reluctant to do this trial, so if I do not get any/great results with this doseage I am not repeating it with a higher one. They can take another look at my case instead!
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06-04-2012, 09:43 AM   #17
David
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Nikimazur,

If you are going to cut and paste from other sites please be sure to reference them so we don't get in trouble and they get the credit they deserve. I've edited the sources into your post.

Thanks!
06-04-2012, 04:25 PM   #18
MelissaM24
 
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I was on only 15 mg of Pred for awhile and after a year and a half I am now down to just 2.5 mg, but I gained over 60 pounds, which has never happened before in my life, and I have barely enough energy to exercise because I'm so tired all the time! I also take 9mg entocort and get steroid injections every 4-5 months in my spine for a bulging disc/arthritis. So I guess all of that together could still be causing me to have all of the pred. side effects? (Weight won't go down, high blood pressure, stretch marks almost EVERYWHERE, sleeping problems, fatigue, easy bruising, you name it) Does anyone else have this many problems from this drug? And if so, do you have any other tips on how to get off of the last bit of pred.? I cannot seem to go down below 2.5 without my symptoms getting terribly worse. Oh and I also take 40 mg Humira shots weekly, 50 mg Imuran, 100mg Allopurinol and the Entocort mentioned above (and these are just the meds for the Crohn's... I also get chronic kidney stones which is related to Crohn's, and then the long story of my back pain problems...)
12-03-2012, 05:37 PM   #19
rylanmede
 
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The best way to avoid weight gain or at least maintain it when on Prednisone is to eat less sodium rich foods like salt and processed foods and eat more potassium rich food.
Your appetite also will increase and this is the basics of how to gain weight so to fix this you need to avoid carbohydrates as much as possible and avoid processed sugars because they are empty calories that make you feel hungry and leading to weight gain.
12-04-2012, 12:48 AM   #20
Hobbes650
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The best way to avoid weight gain or at least maintain it when on Prednisone is to eat less sodium rich foods like salt and processed foods and eat more potassium rich food.
Your appetite also will increase and this is the basics of how to gain weight so to fix this you need to avoid carbohydrates as much as possible and avoid processed sugars because they are empty calories that make you feel hungry and leading to weight gain.

Actually, it really depends on if you still have your colon. If not, then eat all the sodium you want because your colon is where sodium is mostly absorbed. Potassium too. I started adding Morton's lite Salt to my juice and ice tea drinks because it's another good source of Potassium. Staying hydrated is a good way to control appetite. Anything with caffeine also helps. I got a huge sweet tooth this time around on Pred and that pretty much ruined any chance for me to stay thin. Especially when the place down the street sells gelato- truly evil food when taking Prednisone.
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