Friday, April 9, 2010

What I Wish Doctors Had Told Me About Living with Prednisone Side Effects

First, I want to say that, this time around, the prednisone is kind of amping up my 'ranty pants' qualities. So if I've been sounding really over-the-top in my previous posts, that's why. It should abate soon.

I hope. Or maybe I am a lunatic. Time will tell.

I did want to spend some time talking about prednisone and weight gain. I spent most of my teen years through my late twenties more on prednisone than off. This eventually led to Cushings twice.

Just getting the Cushings diagnosed was a huge challenge, forget about help with the side effects of prednisone. The first time I had Cushings, it went undiagnosed and I gained a lot of weight. The second time, I had a pulmonologist and it was diagnosed but I didn't get much help beyond that. I eventually concocted my own brand of coping skills to avoid weight gain. In the year it took for my adrenals to wake back up, I managed to avoid weight gain, control my eating and consistently exercise (despite lots of muscle cramps).

Now that I'm on prednisone again for a decent length of time (as opposed to a 5 day burst which is nothing), I'm back to trying to figure out how to avoid weight gain, stay active, and properly feed my body. Here's what I wish my doctors had told me about living with the side effects of prednisone.

1. You're going to be hungry. The kind of hunger that makes cannibalism attractive. Do NOT eat a bunch of junk or you will gain a ton of weight. Prednisone hunger is insatiable, you can't satisfy it so don't try. Skip the pizza and ice cream, go for low calorie options like veggies. If you must binge, displace your appetite to the lowest calorie food you can. I once ate a box of Cheerios, which I felt was better than inhaling a large pizza. Last week, I ate an entire bunch of celery in one sitting.

2.Invest in hard candy and flavored waters. Use them to distract yourself and avoid eating.

3.Don't skip meals. Eat protein and fat at every meal to balance blood sugar and slow down the appetite. Avoid simple carbs to prevent blood sugar spikes which can drive prednisone hunger.

4.Don't snack. Just make a commitment that you're not going to eat unless it is meal time. Once the prednisone is done with you, snack away. However, since it can be so difficult to moderate food intake under the influence of prednisone, it makes sense to avoid snacks.

5.Watch your portions. A 'little bit' more at every meal adds up to 'a lot.' The problem with prednisone is the appetite doesn't stop, it just expands to demand even more. You can't eat yourself out of the hunger. I can not emphasize this enough. There is NO satiation with prednisone so you must to learn to cope with the hunger.

I have literally sat on my hands in the past to keep myself from eating while under the influence.

6.Exercise if you can. Even a little bit will help.

7.Take a good vitamin B supplement as well as calcium and magnesium, but NEVER take them at the same time as the prednisone. Prednisone interferes with your body's ability to absorb/use nutrients including vitamin pills. This can result in muscle cramps and lack of energy. Good supplements are a must for your own comfort.

8.Find something else to do. Get absorbed in a new project or go do something fun that doesn't involve food. Keeping busy is a great way to avoid overeating while on prednisone. I started this blog, for instance (now you know why it's just long post after long post, I'm trying to stay away from the kitchen!). Do you have something you've always wanted to do, but have put off and put off? Well now would be a great time to finally go out and do it. Go! Have fun!

9.Don't weigh yourself. No matter how well you eat, you're going to gain some weight. If you're careful, it will just be a fluid fluctuation that will resolve on its own. So don't panic. Don't fixate on weight. Focus instead on eating right and exercising. If you do that, everything else will fall into place.

10.Be vigilant. Prednisone can still affect you long after the last dose. You may not have any appetite issues while taking it only to find yourself being banned from an all-you-can-eat buffet a week after your last dose. Water weight can show up later too. I once gained 20 pounds of water after I stopped prednisone. It was very uncomfortable and it took several days for me to get it out of my system.

11. Don't beat yourself up if you slip or gain weight. Prednisone is a bitch. Do your best because even if you aren't perfect, you still will gain less weight than if you had given up.

12. Remember this is temporary. This too shall pass. Just breathe.

And if, like me, you are on prednisone too, here's a virtual {{{{{{{hug}}}}}}}. You can do this, but you have to fight for it. It won't come easy. It's not fair, but that's the reality.

For me, currently...I am doing okay with the eating. Eating a bit too much here and there but keeping it low carb. I actually lost a pound at yesterday's weigh in. However, I know that I really need to exercise to stave off weight gain and I'm not quite there yet. I've been nebulizer free for 2 days now, but the peak flow is still not back to normal (actually I wonder if the lower number is my new 'normal' which is not a pleasant thought). I've also got a couple more weeks of prednisone side effects to battle through.


  1. Very well done post! To hear it from the side of a patient, you couldn't have done it any better. Very good tips and I'm sure many will be grateful for your post.


  2. Thank you for the kind comment. :) I do hope it helps someone else.



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