Friday, June 01, 2012

Sunday, October 25, 2009 dcr-ra-2005 asks

Q: why is pain back after i started prednisone?

I was doing fine before my family doctor put me in prednisone to help start up my adrenal glands - whom, based on her assesment, are numbed due to years of inmunosuppressants. She is trying to help me get rid of an upper respiratory infection I've had for 6 weeks. We tried 3 different antibiotics, fluids, rest and stopping my inmunosupressant for a month but the upper resp inf. keeps coming back. Therefore, she went for the prednisone. After two days (40mg the first day and 20mg the following day) I feel like I got hit by a train and can't barely move. The RA is back - after it had been pretty quiet for months. I don't understand how the prednisone triggered a flare up. I thought taking cortizone would reduce the RA. What is happening??

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Answers (2)
10/26/09 9:38am

I'm a little confused.... Steroids will generally suppress the body's own production of steroids (i.e., prednisone, cortisone).  That's why it's so important to go off them slowly.  Maybe dropping from 40 mg to 20 mg was too fast? For some people, it can be very hard to get off.  Or, maybe it's not the right thing at all.  Not the right target... did you have tests for adrenal function?

 

Since cortisone is an immunosuppressant, it can also 'release' infections that maybe be localized in the body.  The only parallel I can draw personally, is that before my official diagnosis of RA, I had a very stiff thumb.  When I got an injection of cortisone in that part of my hand (for the tendon - supposedly it was tendinitis, ha ha!), it cured the thumb permanents, but I got pain up my arm for 3 weeks, and ended up with a seriously damaged wrist!   Yet - I've gotten cortisone injections elsewhere in my body with no problem (jaw, shoulder, back, foot).  So - my guess (other than wanting to sue the orthopedist who did it!) is that the RA 'infection' was only in my hand, but the cortisone broke down the local immunity and allowed it to migrate. 

     Cortisone usually does help.  But what I'm thinking is, if they have not really diagnosed what you've got, the treatment may be not only not helpful, but counterproductive.  Maybe some effort should be put into determining whether it's viral, bacterial (and what kind of bacteria?  Is there any cough/spit/phlegm fluid you can give them to examine and test?)  

     I don't know, but please keep it touch, I'd like to know how this comes out, and how you are doing!  What were your upper respiratory symptoms (If i"m not being too nosy .... I am not a medical professional, just an interested friend...)

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10/27/09 7:40pm

I was on prednisone for 4 months and a high dosage.  Gained over 80 pounds.  it is not a good drug stay away from it if you can.

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By dcr-ra-2005— Last Modified: 12/26/10, First Published: 10/25/09