Prednisone Effects: Your Results May Vary
Prednisone effects can seem miraculous. But does it work for everyone? At what dose? And at what cost? Here are some basic facts on prednisone and links for more information on specific questions you may have.
Desired prednisone effects
Prednisone and similar corticosteroids like prednisolone are extremely effective at reducing inflammation in most people. Steroids are considered immunosuppressants and they are used to treat everything from minor rashes to asthma to cancer. Of course that includes rheumatoid disease (RD), an inflammatory disease that can affect almost any part of the body. Actually, prednisone effects were first demonstrated in treating RD as cortisone was developed.
READ MORE: The History of Cortisone and Rheumatoid Arthritis
The effect of cortisone, and later prednisone, was nothing short of miraculous. Inflammation was reduced quickly and effectively. People who were crippled by RD literally got up and walked at the Mayo Clinic with newly discovered cortisone. It was the reason Mayo doctors won the Nobel Prize in 1950. Since then steroids, especially the oral form prednisone, have become the mainstay of treatment for many conditions, at doses from 5mg to 60 mg per day.
Negative prednisone effects
Side effects are the added, usually unwanted effects of a medicine. Prednisone is famous for its side effects, maybe as much as for its effectiveness. Not only is it not fully understood how prednisone reduces inflammation so well, but its side effects are also a mystery. The list of side effects is long: from thinning skin and hair to a malfunctioning metabolism, to vision clouded by cataracts, and redistribution of body fat.
READ MORE: Prednisone Side Effects
3 Rules of thumb for prednisone
What do we know about how prednisone affects people? Some experimentation may be necessary.
1) People are affected differently at different doses.
2) We can’t predict which side effects will occur or how severely.
3) Both good effects and side effects may change over time.
4 Suggestions on taming prednisone effects
I hate taking it. How can I make the most of prednisone?
1) Try slightly different doses if prednisone was ineffective or side effects were overwhelming. Find the lowest possible effective dose.
2) Try another form of steroid such as prednisolone or systemic steroid injections if prednisone was ineffective or intolerable.
3) Try one of the newer delayed-release versions such as Rayos or Lodotra.
4) Be sure to address other factors which can magnify side effects, such as any dietary deficiency, thyroid imbalance, or blood glucose levels.
READ MORE: Low-dose Prednisone in Early Rheumatoid Arthritis
What are your suggestions to make the most of prednisone?
Stay tuned next time for part 2 of this series, a look at how prednisone dosage varies with individuals: my secret prednisone dosage experiment.
Recommended reading
- Is Prednisone Over-Prescribed?
- Steroid Injections for Rheumatoid Arthritis: 5 Questions
- When You Can’t Get Off Prednisone
I have been on prednisone since 1997 for severe RA and Spondylitis. I know for a fact, Prednisone was the drug of choice for Mr. Hyde. It fixes my RA symptoms almost instantly in high doses but the side effect of aggressiveness, agitation, and irritability are all over the map. I get the same results both in pills and injections.
Why Why Why, would anyone ever take this home wrecking drug some would ask. The answer, like all of our drug options, is that it beats my symptoms, but just barely.
well put Roger.
This past summer I was finally diagnosed with Aggressive RA/RD. After 10 months of indescribable pain and inflammation from my jaw to my toes and every joint in between, I finally got to a great Rheumatologist who has told me that I`m her sickest patient with inflammation levels she hasn`t seen that high before. The first drug she gave me was Prednisone off and on a few times and I love him, he`s my boyfriend that I love and hate at the same time. It gives me energy I don`t normally have, the inflammation goes down and the pain is greatly reduced. I have since began taking MTX and Enbrel. The only side effect I see from Prednisone is hunger and less patience. I pray over all my medicines and so far no side effects, that I can see anyway. Because my disease is so extremely aggressive, the MTX and Enbrel combo is only doing about 50% of the job.So she gave me another short round on steriods to “cool me off”. My levels are still very high, even with Prednisone. Sorry for the long comment, I`m new to all of this and like your blog. I tend to feel no one around me understands, even though my husband is finally processing it all and being very supportive. I`m only 37 and was always active and on the go, busy taking care of everyone around me, then bam! overnight I can`t brush my teeth or wash my hair, walk normal, chew, lift my blanket..etc.. I`m sure you know what I mean. Thanks for listening, or reading..God bless you,I pray the Lord heals us all and delivers us from this disease.
thanks for taking time to type that out Heather. Your comment was a blessing to me tonight.
I’m sorry you know what it’s like to not be able to hold a brush or a soft blanket, but it’s good to know we can connect with each other.
best of luck with it all.
Like everyone else I love and hate Prednisone. It takes away all my inflammation which is a God send. My biggest problem with coming off it is, no matter how slowly my doctor weans me off, I become a blubbering mess. Not a cryer my nature, I rarely cry but coming off Prednisone I cry over everything. Doesn’t matter if it’s sad or not. I just lose all control over myself. It’s pretty scary and I’m not sure the benefit of it is worth the coming down.
Unfortunately ( or Fortunately?) prednisone barely helps me. If I use a step down pack, all I do is get headaches and really hungry and irritable with a TINY reduction in symptoms. Even as an injection pretty much nothing. Though I have had it help ias an injection into a specific joint (knee, shoulder).
The good news: no long term consequences of pred. The bad news: nothing to help me through trips or sudden severe flares.
My RD is less aggressive but still very pervasive. With me being seronegative, my intuitive rheum doc has to go by my reports as to how my disease progresses. I have a standing Rx for Medrol dose-paks that I may use once every 6 weeks. I seldom use them, preferring to avoid the side effects I have when on it – severe gastric pain, nausea, diarrhea, feeling hyper, insomnia, and irritability. AND I never know how much relief I will get. Sometimes I get complete relief, other times less than 1/2 the relief I need. When there is something big coming up and I need low symptoms and higher energy than usual, I will take it – as I did when I went to ACR in 2013 (it was a pleasure to meet you and the other RA Warriors who were there!!). I worked better than usual (thank goodness) and got me through – it stopped working the day we left and I was an absolute limp rag by the time we reached home.
Cortisone injections are “iffy” for me, also. Sometimes they really work – in individual joints. They seldom work as an intramuscular injection in place of a dose-pak.
have been diagnosed with RA 2 years ago. I have been on methotrexate, plaxqunill, embrel,humira and now on orencia. Prednisone seems to be the only thing that helps when i have a flare up. I really dislike begin on it for any length of time.I feel agitated. Having a hard time with the whole thing sometimes i feel like know one understands.I found RA worrior and read other sites and am glad there are others who know what im going threw. Hope a cure is found.
Has anyone experienced recurrent respiratory infections with doses of prednisone? Asthma specialist prescribed 40 mg of prednisone for three days. But, every week we try to “dial it down”, I get a recurring infection. Now my primary doctor is suggesting I may have a fungal infection in my lungs due to being on oral steroids for so long. I was prescribed antibiotic #3 and taken off of humira and mtx until my immune system can catch up with this bugger. Just wondering if anyone has had these symptoms as a side effect? Thanks for reading this. This website is one of THE best resources out there! Blessings, Kim
Thank u Heather! I’m a Christian and have been praying for healing of all this pain to go away, I have recently been diagnosed with RA taking Methotrexate n now supposed to start Prednisone I’m upset because I’ve taken prednisone a few times in my life after a bad reaction after surgeries with horrible hives N thankful it helped but didn’t like the side effects Anyway I’m thankful for ur testimony n your faith in God ? Thank u!
I have a lot of face swelling and the doctor said it was do to the methotrexate,the doctor said that it was lymphnotes has any body had this problem
I hope you get to see this reply Teri Trent, while on mtx (which I was not on for long as my mouth felt like it was filled with cotton when I took it) I’d get these horrible small cluster of nodules on my elbows.
I was taken off of mtx and they went away with time and never came back.
Prednisone on the other hand gave me a moon face and more stretchmarks than was necessary but hey… at least I could walk lol.
After reading some of the comments I’m kind of shocked at the combination of meds. I’ve never been on anything more than 2 meds at the same time; Prednisone and MTX, Embrel and Prednisone, Humira and Arava, now Arava and Sulphasalazine.
Come to think of it i foolishly tried to get off of Arava while on Humira and the pain came right back. I HAD to go back on Arava even though I didn’t want to…I was hoping Humira was enough ?
Of all the drugs I’ve ever been on, prednisone is one of the few that are so insidious. It is a real Jeckel and Hyde experience. While a great help when needed, the weight gain and mood swings make it a medicine that I try to avoid when I can.
I was initially given dose packs for flares and injections in joints that didn’t help, but since I shattered my ankle 3 years ago, my seronegative RA has gone CRAZY. I’ve been through Enbrel, Humira, plaquenil, sulfasalazine?, Actemra, Xeljanz, methotrexate(both pills and injections)Orencia(which worked the best until it didn’t work anymore)and the only thing that has helped at all other than the Orencia is Medrol. Since I shattered my ankle I have not been able to get off of steroids due to secondary adrenal insufficiency. I don’t know yet if it is permanent, though before I was always able to get off, so I’m thinking this doesn’t bode well for me being able to stop the Medrol. I’m currently on my first 2 doses of Rituxan and so far it doesn’t look promising. Of course, recovering from spine surgery may have an influence on how poorly I feel I’m doing! 😛
I have taken prednisone off and on for years, mainly for my asthma and copd, but it also helps with my RA and Osteoarthritis. I was taking methylprednisone daily for about a year but it did not seem to work for me for my RA and OA , so,,I stick to just letting my doc know when my breathing gets worse, usually due to allergens in the air here.
my worst side effect is that I get the shakes , and my skin is thinning, but I can cope with it. I try to eat right ,stay hydrated and active as possible. At my age with RA diagnosed so late , I feel prednisone is my best bet , and I know the side effects verses trying something I may have a bad reaction to, and have no one to help me if that were to happen. I tried plaquenil and had an awful reaction to it, anorexia, it was awful. so I will stick with what works for me.
Most days I do cope with my RA on my own, no pain pills, no anything, except the store bought patches for pain when it’s bad, and I wear gloves when my hands hurt.
To me the secret of taking prednisone is indeed to monitor your responses to it, and adjust your dosage to what you can handle and keep your doctor informed. As you should do with any medications you take. I only see my regular doctor because I cannot find a good Rheumy who will see me on medicaide, the one I was seeing was just a miserable person. 3 visits with her , I’m done.
sorry if I rambled to much !
Prednisone gave me Cushing’s syndrome – moon face, horrible weird fat deposits that will never go away, and worst of all diabetes. I am now insulin dependent. Prednisone also gave me Central Serous Choroidopathy, basically retina damage that is permanent and destroyed the vision in my eye.
I have been battling RA for 25 years & have been taking Prednisone daily for approx. 8 years,(in addition to mtx & Enbrel). I have been attempting to taper down the Prednisone but every half mg. I decrease causes a flare. It’s caused belly fat that I can’t lose & raised my blood sugar. I couldn’t get by without the Prednisone but it really is a double edged sword.
Been on Prednisone for a little over 2 years now. I have R.A/R.D., Fibromyalgia, peripheral neuropathy, migraines, 2 cervical fusions….and the list only gets longer. 😢 I’m 38, and have been told that I have the body of a 70-80 year old. Without Prednisone, or “my crack” as I jokingly call it, I wouldn’t be able to even get out of bed. Found out the hard way I’m allergic to the Midral pack, weird yes drs and I are puzzled. I was given Rayos and I can say it was WONDERFUL!! Worked great, without as many side effects, for me at least. So far other than MTX, I’ve been allergic to everything else my Rheumy has had me try. But of course since it is a “newish” med, my insurance won’t cover it.
My husband has Lupus, and on/off prednisone for about 12years now (1 kidney transplant down now). What I do know about prednisone is that after long term…it softens your bones (husband has bone scans 1X/yr)…which has caused him to shatter both ankles and a 3 vertebrae burst fracture in his spine. Beware…but then what else is out there??
You’re so right, Wendy. Nothing else works like it does on so many problems.
My best to your husband.
So true! I’m glad I found other people that know exactly how it feels. I was diagnosed with RA when I was 24 yrs old and it completely changed my life, I would hike every weekend, ride my bike, stay active all the time and ever since then, I’ve changed so much and it sucks. Prednisone was giving to me since then and it caused avascular necrosis on my right hip, by the insomnia and the alopecia it caused on my hairs have really affected me as a young woman, because I used to have such beautiful hair. Anyway, and since it’s a immune suppressant I have dealt with so many infections, like meningitis several times and mollarets, so it helps one thing but destroys other things, I have also developed feltys syndrome, and I’m not even 30 yrs yet!