Prednisone issues (post wean off) HELP??

[SharonStudent]

Hoping Doc can chime in on this.  Hubby got a really bad rash all over his upper torso.  He decided that the doctor knew best on this, and when the doc said it was a drug reaction (we had been taking a lot of pure powdered vitamins), and he prescribed prednisone.  60 mg for a week, 40 for a week, and 20 for the last week (which I split and gave him a couple of days of 10mg at the end instead of ending on 20 mg).  About the last day or two of this horrible drug (at least to him), he got so weak and tired he could do nothing, couldn’t sleep, and had no appetite (at times throwing up even water). After several days of this, he added a terrible cough (again making him throw up a couple of times), and just racking his body with those awful coughing fits.  Finally last Sunday (about 6-7 days into this), we went to the ER and spent about 3.5 hours getting all kinds of tests because of what they diagnosed as prednisone withdrawal, and wanted to rule out things like bleeding ulcer and such.  They did emphasize that prednisone is a terrible drug and has a long laundry list of symptoms, including his mega crabbiness for almost 3 weeks. He has about 11 of the symptoms associated with prednisone now).  I’m giving him all the “sick” tinctures (COF, EXP, cold away, shoo floo), plus mullein, immune support, pine needle, and gumweed (debating on cytokine balance, but I kind of think no on that).  I am starting to feel like a total failure with herbs since I can’t seem to find anything to help the lack of appetite, massive fatigue, horrible racking cough, and sleep troubles.  We don’t want any more pharma products if we can help it.  This all has been going on since around the 18th or so (this month).  I’m not sleeping well either with all his violent coughing.  ANY HELP is welcome!!

[Beth TrujilloStudent]

Good evening.  I’ve been a pharmacist for almost 30 years.  Prednisone withdrawal is really adrenal insufficiency.  Prednisone is a corticosteroid like the type released from the adrenal glands, cortisol.  When we give prednisone at certain doses or for certain durations, the body thinks it needs to cut down on its own production.  When the prednisone is stopped, the adrenals aren’t making enough and it takes time for them to begin increasing their own production again.  In severe cases, adrenal insufficiency is life-threatening.

Giving herbs to support the adrenal gland would be my instinct.  Adaptogenic herbs like ashwagandha and adaptogenic mushrooms like reishi can help with adrenal fatigue.  It’s not a cytokine issue nor is it bacterial/flu virus, so I think you can stop all the other sick tinctures.  Doc’s nutritive formula has chaga (adaptogenic mushroom).

Your husband should be kept from any type of stress while this is happening.  Give nutrient dense, mineral rich foods like bone broth with unrefined salt (salt restriction elevates cortisol response, and salted bone broth will blunt the cortisol response), warm raw milk (living nutrient dense food) if you have access to it.  Small frequent “meals”–fasting increases cortisol response.  Also, nervine herbs like chamomile, etc.

I hope this helps.  He is in my prayers.

Beth

Beth Trujillo

1 user thanked author for this post.

Sharon

[SharonStudentTopic Author]

Beth – thanks so much.  We did know that his adrenals are in trouble.  He’s currently taking dessicated adrenals, but I’ll drop the “sick remedies” and pick up on a few of the ones you mentioned!  Also taking Doc’s Adrenal Support tincture.  Thanks for the prayers also 🙂

[Beth TrujilloStudent]

Would love for you to keep us updated–it will help us learn. 🙂

 

Beth Trujillo

1 user thanked author for this post.

Sharon

[SharonStudentTopic Author]

Beth, sorry I didn’t mention earlier how much your pharma perspective means to me!  So many people gloss over prenisone and it’s effects.  We have been working on our “shot” adrenals now for about 3 months, and just when we were ready to retest and see where we are now, this happens.  So I guess we’ll work on them another month or two at least before the retest.  I did get confused on the “meals” (like he’s eating a whole meal these days!!).  Actually to give it an easy to relate to amount – about the best he’s done since this started is 1/2 hamburger (just for reference).  So should he have small meals or should he be fasting?  The terms “increases cortisol response” and “elevates cortisol response” rather confused me.  I think that either of those are what we want, yes?  And since he’s had so much trouble with breathing and coughing, he has gone back to his Advair and rescue inhalers when needed (it’s been 2+ years since last used) – does this do further damage to the adrenals?  I really and truly appreciate your help!  Starting him on onion/honey concoction today for the coughing.  You know what babies men can be when sick – “that’s nasty, I’m not taking that”!

[Beth TrujilloStudent]

Good evening, Sharon.  I’m so sorry I didn’t see this reply earlier.  I hope doesn’t sounds rambling, but here are my thoughts…

The adrenals in his case, have stopped making much of their own cortisol because of the external corticosteroid (prednisone) he received.  The prednisone caused his body to essentially say, “We’re making too much, so stop production!”  This process is called a negative feedback loop which is common for hormones–higher blood levels cause the adrenal system (in this case) to decrease production of similar hormones.

So the problem comes when the external source is shut off, and the adrenals haven’t had time to respond with an increase in production again.  So, now, any stress of any kind results in the adrenals not being able to produce enough cortisol needed to deal with the stressor, because they have been “shut off”.   Any stress (emotional, physical, whatever) demands a response from the adrenal glands that the adrenal glands can’t respond to.

Until his body starts to kick in its own cortisol production again, we don’t want to give his body stressors that will put another load on the adrenals that they still can’t respond to.  So, although, we want  his body to eventually produce a cortisol response to stress, we don’t want to give him more than he can handle at this point in time.

Yes, I think small meals throughout the day would be best.  This way your not letting him go too long without eating which creates stress that he can’t deal with right now.

You’re trying to decrease the situations that his body would subject to that would also cause it to need to make more cortisol than it can right now.

Of course, I’m very late to respond!  And hopefully you are seeing some improvement?

And, yes, I think he should stay on his inhalers until he can taper off of those.

 

Beth Trujillo

• This reply was modified 1 week, 2 days ago by Beth Trujillo.

1 user thanked author for this post.

Sharon

[SharonStudentTopic Author]

Answered you on your other comment – but just to quickly repeat that I greatly appreciate your kind and thoughtful responses to my concerns!

 

[SharonStudentTopic Author]

Maybe someone can tell me what we SHOULD have done instead of the allergy doc/dermatologist and prednisone!?  I tried plantain, comfrey and histamine before the doctor visit, but nothing was helping.  What did I miss and what should we do should this nightmare ever replay again?  Thanks all!

• This reply was modified 3 weeks, 5 days ago by Sharon.

[Beth TrujilloStudent]

Such a good question!  I had to spend a little time thinking about and praying about this question.

Everything we take into the mouth goes first through the intestines and then into the blood supply that goes straight to the liver to get cleaned up before the circulatory system takes what is left in the blood to the rest of the body.  This is called “the first-pass effect”.  All oral medications/herbs/food/supplements are subject to the first-pass effect.  When medications are dosed, this effect is taken into account and is why oral medications are dosed at higher doses than injectables or topical preps like patches.

So, the first factor taken into account is dose.  Another factor that has to be taken into account is liver function status.  For known liver disease issues or the older we get, the less efficient and effective our liver is at cleaning up during this first pass effect.  Doses have to be lowered in those cases.

When rashes appear on the skin, it is often (not always) a sign that liver is not able to keep up with whatever is coming into the body.  We would want to create a simple planto deal with the problem, but which would help to also confirm that what we are thinking is what is really happening.  If we do too many things at once, we don’t know what is really helping. So, it would look something like this:

1. Stop the thing causing the problem (of course)

2. Give support to the liver to help it metabolize what needs to be metabolized, (milk thistle, dandelion are classic liver supportive herbs)

3. Give symptomatic relief while you wait for the liver to be able to deal with the overload. (topical ointments/herbal infused oils with anti-inflammatory herbs, oatmeal baths, etc)

4.  Give the plan time to work.

I will say this about large doses of vitamins, especially antioxidant types like vitamin c, etc.   The body actually needs a good balance of some oxidative molecules to perform some basic cellular functions.  For example, in the mitochondria some oxidative molecules are used in the process of cellular respiration.  The problem comes as a result of too much oxidative stress (too many of those molecules) due to poor diet and other lifestyle issues.  There has been seen, people who take too many antioxidants or too high of a dose, have very detrimental outcomes than those who do not, because they eliminate these oxidative molecules that are necessary for cellular respiration.  We often think that when something is good, it can’t be harmful.  But our bodies were designed for balance, and the gentle, natural approach is often the better and more elegant approach, because it allows the body to function according to its design which is so complicated, that we can not (and do not) fully understand all of its complexity.

This is the way we heal any ecosystem (including the ecosystem of the body): we study its design when in good health and then copy that design to bring healing.  The system will do what it is suppose to do, and it will do all the things that we can see and all the things that we cannot see or do not yet understand.  For the human body, that means that most of our nutrients should be from  nutrient dense foods and herbs, not high dose vitamin powders.  Sometimes we need extra targeted vitamins to help us with a specific situation, but good food and herbs should be the foundation, and supplements like vitamins should be taken for needed situations and at appropriate doses.

How is your husband doing?

 

Beth Trujillo

• This reply was modified 1 week, 2 days ago by Beth Trujillo.

1 user thanked author for this post.

Sharon

[SharonStudentTopic Author]

Thanks so much Beth – and anyone that prays about an answer is someone I trust more than those who just “wing it”!  Appreciate the very detailed and thoughtful answers.  Suffice it to say that that horrible prednisone will never enter our home again!  Hubby is almost completely back to normal now other than the residual cough and phlegm from whatever he got right on the heels of the prednisone stop (and of course, being the sweetie that he is, he shared his crud with me!).  So we will keep all your great info and advice in mind (and likely in my herbal notebook) in the hopefully non-existent repeat of a nasty itchy rash like that one was!  Stay well this winter.  Appreciate your help!!

 

[Beth TrujilloStudent]

So happy to hear that he is feeling better!  God bless you.

 

Beth Trujillo

[Author]

Posts