antihistamine
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antihistamine
could you please explain how antihistamine helps in coming off endocort. Each time I have tried to wean off VERY VERY slowly I end up back to square one, this time I am also taking antihistamine, Zyzal, and am down to one a day, all good so far and am going onto 1 daily followed by the next day half, I see my GI on 22nd August and want to explain in an inteligent way how antihistamine helps, thanks Beni
Beni,
He's probably not going to believe your explanation, because most doctors are unaware of the fact that mast cells are involved in the inflammation process that causes MC. If he isn't aware of that connection, then he isn't going to understand why an antihistamine would help when weaning off Entocort. That said, here's why it can help:
Basically, inappropriate degranulation of mast cells leads to elevated histamine levels, a condition that directly promotes symptoms and also promotes the release of other inflammatory modulators which tend to cause additional inflammation. Corticosteroids suppress inflammation by suppressing mast cell numbers. When a corticosteroid is discontinued, mast cell numbers tend to return to normal levels. However, as with the withdrawal of many drugs, there can be a rebound effect, whereby mast cell numbers repopulate so quickly that they overshoot, and the result is higher-than-normal numbers of mast cells, resulting in a proinflammatory environment. This condition typically triggers a relapse of symptoms in many cases, as the inflammation level exceeds the threshold at which a reaction is initiated.
In some cases, a relapse can be prevented by the use of antihistamines to preempt a proinflammatory state from redeveloping as the corticosteroid dosage is tapered. Also, the slower the rate at which the dosage is reduced (the longer the tapering process is drawn out), the better the odds that a proinflammatory state will not redevelop and trigger a relapse of symptoms.
Tex
He's probably not going to believe your explanation, because most doctors are unaware of the fact that mast cells are involved in the inflammation process that causes MC. If he isn't aware of that connection, then he isn't going to understand why an antihistamine would help when weaning off Entocort. That said, here's why it can help:
Basically, inappropriate degranulation of mast cells leads to elevated histamine levels, a condition that directly promotes symptoms and also promotes the release of other inflammatory modulators which tend to cause additional inflammation. Corticosteroids suppress inflammation by suppressing mast cell numbers. When a corticosteroid is discontinued, mast cell numbers tend to return to normal levels. However, as with the withdrawal of many drugs, there can be a rebound effect, whereby mast cell numbers repopulate so quickly that they overshoot, and the result is higher-than-normal numbers of mast cells, resulting in a proinflammatory environment. This condition typically triggers a relapse of symptoms in many cases, as the inflammation level exceeds the threshold at which a reaction is initiated.
In some cases, a relapse can be prevented by the use of antihistamines to preempt a proinflammatory state from redeveloping as the corticosteroid dosage is tapered. Also, the slower the rate at which the dosage is reduced (the longer the tapering process is drawn out), the better the odds that a proinflammatory state will not redevelop and trigger a relapse of symptoms.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
thanks
many thanks for the info, I can understand fairly well what you are saying but trying to explain this will be hard as sometimes I feel like "a rabbit in the headlights" in the consulting room so will print your reply off and keep it in my pocket! Beni
I was going to ask you Beni, when you first started on Entocort. Is it possible that you are just not ready to taper off? Or is it possible that your diet still isn't "clean" of everything that sets you off? Everyone is different. I know that going from three to two pills was fairly easy for me. Going from two to one was a bit harder. But eventually constipation sets in and it's time to taper down again. I am now on one pill every other day. This whole process has taken five months. I will stay on this dose until I feel somewhat constipated again. It's such a low dose that my doctor and I are not very worried about long term side effects.... for now. I , of course, want to be off of it, but it sounds like the longer you take to do this tapering thing, the more successful. good luck
Leah
Leah
antihistamine
I am doing well just now at 1 one day and half the next, also taking antihistamine daily, last time I tried I got down to one a day for 6 weeks then one every other day but after 9 days the D. came back so I went back up to 9mg for a few weeks till I became a little constipated so dropped back to 6mg, stayed on that dose for a couple of months and then to 3mg till I started to get a little bound up and now 1 then half, have only been doing that dose for a week so dont know how that will go, I am able to eat quite a lot of foods including cheese in moderation and two days ago I ate green beans and cauliflour for the first time, ok so far!! want to try coffee, chocolate before October as my daughter and I are going to Rome for 4 days for some people watching and shopping, I would like to have a coffee but will wait another month before trying to introduce that. I dont really mind if I end up having to take 3mg for potentially ever but would very much like to TRY to come off compleatly if I can. I think often of how lucky I am really am as my life long best friend died of brain cancer and last year another very close girlfriend also died of cancer, as they say here "I am still above the sod" so lucky me, I have to also say most of my posative attitude comes from finding this site, many thanks to you all, Beni
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Deanna in CO
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Beni,
I could be wrong, but I think if I were in your shoes I'd stay off the cheese (and other dairy), at least until you are completely off the Entocort for a number of weeks and very stable. Almost all of us react to dairy in any form (even butter) - Entocort might mask your reactions but you could end up with a nasty relapse without the Entocort. My reaction to dairy on the Enterolab tests was just as strong as my reaction to gluten.
Just a thought.
Deanna
I could be wrong, but I think if I were in your shoes I'd stay off the cheese (and other dairy), at least until you are completely off the Entocort for a number of weeks and very stable. Almost all of us react to dairy in any form (even butter) - Entocort might mask your reactions but you could end up with a nasty relapse without the Entocort. My reaction to dairy on the Enterolab tests was just as strong as my reaction to gluten.
Just a thought.
Deanna
I'm so Jealous- Italy! I have never been to Europe, but would love to go one day. We are still putting two daughters through college though.
I so get where you are Beni. I too think that you probably have added too many foods back in that are preventing you from completely getting off of the drug. I think I am guilty of the same thing... kind of. I haven't touched gluten, dairy, or soy ( and probably won't), but I have added or tried some "aggravators" that may be giving me more gas and bloating ( but not D). It's all an individual decision when it comes to wanting to be in complete remission with no drugs- BUT a very limited diet..... OR taking a small dose of meds and being able to eat more things. I am caught somewhere in between.
Leah
I so get where you are Beni. I too think that you probably have added too many foods back in that are preventing you from completely getting off of the drug. I think I am guilty of the same thing... kind of. I haven't touched gluten, dairy, or soy ( and probably won't), but I have added or tried some "aggravators" that may be giving me more gas and bloating ( but not D). It's all an individual decision when it comes to wanting to be in complete remission with no drugs- BUT a very limited diet..... OR taking a small dose of meds and being able to eat more things. I am caught somewhere in between.
Leah
antihistamine
just wanted to say I have never stopped eating dairy so havent reintroduced it, the only cheese I cant eat for definate is large ammounts of soft french cream cheese, ie brie, I am fine on parmisan and sheep cheese, when I come off endocort entirely if I end up back to square one I will probably try cutting out dairy before I try again but for now I will keep on eating dairy. Dont be jelous of Italy, we couldnt travel when we had dependants either but now we travel alot in our winter, always self catering since the L.C. this trip to Rome will be a big test, no loving hubby if I get a flare, we chose Italy for our girls trip because beleive it or not its best for GF, in Italy all kids are tested for ceolac at an early age, if you ever go buy a book called Gluten free Italy, Spain is also good , even stayed in a hotel that was Totaly G.F. the menu was amazing with things like G.F. tempura for starters, hubby was forced to have G.F.beer,no choice and loved it. Strangely I find the U.K. hardest for resturants and France isnt too good either, the worst for me is Mauritius, they have no concept of G.F. except in the 5 star resorts which I dont like anyway, we go to Barbados in November for 3 weeks self catering, Trip advisor reveiws say there are good eating places for G.F.. Will post how my reducing goes, so far so good Beni