Started prednisone, then doctor said stop - what to do?
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Started prednisone, then doctor said stop - what to do?
I came down with severe food poisoning last Sunday night from badly cooked salmon (my fault!) and have been extremely ill ever since. Ended up in the ER with severe dehydration on Thursday. This morning went to urgent care, and the doctor thought that the FP had kicked off a massive flare. So she advised going on a round of steroids, starting at 60 mg. I took the first pill this morning, and then this afternoon I found out that the labs from the ER visit were back and I'd contracted campylobacter, which requires antibiotic treatment. I emailed my GI doc to ask him what to do and all he said was not to take the steroids and to take the antibiotics. But now that I have the first dose in my system, what do I do? Just not take any more? Jump down to 20 tomorrow and do a taper from there? Thanks.
Hi Elizabeth,
That's a tough question. Especially since that was a fairly stiff starting dose of prednisone. I'm not sure that any research has been published that covers this particular situation, so we are sort of in uncharted waters.
Since it takes a while for even prednisone to suppress adrenal function, I'm inclined to believe that your doctor might be right, that a single dose of prednisone should not have a major effect on the adrenals. We don't have any way of knowing that for a fact, but it's a reasonable assumption, under the circumstances.
It's certainly not a good idea to take the two together, because the prednisone will weaken the effect of the antibiotic. And he is right of course — if you need to treat a campylobactor infection, then you need the antibiotic, and since prednisone would make the treatment less effective, then it should be withheld.
I'm just guessing here, but I'm afraid that if you take another (reduced) dose of prednisone, and do a fast taper, that may just make the situation worse. I never dreamed that I would ever find myself concurring with a doctor's decision to stop a prednisone treatment cold turkey, but in this particular situation (since you have only taken a single dose), cold turkey appears to be the way to go.
Good luck with this, and if you should happen to develop any corticosteroid withdrawal symptoms, please don't hesitate to check with your doctor (or the ER).
Tex
That's a tough question. Especially since that was a fairly stiff starting dose of prednisone. I'm not sure that any research has been published that covers this particular situation, so we are sort of in uncharted waters.
Since it takes a while for even prednisone to suppress adrenal function, I'm inclined to believe that your doctor might be right, that a single dose of prednisone should not have a major effect on the adrenals. We don't have any way of knowing that for a fact, but it's a reasonable assumption, under the circumstances.
It's certainly not a good idea to take the two together, because the prednisone will weaken the effect of the antibiotic. And he is right of course — if you need to treat a campylobactor infection, then you need the antibiotic, and since prednisone would make the treatment less effective, then it should be withheld.
I'm just guessing here, but I'm afraid that if you take another (reduced) dose of prednisone, and do a fast taper, that may just make the situation worse. I never dreamed that I would ever find myself concurring with a doctor's decision to stop a prednisone treatment cold turkey, but in this particular situation (since you have only taken a single dose), cold turkey appears to be the way to go.
Good luck with this, and if you should happen to develop any corticosteroid withdrawal symptoms, please don't hesitate to check with your doctor (or the ER).
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 for the feedback, Tex. I started responding to this post days ago, and then clearly I got interrupted. I've just been taking the antibiotics and not the prednisone and am starting to feel a lot better. I'm still very, very worn out and am back in my usual flare mode. But at least I don't feel like I need to be hospitalized any more!
Gabes, thanks so much for asking about me. I was kind of getting back on track - sort of. So I'm going to be going to see an herbalist who specializes in helping people with colitis. I have high hopes. We'll see!
Gabes, thanks so much for asking about me. I was kind of getting back on track - sort of. So I'm going to be going to see an herbalist who specializes in helping people with colitis. I have high hopes. We'll see!
Thanks for the update. I was beginning to be concerned that I might have inadvertently led you astray, and things weren't going as planned.
It's good to hear that the antibiotics are working.
Tex
It's good to hear that the antibiotics are working.
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.
Hi Beth, I'm sorry you've been through the ringer. Food poisoning, campylobacter, and a flare....wow. I'm glad to hear you are feeling better with the antibiotics. Here's hoping the flare resolves quickly when you are done with the antibiotics. take care,
Carol
“.... people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” Maya Angelou
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MaggieRedwings
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Beth,
Hope you are feeling better and please do let us know about the herbalist. I don't want to be a wet blanket but please do not overload yourself with a lot of herbs, etc. They rarely do us positive results.
Love, Maggie
Hope you are feeling better and please do let us know about the herbalist. I don't want to be a wet blanket but please do not overload yourself with a lot of herbs, etc. They rarely do us positive results.
Love, Maggie
Maggie Scarpone
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Resident Birder - I live to bird and enjoy life!
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Resident Birder - I live to bird and enjoy life!
I'm doing much better. Still very tired, but I imagine that's just par for the course.
The herbalist was questionable, to be honest. In the first 5 minutes he said I needed to think about getting a fecal transplant, which I found quite extreme since I'm a healthy weight, I can exercise (when I don't have campylobacter!), I can eat, just within a very narrow range of foods, and I can work. But once I steered him away from that idea, I got him to give me some suggestions. He told me I really needed to start getting some fiber in me since that's how the good flora flourishes (I'd been eating only meat for several months), and he recommended going slowly and keeping a food diary and eventually adding in some fermented foods. He also gave me a tea that will help soothe and heal the gut. Nothing crazy. I'm feeling pretty good, and I've been adding in some carrot and seaweed without any adverse effects - yet. Going slowly.
Also trying to figure out my daughter's eczema. Seems she has a quite an allergic reaction to salycilates. Anyone heard of adding in quercitin for lowering the body's overreactive histamine response? Apparently that's supposed to help with eczema - and maybe it will help me with my overreactive flares. Worth a try, I guess.
Thanks for your kind thoughts!
The herbalist was questionable, to be honest. In the first 5 minutes he said I needed to think about getting a fecal transplant, which I found quite extreme since I'm a healthy weight, I can exercise (when I don't have campylobacter!), I can eat, just within a very narrow range of foods, and I can work. But once I steered him away from that idea, I got him to give me some suggestions. He told me I really needed to start getting some fiber in me since that's how the good flora flourishes (I'd been eating only meat for several months), and he recommended going slowly and keeping a food diary and eventually adding in some fermented foods. He also gave me a tea that will help soothe and heal the gut. Nothing crazy. I'm feeling pretty good, and I've been adding in some carrot and seaweed without any adverse effects - yet. Going slowly.
Also trying to figure out my daughter's eczema. Seems she has a quite an allergic reaction to salycilates. Anyone heard of adding in quercitin for lowering the body's overreactive histamine response? Apparently that's supposed to help with eczema - and maybe it will help me with my overreactive flares. Worth a try, I guess.
Thanks for your kind thoughts!