Does Budesonide impair healing?

[LJL547!]

Greetings, this is my first time posting on this forum - I'm so happy you are here! I have a prescription for Budesonide which I have not yet started. I have lost 20 pounds and am feeling weak but recently got results from Entero Labs and learned some of what I had been eating (rice for example) is not safe for me. My question is this - if I take the Budesonide, am I slowing or preventing healing? Or if I take the Budesonide and am careful about my diet, will I continue to heal? Thanks so much for all your info - I learned about Entero Labs from WP's MC Diet book.

Best,
Lisa L

[tex]

Hi Lisa,

I responded to the post you entered yesterday, but apparently you didn't find it, so I'm copying it here io save having to rewrite it:

Hi,

Welcome to this group. Inflammation is the first step in the cycle of the healing process, so from that viewpoint, since budesonide suppresses inflammation regardless of the origin, yes, it tends to slow down the healing process. So theoretically, at least, although using budesonide while following the diet should make life more pleasant by masking the symptoms, it will do so at the expense of delayed healing. When properly used (ending the treatment with a slow dosage taper), the difference in healing times would probably be difficult to measure. This is because gluten antibodies (antigliadin antibodies) have a 120-day half-life, making them very persistent.

Consequently, for most of us, it probably takes roughly 6 to 8 weeks to get the effects of gluten out of our system after cutting gluten out of our diet. A few respond to the diet much faster (if their antibody level is relatively low to begin with). The point is, our body is not likely to do any significant healing until the antigliadin antibodies have declined sufficiently so that gluten is no longer dominating our immune system, causing us to continue to react. If we're using budesonide, we should be able to enjoy a cessation of the symptoms for most of that period, but the actual healing will probably begin at about the same point in both scenarios. So I suppose what I'm trying to say is that, yes, budesonide slows down the healing process, but it probably doesn't really matter very much for most of us, in the long run.

Although the symptoms should be under control after a few months of following the diet, healing of the intestines is a slow process (the Microscopic Colitis Foundation published a newsletter on October 1 that explains why https://www.microscopiccolitisfoundatio ... 864178.pdf ). Complete healing of the intestines, so that the cells of the epithelia of the colon return to normal histology, can take from 5 to 10 years, depending on our personal situation, our age, and various other factors. In other words, after healing is complete, a pathologist looking at samples taken from the epithelia of the colon during a colonoscopy would see no evidence of MC, because the composition of the cells would be back to normal.

I hope I haven't just confused the issue,

Tex

[LJL547!]

Greetings Tex, and thank you so much for your prompt (second) reply to my question! Yes, the issues are confusing, but you are a beacon of clarity to me as I sort through what to do. I just read about Balanced Electrolyte Concentrate elsewhere in this Forum, and will incorporate that. I can be patient and slowly let the right diet work for me, but I am a little scared at having lost so much weight and feeling weak. But I will say that since I have incorporated the suggestions from Entero Lab, my mucky guts feel a bit calmer.

Thank you again for being there. You and your team have obviously helped so many sort of desperate people and now I am among them.

Cheers,
Lisa

[LJL547!]

Greetings Again,
I have some follow up questions as I continue to weigh the pros and cons of taking Budesonide.

Tex, in your last post, you said gluten has a 120 day half life. Does that mean after 120 days half of the gluten is gone? And does it follow that it's not all gone until 240 days have passed?

You also mentioned that it takes 6 to 8 weeks to get the effects of gluten out of our systems after cutting it from our diet. That sounds much more optimistic than 240 days! Perhaps the effects of gluten wear off before it is all out of our systems?

I do have a prescription for Budesonide: 3 MG capsules, and I am supposed to take 3 per day in the morning. The prescription is for 90 capsules with 1 refill. So that would give me 2 months of Budesonide. Is that enough? I believe I read elsewhere on this forum that I would know its time to start tapering with the Budesonide when I start having normal poops - but I thought I also read that Budesonide masks the symptoms (diarrhea) right away. So how will I know when to start tapering?

My primary care doctor is not very familiar with this disease, but he is respectful of your work and website and I believe he will prescribe what is needed based on your feedback.

Thanks again (and again and again) for being there! I have read a lot of what is on your website, and am moved by your kindness and willingness to help people, and inspired by Sally R who I never met but am so grateful for what she has done.

Best,
Lisa L

[tex]

Hi Lisa,

Your analysis is basically correct, but the situation is much more complex than that. Anti-gliadin antibodies have a half-life of 120 days (on the average). So in 120 days approximately half of the antibodies that existed on the day you eliminated gluten from your diet, will have expired. But the problem is, our immune system continues to produce antibodies, just in case any gluten sneaks into our diet, until it is sure that the risk is gone. That's why vaccines work. If our immune system didn't produce antibodies, it wouldn't be able to detect the presence of a pathogenic threat, because it relies on antibodies to spread the alarm by latching onto the detected antigens, so that other immune system components can identify and destroy them.

Our antibody level continues to climb as long as we react, and once we eliminate the threat (gluten) our antibody level slowly decays until it eventually reaches a normal level. But the secay process can take years. For most of us, our antibody level is so high by the time we discover the problem, that the EnteroLab tests, for example, can detect gluten sensitivity for up to two years (or more) after we remove gluten from our diet.

We continue to react to gluten until our antigliadin antibody level declines sufficiently that it is below our threshold level at which it triggers an immune system reaction. In other words, the gluten is long gone, once we cut it out of our diet, but the antigliadin antibodies are not, because antibody production will continue for years, in the case of gluten.

You should have plenty budesonide, if you adopt the elimination diet when you start taking the budesonide. Definitely don't reduce the dose just because the budesonide stops the diarrhea. Reduce the dose at the first signs of constipation.

Yes, Sally was a pioneer regarding her design of a website to be used by MC patients for sharing their experiences as they learned to live with this disease. I remember when I first joined her forum, after I made a few posts, she sent me a private message warning me that appearing to be too knowledgeable about the disease can scare people off. I've always gone by the philosophy that the more you know about this disease, the better off you're likely to be, and fortunately, she never threw me off her website, even though I didn't "dumb down" my posts. I've always thought that we learn from each other, and we're all learning together.

Tex

[LJL547!]

Thanks, Tex, for getting back so quickly! And for not dumbing it down - what you said made sense and was very helpful for my understanding. Keep up this great work!

Best,
Lisa