It’s amazing how often the topic of steroids comes up. In the last two weeks alone, three people told me they were taking prednisone and were irritable from the side effects. One took them for sinus problems; another was taking prednisone for arthritis. The third was taking them for a bout of MS.
They are powerful medications and are often prescribed for people with and without MS. Why? Because its main purpose is to reduce inflammation. And inflammation occurs in all parts of the body, and these medications help.
But there is a lot to know about steroids, and unfortunately, the doctor and the pharmacist never tell it all. The first steroid experience is horrible to say the least and creates tremendous confusion and stress. Personally, I hated them at first, but after understanding my own body’s reactions and the fact that they worked for me, steroids became my friend.
For people with multiple sclerosis, corticosteroids (“steroids”), usually Solu-Medrol and prednisone, are used to reduce the duration and severity of a flare (or exacerbation, or attack). Solu-Medrol is given intravenously for 3 to 5 days, usually at home (about 1 to 2 hours a day). Prednisone is given orally usually over a 10-14 day period, starting at a very high dose (eg 80mg/day works for me) and tapering down the last week to 10mg. for the last day.
What you should know about steroids:
- Again, the purpose of steroids is to reduce inflammation. When the dose is high, the immune system will be suppressed. Therefore, you want to take every measure to keep your resistance high and your exposure to infections, colds, and viruses low. If you currently have an infection or virus causing the outbreak, try to get rid of the infection/disease before starting steroids, if possible.
- A very common side effect of steroids is water retention. Eliminate as much salt as you can from your diet while taking them. This goes beyond table salt. Canned, frozen and packaged foods, pickles, condiments, cold cuts, etc. they are loaded with sodium; so avoid them and eat soft and fresh foods. Often people will get what they call a “moon face”; the face may become full and rounded.
- Appetite usually increases when taking steroids, so eat snacks like carrot sticks, celery sticks, apples, or unsalted popcorn. The sacrifice of a strict diet for up to two weeks is well worth the extra pounds you won’t gain and have to worry about later.
- Once you start taking steroids, follow the entire program and don’t stop taking them. Doing so can inhibit your adrenal glands from producing the natural amount of cortisol later on.
- A universal complaint is insomnia. Talk to your doctor about sleeping pills. Even with a sleeping pill, you may only get four to six hours of sleep. Try reading, doing paperwork, or anything that keeps you from thinking about not sleeping.
- There are many other side effects of taking steroids; the amount, type, duration will be different for everyone. For example, I feel supercharged and euphoric when I take steroids, especially when they kick in and my symptoms are improving. I am also very constipated. Other frequent complaints include irritability and mood swings. If you’re anxious, consider asking your doctor about an anxiety pill to minimize stress.
- For women, it has not yet been proven whether steroids affect birth control pills. It is always a good idea to use extra protection while taking steroids.
- Try to temper your expectations and don’t compare yourself to anyone else. Some people respond faster and better than others. Take notes every day about what’s improving, what’s not, how much… It will help you with your next episode. You will learn your own body reactions and patterns as time goes by.
- When a steroid program ends, a person will often go into drug withdrawal. The symptoms may worsen again and different side effects may appear. For me, I have tremors, anxiety, crying, acne, some hair loss, sleep; and my symptoms will be worse than before taking the steroids. After my “withdrawal” period, my symptoms will adjust to what is normal for me; and all other steroid side effects will go away. Having been taking steroids an average of twice a year for the duration of my MS, I learned what to expect and how to cope.
- There are serious side effects from using steroids over a long period of time, such as months or even years. These include things like loss of bone density. As always, one must weigh the benefits against the positives when taking any medication.
Sometimes steroids work for a person and sometimes they don’t. And of course, everyone reacts to a drug differently, both in response to efficacy and side effects.
All you can do is try. If it works, great; if not, well, something else will have to be tried to alleviate the problem.
