steroid dosage ... what do you think it will do to me? Any advice useful! :)

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Veteran Member

Date Joined Sep 2005
Total Posts : 769
   Posted 9/18/2007 3:18 AM (GMT -6)   

Hi all,


I was just wanting to call upon the knowledge of all you prednisone veterans … I have only been on steroids once, and it was when I was in hospital so it was only for a few days.


Basically I am in a flare at the moment which has me completely exhausted, in lots of pain and feeling nauseous, weak and absolutely awful. I have had Crohn’s for two years now and I don’t think I’ve ever felt this bad, even when I was diagnosed and lost so much weight etc. I am finding it hard to get through day to day life, I am a full time university student who also does work experience one day a week and works a couple of days a week at a bakery. I'm 21 and I graduate in six weeks and honestly at the moment thinking of having a full time career in this state of health freaks me out big time. I have also been getting debilitating migraines which take away my sight momentarily and leave me really out-of-it and feeling like I am hopeless and have no control over my health. I want to be able to start work after xmas and I'm scared about not being well enough to do so.


I saw my gastro today and he has given me 3 options: stay on sulfazalazine at 6 a day, try flagyl, or try a short course of steroids. I have been so scared of steroids because of all the horror stories of prednisone, I don’t want to get acne, gain weight and get a moon face. But it would be 25mg (1 a day) for around 3 weeks. I was wondering if anyone could advise me what sorts of side effects I would encounter at this dosage? I really only want to use steroids as a last resort but I cant go on much longer feeling like this, my Crohn’s has never gotten to me as much as it is right now. I’ve never been scared to eat or leave the house and that’s how I feel at the moment!


Thanks for your advice guys; I hope you are all well!





Regular Member

Date Joined Apr 2007
Total Posts : 254
   Posted 9/18/2007 3:39 AM (GMT -6)   

Hi Phoebe,

It's true that prednisone has some serious side effects.  The thing is that if you are feeling so bad, prednisone will help you stand on your feet within 2-3 days.  When I took it it was for almost 4 months and it was the first time I felt hungry again, no pain in my stomach and as far as energy levels, I could participate in the Olympics!!!!!

Prednisone and steroids in general are not long term treatments, but they can help you get out of a flare within days.  The side effects I experienced was moon face which was nothing serious because I was very carefull with salt and sugar, and mood swings.  But I would rather have these side effects, than running to the bathroom 10 times a day, feeling nauseous and sick.

The dosage your doctor proposed is not very high and the period of time is very short (3 weeks), so I really don't think you will have serious side effects.  Of course the decision is yours, but sometime we have to weigh the situation.

Hope this helps,



Elite Member

Date Joined Sep 2005
Total Posts : 10404
   Posted 9/18/2007 4:52 AM (GMT -6)   
Hi Phoebes,

Sorry to hear you're so unwell.

I reckon you should try the steroids. Flagyl could make you feel worse, and at least the pred will give you a surge of energy to get you through the exam period. I know what the end of third year is like - total, total exhaustion.

Unfortunately, too, because of the pbs rules, you have to go through the pred / imuran hoops before you can get to Infliximab (Rem). So, don't muck about - try the pred, if it doesn't work, try the imuran, so that you can get on I'mab and get better quickly.

That's what I think, anyway.

Hope you feel well soon,

Co-Moderator Crohn's Forum.

Veteran Member

Date Joined Mar 2007
Total Posts : 4527
   Posted 9/18/2007 6:25 AM (GMT -6)   
Hi I agree with the above that the doseage is low and that you should not have too many side effects for a short time don't let yourself get runnned down by not eating, the pred, will help with that and is better then getting sicker in my opinion.Food keeps us stong. I was totally amazed by the pred how well it worked and my BM's got solid in no time . Wishing you all the gail

Elite Member

Date Joined Apr 2005
Total Posts : 14995
   Posted 9/18/2007 8:46 AM (GMT -6)   
You really should go with the steroids. They are what we call a necessary evil. It is the best med to get your flare to calm down. And 25 mg. is low and for only 3 weeks, you really should only have minimal side effects. But I would take the side effects over feeling like crap all the time. JMHO
Been living with Crohn's Disease for 32 years.  Currently on Asacol, Prilosec 60 mg, Estrace, Prinivil, Diltiazem, Percoset prn for pain and Calcium.  Resections in 2002 and 2005.  Recently diagnosed with Fibromyalgia and doing tests to see if I have Inflammatory Arthritis or AS.

Veteran Member

Date Joined Sep 2005
Total Posts : 769
   Posted 9/19/2007 4:16 AM (GMT -6)   
Thanks for all the advice guys. I was feeling so much better today, something I have put down to not having any breakfast. At the moment it seems my body just does not want food, what a pity we have to eat, I've never had this problem before! I feel like if I didn't have to eat I would be able to deal much better! Food sends me to the toilet and I feel on the verge of throwing up!

I think I will take the steroids because it is a low dose and not for long, are the most common side effects acne, mood swings, moon face and weight gain? Just curious as to what I should expect.

I hope you are all well!

Veteran Member

Date Joined Mar 2007
Total Posts : 4527
   Posted 9/19/2007 5:02 AM (GMT -6)   
Hi I did not have a problem with acne however I was on 40 mgs and did have sleeping problems. If I had only been on it for a few weeks it wouldn't have too bad. I was having night sweats too then and that didn't help with sleeping now I don't have the night sweats.I did eat lots but I was run down when I started them and needed the weight. The thing is I would have got very sick without the pred. I was recovering from surgery and very glad to have something that would help.I should have tried to lower my sugar intake on them because now my glucose is up so try not to overeat sugar stuff. Mood swings weren't t too bad.At 20 mgs it wasn't too bad at all and easier to handle like I said the night sweats were bad but I had them for 2 years so it wasn't the pred. that caused them. After my last Rem. IV that was doubbled I now don't have night sweats so hoping that last. Hope this helps some. If you are worried and not doing good it is probably better for you to do something that will help you rather then suffer and not be well. Best Wishes and let us know how you are gail

Veteran Member

Date Joined Sep 2005
Total Posts : 769
   Posted 9/19/2007 6:16 AM (GMT -6)   
thanks Gail. I am thinking of taking my 1st pred tonight. I was also prescribed Flagyl so I really dont know whether to go with the antibiotic or the steroid. I do get fevers at night so perhaps the antibiotic would help with that if it's an infection? I don't know I'm so confused. Whatever I ended up deciding on, I wanted to do it while I was at my parent's place 5 hrs from here but I'm not going there until next wednesday and I don't know if I could last that long feeling like this and not being able to eat much.

Regular Member

Date Joined Apr 2007
Total Posts : 217
   Posted 9/19/2007 9:44 AM (GMT -6)   
I am taking entocort...another steriods...but it's not working well with me....I will listen to my gi and try the pred...I am really scarde of it because of the side effect and I never took pred maybe I will feel better. in my opinion you should try the pred and see what happens......just my 2 cents lol

35 yrs female, dx with crohn's on july 13th 07 increasing my  entocort 9mg . starting imuran 250 mg  pariet ,dx with depression in 2002 ,effexor tappering off, welbutrin,resperidal and lemotrogine.

Regular Member

Date Joined Jul 2007
Total Posts : 137
   Posted 9/19/2007 12:53 PM (GMT -6)   
It really is the lesser of 2 evils, I was always scared of taking it and really only take is as the last resort, but within 2 days the improvement in my symptoms was incredible. I try to limit when I get back on the pred with my flares to when it is absolutely needed since I do get moon face, acne, weight gain(already overweight :{ ), mood swings etc. But once I relent and start taking it I am much happier. Such a low dose for a short time really isn't that bad. Also with the flagyl, I have had to do pred, flagyl and cypro all at the same time during a flare and it's a catch 22, pred makes you feel better but the flagyl and cypro can make stomach upset and I get yeast infection in my mouth really bad from them. If you are running a fever, chances are there is infection so should do the flagyl too to eliminate that problem.
good luck!!
Dx 2003 but probably had it 10 years prior
GB out '95, Appendix out '96, Kidney stent '02/stone removal '02, Resection '04, fistulectomy '06 2x, tubal '05
Currently on 100mg 6mp and Remicade every 8 weeks, Ambien as needed, preds as needed

Veteran Member

Date Joined Apr 2005
Total Posts : 3763
   Posted 9/19/2007 1:39 PM (GMT -6)   
Prednisone is really the drug that will bring you the quickest relief of all of the drugs in the CD arsenal. As everone else has said, it is a relatively short course and a reasonable dose. Some of the side effects can be counter acted by other meds if they get to be too much, but on a short course you probably will be alright. If you can't sleep, ask for a mild sleeping pill. If you aren't sleeping your body isn't healing. If the mood swings are too much ask for a mild tranquilizer. Some doctors are more willing than others to help with the side effects, only you know what your doctor is like. But with your schedule and everything on your plate this fall, you really need to get your health under control and ask for and demand whatever assistance you need. Once you lower the dose you won't need a sleeping pill or a tranquilizer and you may be one of the lucky ones who doesn't have side effects at all. Don't cross those bridges until you have to. Just do what you need to to take care of yourself, so that you can acheive your goals this fall.

Best wishes and I hope that you feel better soon.

CD 19 years offically, 29 unofficially. 3 resections '93, '95 '97
Symptoms constantly but all tests show only minor ulcerations. Currently having multiple episodes of gastritis with no known cause.

Prednisone, 6MP,Prevacid, B12 shots, Bentyl, Xifaxan.....

Veteran Member

Date Joined Feb 2007
Total Posts : 1010
   Posted 9/19/2007 2:22 PM (GMT -6)   
You said something significant to me in your last post:

"what a pity we have to eat, I've never had this problem before! I feel like if I didn't have to eat I would be able to deal much better!"

In my misbegotten past I have mouthed those words so many times and they alwasy foretold trouble. It took me years to recognize those sentiments for what they are -- a big fat warning.

Please re-read what you wrote -- and keep re-reading it until you get the message you are sending. Eating is the most basic human function. Imagine how sick you are that you are wishing, "if only you didn't have to eat."

This is the ambulance siren, the flashing lights of the fire truck, this is the red light -- stop look and listen to what your body is telling you.

Many of us have been in this place at some point during our disease. I've been there many times. I dreaded needing medication too. And I dreaded acknowledging to anyone, especially myself, that I couldn't cope. So I often convinced myself that I just needed a vacation from food, or I was too busy to eat.

Now my family knows that when i start saying, "I'm just not hungry" or, "I feel better on an empty stomach" or like you, "I wish I didn't have to eat" it's time for an intervention.

My best friend invites me over sometimes just to test whether I can drink my tea or eat a biscuit. Even though I think I have finally gotten the message and I'm trying to change my behavior, they don't trust me anymore because they've watched these declines too many times.

Hope you can give the steroids an opportunity to work. For me they have turned into a miracle drug (even though at a price) I know that if things get really bad, within 24-48 hours of starting steroids i will have relief. I call steroids my vacation from pain and when used in the short term I don't suffer many side-effects.

30+ years living with Crohn's.

Regular Member

Date Joined Mar 2006
Total Posts : 494
   Posted 9/19/2007 3:04 PM (GMT -6)   
I feel your pain when you worry about starting a career with this disease.  I worry all the time too and then I get really good days where I can get a lot of work done and be productive, so you will get through your flare, and hopefully things will look more positive.  Believe me you will get through it.  I have been there!
I turned down the prednisone option and was on Entocort for almost two years. I just tapered off and am on Remicade.  Has the doctor discussed either of these options with you? Maybe he will recommend them after your short course of prednisone.
Diagnosed 1/06
CD of Terminal Ileum
Taking Pentasa, Entocort, Prograf and Remicade.

Veteran Member

Date Joined Apr 2006
Total Posts : 1665
   Posted 9/19/2007 4:54 PM (GMT -6)   
don't get too freaked reading about side effects. the only one I had was not being able to sleep. no weight gain or moon face.
it is more important to take care of yourself and bellenstein said that all very well. I, too, consider just not eating, but I know that is not a long-term solution. yp
48 y/o woman.  Diagnosed 4/06 after colonscopy, SBFT, CT-scan all showed crohns. 3 months later, after pred and remicade, all tests showed no crohns. In December had adhesions cut through a laparoscopy. Now just taking Glycolax, metamucil, and with pain, but doing ok.

Veteran Member

Date Joined Sep 2005
Total Posts : 769
   Posted 9/19/2007 6:35 PM (GMT -6)   
Thanks so much for all the advice guys. I took my first prednisone this morning. My gastro has told me that because it’s such a low dose I shouldn’t have to taper off too slowly. Therefore I am just reassuring myself that because its only 2 weeks and not 2 months, I shouldn’t have any weight gain, moon face or bad mood swings. If I do start getting side effects that I really dislike my GI said I can always go on to a lower dose.

I did have prednisone in hospital and I did ok from that, I did have ‘snappyness’ towards my partner but it was very short lived. Anything to feel better at the moment. If I went on feeling like I did last night I know I would just waste away because I was literally scared to eat anything.

For those of you who say you only had minor symptoms, I'm just curious, what were they? I just wonder what the ‘minor’ symptoms are and what I should expect to experience. Also, were you on 25mg or a higher dose rate and for how long?

I have heard horror stories about pred but hopefully for me it will be a positive experience. Thank goodness the option is out there for the truly desperate! For some reason I was naïve enough to think ‘it’ll never happen to me’ … or that I would never get so sick. I am so looking forward to feeling better now. I don’t know what is in my future in terms of graduating, working etc but I am not allowing myself to think about it at the moment, I'm just going to try and concentrate on getting better and see what happens from there…

Belleenstein, thank you for drawing my attention to my last post, it really is a wake up call to how bad I have been feeling and the importance above enerting else of getting better and feeling better, I have to remember it is possible to feel normal again.

I will keep you all updated as to how it’s going, at the moment I feel better than I usually would at 9:30am! Whether or not it's the placebo effect or it's really working so early, I don't mind either way!

I can’t thank you enough for your support and advice.

Lots of love to you all!

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