Pred is metabolized to cortisol, which is natural and oresent in the body at all times even when not on prednisone. Toxicity comes from cortisol in the bidy in excess, especially much in excess, of the normal physiologic dose. People who have had their adrenals removed surgically have to take prednisone for life but get no toxicity whatsoever, because the pred just replaces the physiologic dose (equivalent to about
5 mg prednisone, if one werent also producing cortisol.)
So if one is on long term pred and ones adrenals temporarily shut down, low dose pred will essentially be seen by the body as non-toxic, physiologic dose cortisol. I am no fan of prednisone, but one has to weigh the options if one doesnt respond to or is intolerant of standard maintenance drugs, and I'd sooner kill off a flare quickly then let it spiral outif control and then definitely have to be on high doses of ored for a while (even if only to stabilize oneself for jpouch surgery). The problem with just "living" with undampened UC js that it feeds into itself- inflamed tissue disables the gut's healing function, increases intestinal permeability, etc, so sustaining a vicious cycle. Prednisone was instrumental in gaining me a ten year total med free remission. I desperately try to avoid pred, though.
Post Edited (Probiotic) : 8/25/2012 7:14:25 PM (GMT-6)