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Osteoporosis

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Ulcerative Colitis
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Theanxiousaries
Regular Member
Joined : May 2021
Posts : 424
Posted 12/21/2021 2:02 AM (GMT -8)
Does anyone have this from steroid use?
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UCyousee
Regular Member
Joined : Feb 2014
Posts : 477
Posted 12/21/2021 6:53 AM (GMT -8)
I once had osteopenia but I reversed it by walking uphill on a treadmill with a weighted bag on my back. I also regularly take vitamin D but I'm not currently taking calcium (I'm currently relying on diet for calcium). I have Dexa scans every few years, and once I'd reversed the oesteopenia it stayed that way, but I'm due another Dexa soon, so we'll see.
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poopydoop
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Joined : Dec 2018
Posts : 1799
Posted 12/21/2021 7:11 AM (GMT -8)
Yes I got severe osteoporosis in my spine. I have to take drugs to manage it. I was on steroids for 2 years in total, most of that time was presnisone at doses between 5 and 15 mg. I took calcium and vitamin D every day during that period too. Am due for a dexa scan to see if it has improved in the last 3 years, but with covid the hospital keeps delaying it.
Because of my experience I am one of the more vocal people on this forum in expressing the need to avoid long term or repeat courses of prednisone.
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Theanxiousaries
Regular Member
Joined : May 2021
Posts : 424
Posted 12/21/2021 3:58 PM (GMT -8)

poopydoop said...
Yes I got severe osteoporosis in my spine. I have to take drugs to manage it. I was on steroids for 2 years in total, most of that time was presnisone at doses between 5 and 15 mg. I took calcium and vitamin D every day during that period too. Am due for a dexa scan to see if it has improved in the last 3 years, but with covid the hospital keeps delaying it.
Because of my experience I am one of the more vocal people on this forum in expressing the need to avoid long term or repeat courses of prednisone.


Does it shorten your life expectancy
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Theanxiousaries
Regular Member
Joined : May 2021
Posts : 424
Posted 12/21/2021 4:01 PM (GMT -8)
How do I avoid steroids when the drs say they’re my only option?
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3timechamp
Veteran Member
Joined : Oct 2009
Posts : 1788
Posted 12/21/2021 5:07 PM (GMT -8)
Was on Pred many times in my 32 yrs of Uc. No arthritis/bone issues ever. I'm a lucky one
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poopydoop
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Joined : Dec 2018
Posts : 1799
Posted 12/21/2021 5:15 PM (GMT -8)

Theanxiousaries said...
How do I avoid steroids when the drs say they’re my only option?

You always have a choice and options. Noone can force you to take steroids. You're on azathioprine now. That generally needs a few weeks to 3 months to start working. They may advise staying on pred a few weeks to bridge the gap. If i understand correctly you'll have to give the azathioprine a shot before they let you go on biologics. It might even work for you. I have a friend (actually my friend's husband) who was on azathioprine for 5 years then came off it and has maintained remission for 3 years since stopping.
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TroubledTurds
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Joined : Jan 2004
Posts : 8717
Posted 12/21/2021 7:42 PM (GMT -8)
"How do I avoid steroids when the drs say they’re my only option?"

look for a doctor that isn't an idiot -

TT
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clo2014
Veteran Member
Joined : Feb 2015
Posts : 1826
Posted 12/21/2021 8:00 PM (GMT -8)
I avoid steroids as much as possible. Prednisone gave me osteoarthritis in both knees, both thumbs, my hips, and my lower back.

There are times when I can not do without them though so I understand.

Clo
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Theanxiousaries
Regular Member
Joined : May 2021
Posts : 424
Posted 12/21/2021 8:51 PM (GMT -8)

poopydoop said...

Theanxiousaries said...
How do I avoid steroids when the drs say they’re my only option?

You always have a choice and options. Noone can force you to take steroids. You're on azathioprine now. That generally needs a few weeks to 3 months to start working. They may advise staying on pred a few weeks to bridge the gap. If i understand correctly you'll have to give the azathioprine a shot before they let you go on biologics. It might even work for you. I have a friend (actually my friend's husband) who was on azathioprine for 5 years then came off it and has maintained remission for 3 years since stopping.


I took my last 5mg yesterday. Got emotional, shaky severe nausea, extremely anxious. Rang my GI told him my symptoms were gradually returning. Abdominal pain and blood. He said back to 35mg prednisone,taper 5mg a week. Stop imuran. He will apply for entyvio. I’m really struggling emotionally dealing with my illness. I want to make the right decision for my long term health. I want to be here for my children
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VanJordan
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Joined : Dec 2019
Posts : 566
Posted 12/21/2021 11:17 PM (GMT -8)
I used DHEA and pregnenolone while on prednisone to avoid serious bone damage, and it worked. It's unfortunate that MDs don't recommend these to people as a matter of course anytime steroids are used. It could spare people serious damage.
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Theanxiousaries
Regular Member
Joined : May 2021
Posts : 424
Posted 12/22/2021 12:44 AM (GMT -8)

VanJordan said...
I used DHEA and pregnenolone while on prednisone to avoid serious bone damage, and it worked. It's unfortunate that MDs don't recommend these to people as a matter of course anytime steroids are used. It could spare people serious damage.


Is it safe to interact other steroids? I asked about a natural hormone cream while on steroids and they said No they interact
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poopydoop
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Joined : Dec 2018
Posts : 1799
Posted 12/22/2021 1:45 AM (GMT -8)
How long have you been on azathioprine? Unless the side effects are intolerable it generally needs 6-12 weeks to kick in. Entyvio is also slow acting so switching to that won't necessarily get you off steroids quickly. Btw when i started on azathioprine i did 3 weeks on 30mg prednisone then started to taper it.
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FlowersGal
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Joined : Feb 2017
Posts : 1631
Posted 12/22/2021 7:49 AM (GMT -8)
I have had anxiety issues in the past and say this speaking from past experience: sometimes when our anxiety is really high it can affect how we respond to treatment for other conditions. I think if you’re not on an anti-anxiety or -depression medication it could really help you deal with your UC better. And your anxiety can definitely be at least partly caused by your disease. There is strong evidence (not a lot of understanding tho) about the gut-mind connection. My GI sat me down and explained to me —in very scientific terms that I don’t recall the names of now—how gut inflammation increases the number of an enzyme or protein in our guts that can deepen anxiety or depression. This was when I was at my sickest. I started taking antidepressant and it really helped me a lot.

I say this because prednisone can mess with your mental state too and you do sound as if you’re at your wits end. I’ve been there and I understand. I do strongly urge you to consider this. I hope you don’t think I’m saying you’re doing something wrong because you’re not. It’s just another tool that can really help you deal with the awful life altering effects of this disease. I stayed on my antidepressant for about a year and then was able to stop taking it.

I have my fingers crossed that entyvio works as well for you as it has for me.
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Old Hat
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Joined : Feb 2007
Posts : 5853
Posted 12/22/2021 1:10 PM (GMT -8)
I think you should value advice from Poopydoop, Momto2boys, and FlowersGal especially-- and tune out some other stuff on the forum that doesn't apply to your case. That will help reduce your anxiety level. Probably you need to give Imuran more time to work, but in any case, you should be in treatment with a doctor who understands why getting off steroids is of major importance, especially to small-boned women. In the meantime, when you feel anxiety building, try some deep breathing exercises to help yourself calm down. Right now you may feel alone with your problem then worry about staying alive for your kids, but there have been many pregnant women and mothers pursuing advice here over time, who have suffered a lot from UC flares before finding which med(s) they needed, and they've done so well when they get the finally helpful Rx that they stop participating actively on the forum. So keep telling yourself that you'll get to their stage, too. Definitely re-read FlowersGal and keep yourself well-hydrated to withstand med side effects better. I think Straydog has also posted suggestions similar to FlowersGal in recent threads. / Old Hat (40+ yrs with left-sided UC; in remission taking Colazal)
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Theanxiousaries
Regular Member
Joined : May 2021
Posts : 424
Posted 12/22/2021 2:11 PM (GMT -8)
Thankyou all. I appreciate your advice. Flower gal I know you’re 100% right. My anxiety is overwhelming me more than anything else. I broke down to my husband last night because I know my anxiety is destroying me. Even my worst days are made 10x worst because of my anxiety. I believe all that you’ve said about mind/gut connection. I know this to be true. I think it may be time I seek help for my anxiety which has only gotten worst since my diagnosis. I’m also nerovous I haven’t given imuran a chance. The nausea is tolerable. It’s only been 3 weeks. My GI gave me a quick call on his way out of the country for his holidays. I said I’ve gotten worst. More cramps and bleeding. He just said stop, he will apply for biologics. That could be weeks away. My next consult is on the 14th of January. I’m almost tempted to keep going until his back but then going against his advice will not go well if I get worst. I will start having relaxation massages and intend on learning meditation as well. These are things I wish I had done before I got to this point. Old hat you are absolutely right. My daughter constantly tells me to stop taking on other people’s experience which I know I do. Thank you all again
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poopydoop
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Joined : Dec 2018
Posts : 1799
Posted 12/22/2021 4:10 PM (GMT -8)
Since you've already started it, and you can't start entyvio for a few weeks anyway, I would give the azathioprine at least 6 weeks.

DHEA and pregnenolone are both hormonal supplements and DHEA is an androgen - I wouldn't want to touch either as a woman (and pregnenolone lists anxiety as a possible side effect).

When i was in a long flare and on prednisone i remember my emotions being all over the place. It helped to see a therapist and go through my fears logically step by step, in order to break them down. But sometimes.... it's ok to just feel what you're feeling...and be kind to yourself.

about the osteoporosis: yes I am a small-boned woman. I am also on birth control which probably made it worse. I was 36 when they diagnosed it.
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Theanxiousaries
Regular Member
Joined : May 2021
Posts : 424
Posted 12/23/2021 12:35 AM (GMT -8)

poopydoop said...
Since you've already started it, and you can't start entyvio for a few weeks anyway, I would give the azathioprine at least 6 weeks.

DHEA and pregnenolone are both hormonal supplements and DHEA is an androgen - I wouldn't want to touch either as a woman (and pregnenolone lists anxiety as a possible side effect).

When i was in a long flare and on prednisone i remember my emotions being all over the place. It helped to see a therapist and go through my fears logically step by step, in order to break them down. But sometimes.... it's ok to just feel what you're feeling...and be kind to yourself.

about the osteoporosis: yes I am a small-boned woman. I am also on birth control which probably made it worse. I was 36 when they diagnosed it.


I am also small boned 4”9 and 48 kg. What is the prognosis for you? Does it shorten your life span?
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 1799
Posted 12/23/2021 1:07 AM (GMT -8)
No it doesn't shorten your life span smile I will have to manage my osteoporosis long term with medication, that's all, and I wish I didn't.
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straydog
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Joined : Feb 2003
Posts : 19337
Posted 12/23/2021 6:25 AM (GMT -8)
TAA, when was your last Dexa Scan & what was your score? If osteoporosis is caught in the early stages it can be reversed. I have osteoporosis in my spine & did Forteo injections for what seemed like forever. It did help some, however, over time I went from 5"2" to 4"11". Vitamin D3, I get my calcium from food. I do not supplement calcium because I have a history of kidney stones.

Flowers is right about the brain-gut connection. My gi told me basically the same thing. There has been a few occasions in the last 7 years that my stress level was way up there. I am not talking about getting stressed for a few days. The first thing that happens to me is it affects my gut in a nasty way, I end up with explosive diarrhea & cramping from hell. It takes lots & lots of patience & consistency to manage stress & anxiety.

At my sickest & worst time my dr put me on Buspar, it worked on the depression & anxiety. I stayed on it for nearly two years & also went to therapy once a week. This was my pcp that did this & my gi was onboard with it too. I was able to go off of it. An antidepressant can be a game changer.

Is your gi aware of your anxiety? If he isn't aware of it, with you telling him you thought you were worse, this is why he said to stop the Imuran. You can stay on it & tell him you think your anxiety is triggering some of your issues, he should understand that. If I remember right, you are almost a year into this flare, that's a long time. Three weeks of Imuran is not long enough to know if it's going to work or not. It's a slow going medication, same with Entyvio. Considering the length of time you've been flaring none of these medications are going to give you immediate relief, it's going to take time. Please don't fall into the trap of it's not working because I'm not better in a few weeks, this is how people burn through the medications too fast. It took 6 months of being on Remicade before I could really tell it was working. I had some improvements but nothing drastic at first. Unless a patient gets worse, my gi keeps us on a medication 6 months before trying something new. I understand you are in Australia & things are different over there.

Think about seeing your pcp for an antidepressant. Take care.
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FlowersGal
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Joined : Feb 2017
Posts : 1631
Posted 12/23/2021 6:34 AM (GMT -8)
I am small-boned too and have osteopenia. It’s a precursor to osteoporosis. There are medications to take — sometimes hormone replacement is used. It doesn’t shorten your life — just makes you more susceptible to bone fractures if you fall.

I am glad you realize your anxiety is overwhelming you. Please don’t rule out medication. It is such a big help. My pet peeve is when anxiety and depress are talked about as a “mental” disease which implies it’s only in the mind and if only the person was “strong” enough they wouldn’t have it. And that’s simply not true. It’s a physiological condition — just as our UC or diabetes or whatever While meditation and other tools are great for dealing with some of the effects, sometimes the only way to break the cycle is by medication. Not to say you shouldn’t learn meditation or get massages— learning relaxation techniques is a great thing to do. But if your anxiety is overwhelming, don’t feel as if you’ve done something wrong or have been too “weak” if you need a medication to get you over the hump. Anxiety and depression do feed on themselves and breaking that cycle can be difficult. Don’t forget exercise too! I find that to be another great tool.
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poopydoop
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Posts : 1799
Posted 12/23/2021 7:31 AM (GMT -8)
Yes the anxiety is physiological and the gut brain connection is real. At the same time, I get really triggered when people take that the other way and think that colitis is psychological - I had a very senior yoga teacher tell me "You don't have a bowel disorder, you have an anxiety disorder". The ironic thing is I needed a lot of therapy to be able to process these kind of comments (and understand that they are not true).
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FlowersGal
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Posts : 1631
Posted 12/24/2021 7:19 AM (GMT -8)
Wow! Just … wow!

I am truly mystified of how ignorant people can be. 😳
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poopydoop
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Joined : Dec 2018
Posts : 1799
Posted 12/24/2021 9:40 AM (GMT -8)

FlowersGal said...
Wow! Just … wow!

I am truly mystified of how ignorant people can be. 😳


The therapist said it's because people are afraid of things they cannot control (like: a chronic illness which just appears without any explanation...) so they make up reasons for other people's illnesses. Then they are in control again (i.e., "I won't get sick with this disease because I am not doing X/Y/Z"). In the end.... she made me comfortable with the idea that i am doing enough for myself, if i to go to my dr appointments and take my medication (it sounds funny when i write it down, but I was living in a world where everyone tried to blame my illness on diet or psychology problems). That helped to bring my anxiety down. Mindfulness and meditation aren't really my thing - maybe because i remember doing meditation in yoga class and all i could think of was how much i needed the toilet....and then having to disturb everyone else's meditation by running out the room to the toilet...
Sorry to the OP for the digression here 😳
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Theanxiousaries
Regular Member
Joined : May 2021
Posts : 424
Posted 12/25/2021 10:16 PM (GMT -8)
I agree my anxiety is contributing to my symptoms. I don’t believe it is a cause those and I find it frustrating when my GP insists I avoid steroids when I’ve literally had my inflammation spread to my pancreas, and joints as well as a PE with this flare. When I asked him how he said relax.. I was pretty relaxed before my flare but I’m certainly not now. I’m waiting constantly for the next thing to go wrong because this flare has been horrendous. I do believe I need to control my anxiety because I’m suffering a lot more than I have to. I have been able to control my anxiety all my life without medication but I agree flower gal. I need a little help. I have alway in the past felt medication was giving in but I’ve had to admit this time it’s got the better of me. Thankyou for both perspectives
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