Steroid long-term effects

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chicagoatc
Regular Member


Date Joined Sep 2006
Total Posts : 133
   Posted 8/14/2007 7:51 PM (GMT -7)   
  Hi everyone... I hate to even ask about this but what are the long-term effects of chronic steroid use?  Most of my dr's that aren't gastros are always on me about taking such high doses, etc.  I hate taking them too but it's the nature of the beast right now and I'm looking into other stuff.  But, is it just poor bone density?  Anything else?  I know they make me feel horrible when I'm on them so I can imagine 10 years from now...
 
Becky
29 years old; diagnosed since 1997 (but I've had it forever)
 
Current meds:
-10mg Prednisone/day
-Asacol 12/day
-Remicade (started in 8/06 but it's not as effective anymore)
-Calcium (for my steroid-affected bones)
-Prenatal vitamins (for the extra stuff, not for pregnancy)
-Miralax (because surprisingly I need it sometimes)


Delarge
Regular Member


Date Joined Mar 2007
Total Posts : 157
   Posted 8/14/2007 9:47 PM (GMT -7)   
Androgen suppression is another complication of chronic prednisone use.

Another UC wife
Veteran Member


Date Joined Jun 2007
Total Posts : 2111
   Posted 8/15/2007 6:36 AM (GMT -7)   
We had a dexa scan (bone density) just done to establish a baseline since hubby has been on and off the prednisone for a year or so now...more on than off actually.

It showed some osteopena in the low spine area. He takes the calcium daily but we are now waiting for the fosamax to be delivered today or tomorrow. The femur and other areas are good at the moment.

He is starting to taper once again.....this time a bit slower with a 5 mg drop and when he gets to 20mg hopefully he is fine and good to go for further tapering - maybe even slower and by 2 1/2 mg??? I hate it and he hates it - it causes so many different things to contend with.

Hopefully the prednisone with the imuran that was needed to "jump start" the imuran if I remember my facts straight will now allow a successful tapering.

There are other things to worry about also but that darn drug seems to be necessary for alot of the UC sufferers to get into a remission. Some agree - some do not - I'm not totally sure - we follow the Dr's instructions and opinion.

We are waiting to hear from Mayo Clinic for a consult appt with their Gastro dept. It will be nice to compare notes and see what they agree or disagree with insofar as his care up to this point and what improvements they recommend.

60 yr old male~Colitis 1st diagnosed Jan '05-cleared up within a few wks. Flared again in May '06 ... left sided ulcerative colitis now & fully involved and trying to get in remission. Acute inflammation-pancolitis-tenesmus rectal pain-granulation is showing some healing started. Osteopena of spine from prednisone DX 8/07  July 07 starting to feel somewhat normal 75mg Imuran 40  mg prednisone (tapering 8/07) 12 Asacol, Lidocaine Hydrochloride Jelly 2%,multi vitamin, iron 3X day, DanActive, chewable calcium, Prilosec 20mg, enalapril 10mg, glipizide 5 mg, zocor 20 mg, baby aspirin, (Fentanyl pain patch 50mg 72 hrs  Morphine Sulf 15 mg twice daily)Colocourt enemas at night.


suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5698
   Posted 8/15/2007 7:09 AM (GMT -7)   
Avascular necrosis, cataracts of the eyes, loss of bone density to name a few. Mind you, long term is considered 4 months of continual use of prednisone.

Sue
dx proctitis in 1987
dx UC in 1991, was stable until 1998
1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics
2000 lost all my B-12 stores and became anemic
2001 opted for j-pouch surgery- now living life med-free
 


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5135
   Posted 8/15/2007 8:12 AM (GMT -7)   
My dentist said that Pred is bad for connective tissue, too-- such as the tiny ligaments that hold one's teeth in place. It thins scalp hair, but can give female patients unwanted facial hair. My gastro told me that the highest permissible dose of Pred is 60 mg/daily-- so all takers should beware! I've seen some threads here claiming higher daily doses. This is not a med to pop like candy-- it can affect just about every organ in the body, including the heart. On the other hand, if a UC patient is in danger of hemorrhage or intestinal blockage, it can work wonders in just hours. Keeping up one's calcium + vit D intake while on Pred helps to mitigate the osteo effects. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 X 3 Colazal daily for July flare in descending colon, which is responding)

kb5
Veteran Member


Date Joined Jan 2007
Total Posts : 1015
   Posted 8/15/2007 8:26 AM (GMT -7)   
One affect that I hardly hear about is diabetes. There can be steroid induced diabetes with long term use of pred. It doesn't have to be high doses either. Its scary to think about what this drug can do to us.
Kelly, 29

Left sided UC diagnosed 1/98 age 19, Pan colitis diagnosed 1/07
Currently on 4x3 Asacol, Rowasa every other night, back to 30 mg pred.
Waiting for prometheus test to start Immuran
Prontonix once daily for acid reflux, zofran twice daily for nausea


quincy
Elite Member


Date Joined May 2003
Total Posts : 29859
   Posted 8/15/2007 8:57 AM (GMT -7)   
I have heard bipolar (manic/depression) can be triggered if one has the tendency.

Sue....4 months is considered long-term??? wow, some docs have their patients on that stuff for years..gulp!

I still strongly suggest patients to push/exhaust 5ASA meds if they can take them, both oral AND rectal before accepting pred as a first-line med.

quincy
*Heather*Status:mini flare June 23* 6asacol daily+ Salofalk (tapered every 3rd night)
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals 
~Probiotic 2 (Natural Factors Protec) + 1 (Primadophilus Reuteri) at bedtime
~Natural Factors Multi Digestive Enzymes with supper
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


UCsince1997
New Member


Date Joined Jul 2007
Total Posts : 8
   Posted 8/15/2007 9:27 AM (GMT -7)   
I was on prednisone for about 3 years when I was in my early 20's.  My mom urged me to have a bone density test even though my Dr. thought I would be fine...low and behold I have osteopenia- the stage before osteoperosis- in my upper & lower back.  Good old prednisone!  I recommend Remicade as an alternative to 6mp,Immuran, & prednisone.  I have been having remicade treatments for over 2 yrs now and have never felt so "normal".  I recently had a flare and was feeling noticably better 5 days after my remicade treatment.  In my experience you need to research your meds and keep up on the newest treatments and if possible find a Dr. who does the same.  I had remicade treatments for my UC as soon as it was approved.
 
Best wishes to all

 
1997 Diagnosed w/UC, controlled with asacol
2000 major flare-immuran, asacol, prednisone, suppositories, fish oil, probiotics, multiple vitamens, wheat & dairy free diet (none of this helped)
2003 Sought 2nd opinion when told illos.bag was the only option.  New Dr. - colazal, non-generic form of 6-mp, and remicade treatments- saw improvement in aout 2 months.
Maintenance with colazal, remicade put me into remission for about 2 years.
Feb 2007 colonoscopy showed remission
June 2007 started flare up.


chowser
New Member


Date Joined Aug 2007
Total Posts : 6
   Posted 8/15/2007 9:36 AM (GMT -7)   
Long term steroid use can also elevate the pressures in your eyes. Besides the weight gain it can cause, it also causes you to metabolize fats differently, hence the difficulty in losing wieght while on steroids. I was on steroids for 7 yrs. before I got tired of being " fat, hairy & pimply" and started 6MP. I do have osteoporosis but other than that all other steroid side effects are gone.

chicagoatc
Regular Member


Date Joined Sep 2006
Total Posts : 133
   Posted 8/15/2007 1:23 PM (GMT -7)   
Thanks for all the input. I presently have been on Asacol for 10 years. I've been on mega doses of steroids (on/off for 10 years and continuously for the last year, the highest being 80mg). I've been on Remicade for 1 year and it is waning in its effects. We're considering Imuran although I was on it briefly before and it was not helpful. I'm willing to revisit it. We're also working on Humira (even though it's not yet approved for UC patients). I had a baseline Dexa scan 2 years ago and I too have osteopenia. Woo hoo! I'm supposed to have another one this year. So, I'm working on all this stuff but this disease sucks!
29 years old; diagnosed since 1997 (but I've had it forever)
 
Current meds:
-10mg Prednisone/day
-Asacol 12/day
-Remicade (started in 8/06 but it's not as effective anymore)
-Calcium (for my steroid-affected bones)
-Prenatal vitamins (for the extra stuff, not for pregnancy)
-Miralax (because surprisingly I need it sometimes)


UCsince1997
New Member


Date Joined Jul 2007
Total Posts : 8
   Posted 8/17/2007 8:25 AM (GMT -7)   
Chicagoatc, I am really sorry you haven't found something to put you in remission, that stinks.  By chance, have you tried switching the generic/name brand of the drugs you are on?  Switching from asacol to colazal?  Personally the generic form of Mercapitor (6mp) did not work for me. When I changed Dr.'s he put me on the brand name Immuran combined with switching me from Asacol to Colazal and that did the trick.  It might be worth a try to get you off the Prednisone.  Also you mentioned being on Immuran briefly and it usually takes a good 3 months before you begin to notice improvement, its different for everyone- were you on it long enough?  Do you like your Dr.?  I highly recommend having a 2nd opinion on your treatment.  I did and I still have my intestines because of my new Dr., best thing I ever did was pay (he was not in my health insurance coverage) to see him.  I feel for you and hope you are feeling healthy soon  :)

 
1997 Diagnosed w/UC, controlled with asacol
2000 major flare-immuran, asacol, prednisone, suppositories, fish oil, probiotics, multiple vitamens, wheat & dairy free diet (none of this helped)
2003 Sought 2nd opinion when told illos.bag was the only option.  New Dr. - colazal, non-generic form of 6-mp, and remicade treatments- saw improvement in aout 2 months.
Maintenance with colazal, remicade put me into remission for about 2 years.
Feb 2007 colonoscopy showed remission
June 2007 started flare up.

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