November 29, 2022

Dr. Megan is a third-generation pharmacist who has dedicated her career striving to help people find ways to stay healthy while on prescription drugs.

So today i have a special guest for you her name is dr megan milne she is a pharmacist who specializes in helping counteract prednisone side effects and you can find her on so welcome dr megan thank you so much for being here today hello i’m so excited to join you sarah thank you for having me so can you tell us a little bit about what

You do and what led you to specialize in prednisone particularly yeah so when i went to pharmacy school you know we had to memorize all the side effects of all the drugs and there were some it’s like i could handle being on that drug but that drug i don’t even want to touch with a 10 foot full so when i had this bizarre rash just start start on my chest and

Spread all the way down to my feet and they tested my blood and discovered that i was bleeding internally i said you better go to the hospital immediately and i get there they give me some blood platelets and then they say we need to give you prednisone i was like no you can’t no way and they’re like yeah kind of high doses and you know here’s here here it

Is take it and we know it’s going to cause insomnia so choose which insomnia med you want us to prescribe you because we know you’re a pharmacist and that was where it began i thought it was just going to be a few days that you know the reason i was bleeding was this autoimmune condition called itp i thought it would just go away as soon as i took like 10 days of

Prednisone and then i’d be fine and 10 days turned into 10 weeks turned into nine months and then i had to eventually use a chemotherapy medication to get off of prednisone and get my autoimmune condition under control so during that time i suffered so many side effects it was horrible i had i would go on high doses and then lower doses and high and and it was

Just this roller coaster not just of the doses but of the side effects and how it was affecting me my appearance my emotions and my relationships and so i was lying there one night and not night one afternoon trying to take a nap with my toddler and because i hadn’t slept in a very long time because of or at least i hadn’t slept well for a long time because of

How awful the side effects are with prednisone causing insomnia and i was just like i just need a nap i just need to like recover from the chemo and the prednisone i just need this so that it’ll actually work i’m staring at the ceiling not sleeping and thinking there has to be something better than this and then it occurred to me that the prednisone side effects

Are actually caused by nutrient depletion and you might be like wait what what is nutrient depletion so that was the moment i it just like there’s something i can do i can help myself and other people to counteract prednisone side effects and that was when i first figured it out and so four and almost and a half years later here i am still talking about prednisone

Wow that’s so interesting thank you so much for sharing your experience so when you talk about like the nutrition and how that’s causing these side effects can you go into that a little bit deeper and tell us like what’s going on why is this happening and what we can do to counteract that yeah so the first thing that you have to memorize in pharmacy school about

Prednisone is that the doctors who prescribe prednisone the most recommend everybody who’s on over two and a half milligrams a day takes calcium and vitamin d and why would that be to prevent osteoporosis because a long-term irreversible side effect of prednisone is osteoporosis so i knew that like before i took prednisone when i was just a student and it was just

A bottle on the shelf i knew chronosome causes osteoporosis to take vitamin d and calcium every pharmacist knows that whether they share that message with you or not whether anybody actually recommends that to you that’s a totally different story but they all know it right like so everybody has this baseline understanding that protozoan is causing this amount of

Nutrient depletion it’s stealing the calcium and the vitamin d and causing osteoporosis so everybody gets that but what i didn’t realize until i dug deep into the research was it wasn’t just those two it wasn’t just the calcium wasn’t just the vitamin d but it was at least nine nutrients and possibly 13 or 15 there’s just not a lot of great research right now so

The other nutrients that are depleting um chromium so chromium is vital if you’re going to have healthy blood sugars because chromium makes this matrix with insulin and the blood sugar situation and if it’s not there if there’s no chromium then the insulin and the blood sugar kind of just get out of whack it’s called insulin dysregulation and that causes high

Blood sugars which causes hunger cravings which causes weight gain which causes diabetes which causes all sorts of complications all because prednisone is making you pee out chromium and when i realized that i was like oh my goodness there is so much more that we can do so would you like to dive deeper on that or would you like me to this is so interesting and

I it just occurred to me too i mean like um you know my um audience is primarily chronic urticaria and nutrient deficiencies actually can also contribute to symptoms of that and then you know they get put on the prednisone so it’s like wow this all could actually you know kind of become a cascading event and that’s maybe why people get stuck taking prednisone

And they’re not able to get off it they feel like they have these rebound effects and their hives are even worse than before they took it so it’s very interesting exactly because um you mentioned on our other interview that chronic urticaria causes low vitamin d right and then you’re taking prednisone on top of it so it’s even lower vitamin d and so it’s like

Oh it’s the spiral and so it’s not just those it’s at least nine and i could go into all nine if you want but essentially pronozone is given as a life-saving medication because it mimics our body’s hormone called cortisol and cortisol is mother nature’s miracle stress hormone it’s designed to be released in periods of stress like famine like being chased by a

Tiger like war when you need to just survive and hopefully there’s an end in sight like eventually the crops are going to grow eventually the war will end eventually the tiger will stop chasing you either it’s gonna catch you or it’s going to give up right like these things are temporary they go away and cortisol is meant to be a temporary measure and it’s

Meant to be like this much but when we take prednisone it’s like this much and we’re taking it for way longer we’re not just running away from that tiger we are spending weeks months years taking this prednisone on super high doses and so if we were just having mother nature’s cortisol um being used to run away from a tiger it would be releasing blood sugar

So i mean sugar into your blood so that you can run away from the tiger right and so essentially the idea is cortisol is stealing all of these nutrients from your bank like your bones your muscles so that eventually you can um eventually like replenish those nutrients because it’s going to be short term so how long can you safely stay on prednisone then before

These side effects start becoming a real issue so the real thing is there is no safe dose of prednisone one dose is enough to cause certain side effects and they say that the biggest amount of withdrawal of nutrients from your bones like the biggest jump to osteoporosis is within the first three months so it’s there’s no like safe amount of time to take it but

Often usually between five and ten days is a common short term amount of time people take prednisone and you don’t need to necessarily worry too much about the nutrient depletion at that point but when you’re going beyond 14 days it’s like you better start taking some actions to counteract the side effects right okay so that’s good to know um so when you’re on

Like a shorter term or on the shorter dose like a shorter course of by the zone is there like do you have to taper off or is it okay to go from like you know a higher dose like 20 milligrams and just stop after a few days how does that work yeah so tapering is something that is super confusing and super individualized and so usually if it’s that five day dose

Of 20 milligrams say you’re taking 20 milligrams every day for five days you can just go off that’s a common prescription that people take all the time and no problem um it’s when you’re getting over 10 days beyond 14 days you’ve got to taper so it’s between 5 and 10 it’s like you’ll probably be okay beyond 10 to 14 oh you better start tapering tapering means

Going off slowly so instead of going 20 milligrams down to zero you’d go 10 20 milligrams 10 milligrams five milligrams zero over a period of days to weeks okay okay so that’s the safer course if you’ve been on it for 10 days or more it sounds like yep kind of that 10-day mark where you said the nutrient deficient and all that starts happening too so so can you

Tell us like where would short-term prednisone used to be more appropriate than like your longer-term prednisone yeah so i often call um taking prednisone the nuclear option because it’s it’s kind of blasting your entire body with if you were going in for um you know like choosing a weapon would you choose the like shotgun or would you choose a nuclear bomb

You know which one would you choose prednisone is the nuclear bomb it goes everywhere and can like destroy everything whereas there are targeted medications you could use first so i always recommend using the those more targeted medications first and then if you have to then use it short term the most uh common refrain you hear when it comes to prednisone is

The lowest effective dose and so whatever it is it’s going to get you out of that flare out of that situation you’re in and taking the least amount possible for the shortest amount of time because every single milligram matters and causing side effects okay that’s good to know so for people who are on it more long term they have to take this every day it’s so

The dose matters so it’s better to you know take the lowest dose possible to get your symptoms under control right and and that’s something you really have to work with your doctor to figure out what that lowest dose is but getting there is it needs to be the goal okay okay so with people with chronic urticaria a lot of times you know we’re given like that as

Needed prednisone pack that five day pack of prednisone to take if we’re having a really severe flare but a lot of times too like a doctor will go straight for the long-term prednisone in treating our symptoms without trying other medications first so it sounds like that’s more of prednisone is more of if these other medications don’t relieve our symptoms or

If we’re having a severe if they’re just putting that fire out exactly yeah you would use this if if they’re like if you’re willing to exchange the risk for up to 150 side effects many of which are irreversible and potentially leading to permanently being having to take it so a lot of people are like nobody told me it couldn’t make it so i would become what’s

Called adrenal insufficient where it would make it so your system that normally makes that cortisol no longer works and you have to take prednisone forever and so if you’re willing to run that risk if whatever you’re going through is bad enough that those risks seem they pale in comparison then do it you know like i i was about to believe to death it was worth

It not bleeding to death is important yes certainly okay so it’s that risk versus benefit and that’s what you know again a discussion to have with your doctor and to really think about on a personal level you know um what am i willing to do what am i willing to trade to get that symptom relief exactly okay so we talked about some of the side effects and you

Know you talked a little bit about vitamin deficiency and things like that what are some things that people can do if they have to take the prednisone to kind of counteract that yeah so i have a whole checklist of things people can do it includes the top 15 side effects um 25 ways to counteract them so like i have tons of ways but if you want me to just focus on a

Few like specifically the nutrient depletion i can do that as well okay yeah if you just want to talk about the couple and then we can talk about where people can find that resource awesome so the nutrient depletion you can either eat those nutrients some of them are kind of hard to get or you could also supplement by taking um like there are lots of different

Medications you could use to supplement but i actually was thinking when i have to go back on prednisone i don’t want to have to be taking this and that and that so i created them all together in one it’s everything you need while in prednisone and it’s not just those nutrients depleted it’s also other herbs to help to counteract the side effects so it’s called

Neutrinize nutrinize zone and there’s the the morning bottle that helps with like helping to counteract the cravings the hunger cravings and the bedtime bottle helps you get restful sleep at night so it’s not just the nutrients depleted but it’s also a total of 17 ingredients that help you feel like yourself again while you’re on prednisone so that’s neutronized

Zone and it’s at hey that’s great i love how you have them split up into an a.m and a pm dose yeah that’s really helpful i think for people so well great so where can um they find you if they want more help if they want to look for that resource that you mentioned yeah so i am like i blog i youtube make all the things at

Two of the hardest words in the english language to spell but if you just look at your prescription bottle pharmacy and prednisone just kidding um i’m at prednisone pharmacist on all of the social media and then um this is you can buy this at and at the bottom of every single page of either website it you can download that

Checklist and it’s got tons of information of all the things you need to know while you’re on prednisone okay great i’m really excited to share that resource with my community because i think that’ll definitely help a lot of people so well thank you so much this was so informative you’re welcome sarah i’m glad to help get the message out about prednisone because

Like your condition it is so misunderstood and there’s so much more people can do if they only know about it

Transcribed from video
How to counteract Prednisone side effects By Thrive with hives