November 29, 2022


What’s the best dose of prednisone is it 20 milligrams like this bottle or is it a different dose i’m dr megan the prednisone pharmacist and i’m here to help you not just survive prednisone but thrive while on prednisone and i’ve been asked so what’s the best dose what dose should i be on what dose of prednisone would be best for me and that is a tricky question

So first thing we need to understand is that every single person is taking prednisone for a different reason everybody is different and every person is a different size and all of those are factors to consider when dosing prednisone so when i took prednisone they gave me one milligram per kilogram that meant i got 60 milligrams of prednisone to start out with

The very first time i took it what dose did you get i’d love to know comment below what dose you were given at the very beginning what was the dose you started with usually the best dose to start with is a higher dose usually we start high and we go lower slowly over time that’s called tapering tapering prednisone is necessary because you can’t stop taking it

Just suddenly but why not just stay on 60 milligrams for the rest of my life that would make my disease go away right not necessarily 60 milligrams was good enough to start with but for me it got my body got used to it i got used to the 60 milligrams it wasn’t enough later on so i had to go on chemotherapy other people can start out high and go down and find

A dose that’s more steady that is small enough that if they don’t have a ton of side effects but high enough that it keeps our disease under control for example with rheumatoid arthritis the joints the fingers they really hurt sometimes or maybe the shoulders or the hips whatever joint hurts the reason a person will be taking it for rheumatoid arthritis is so

They can move and a really high dose might get that inflammation gone quickly but then we’d want to get the dose lower as fast as we can because usually the lower the dose the less side effects lots of doctors will say hey you know if you get on a lower dose there aren’t any side effects there’s no risk at being say five milligrams or below and i have to tell

You that that’s not true they’ve done studies and they’ve found that even under five milligrams there’s an increased risk for infections osteoporosis and other complications so there is no safe dose of prednisone that’s true no safe dose your doctor might say it’s this is a safe dose and maybe a safe er there’s a safer dose right the higher the worse the lower

The safer theoretically but if anybody says this dose is safe there there’s no such thing it it’s impossible no matter what dose if there is a dose it’s not technically safe so what are you to do right you need that prednisone to stay alive to counteract whatever disease you have so i the goal is to find the best balance of risks now what risks are there i’m

Going to get a little closer on my screen so i can look at my notes the risks you might be looking at for high doses include cardiovascular events that’s fancy for heart disease cerebral vascular events that’s a fancy word for strokes insulin resistance that’s what leads to diabetes christianoid features that’s high i mean a round face like moon face buffalo hump

Big belly skinny arms peptic ulcer disease that’s having like a a hole in your in your lining of your gi tract that is very painful and makes it hard to eat myopathy that is painful muscle loss mood disorders depression anxiety and anything change in your mood just being a different person feeling different all of those can happen on high glucocorticoid doses

Like high doses of prednisone psychiatric disorders sleep disorders insomnia is huge on high doses um and avascular necrosis that is bone death joint death like in the shoulder or in the hip bone that ball socket next is what are the side effects on high doses over a long period of time those include a lot of the same things cardiovascular events bacterial and

Opportunistic infections so bacterial infections might be sepsis like your whole entire body is infected or an opportunistic infection might be herpes zoster coming back like getting cold sores or maybe having um like when you’re uh shoot what’s it called shingles and it’s incredibly painful rash um or tuberculosis those are all possibilities insulin resistance

Again cushinoid features that moon face weight gain oh of course the weight gain 70 of people on prednisone gain weight dyslipidemia that means like high cholesterol glaucoma that’s a side effect in the eyes that can be permanent and osteoporosis that’s the bone loss that can also be permanent it’s um can lead to joint damage it can lead to bone breaking

Spine compression fractures and you don’t even feel it that’s what’s crazy about that osteoporosis from prednisone is you might not even feel it it’s just suddenly you’ve lost a half an inch in height out of nowhere all right then what about cumulative dose so maybe you’re just on five milligrams for 50 years what can happen what are the side effects for that

We’re back to cardiovascular events so long-term side effects of prednisone definitely include heart problems hypertension which is high blood pressure insulin resistance back to getting us to diabetes skin thinning and bruising so people often notice stretch marks these weird bruises that don’t aren’t painful it’s just the skin is just breaking hypertension

Again high blood pressure and osteoporosis and vertebral fractures again that’s the spine compressing sleep disorders long-term insomnia and a vascular necrosis so those were the things that can happen with just a long term lots of of prednisone over a long time whether it’s five milligrams for 50 years or 50 milligrams for a year it’s a lot of medicine

That is a huge burden for your body to deal with and so what is the best dose of prednisone if no matter what you do you’re going to get side effects well the question is always with every decision you make medically do the benefits outweigh the risks for you and this is only a decision you can make with your doctor with all of the information knowing these

Side effects for long-term cumulative doses high doses and your condition and if your condition is really terrible like mine i was potentially going to bleed to death if you can’t breathe or you can’t get out of bed on your own to use the bathroom by yourself these are all good reasons to take prednisone that in those situations to me for my personal calculus

That benefit outweighs the risks in that situation yes there are risks but there are actually a lot of risks for not being able to get out of bed you’re much more likely to get pneumonia and constipation and all sorts of other things and so whatever you’re doing there’s going to be a risk so it’s always finding what is the best balance of risks and benefits

For you and so you need to gather the data gather all of the side effect information gather all of the benefit information a lot of people i talk to aren’t really fully aware of either of those things i will talk to people who are like i wish i’d never taken it because the benefits aren’t there for me like this lady she just had like a swollen throat and her

Doctor’s like here here’s some prednisone and she’s like i don’t know and she did some research and found out that just high-dose ibuprofen over-the-counter would accomplish the same thing and i was like yes that is the best benefit to risk ratio for you taking prednisone is a lot more dangerous than taking ibuprofen ibuprofen has lots of risks too but there

Are a lot more risks there are 150 side effects to protozoan and so she decided not to take the prednisone and instead to take the ibuprofen and so you want to find what are the actual benefits you can anticipate for me it was not bleeding to death for you what is it what is that benefit is it worth it to run all of these risks that i just mentioned because

It it probably is it’s probably worth it if your doctor prescribed it but if you’re not sure then you need to have a conversation you need to take your health into your own hands and ask do these benefits outweigh the risks for me in my situation for me that changed over time at the beginning it was clear 60 milligrams of prednisone was a risk that i needed to

Take because i had no platelets that clotting little cell that your body needs so that you don’t bleed to death prednisone saved my life and that was vital but over time my body built up a resistance to it my immune system stopped listening to prednisone i had to resort to chemotherapy so over time this can change and so this is a conversation you need to keep

Having you need to keep learning listening to your body deciding does this make sense for me today it made sense for me last year it made sense for me last month but today is this still making sense are there any other options always ask your doctor are there any other options for some conditions like polymyalgia rheumatica there really aren’t any other options

Perennialism is pretty much it and so knowing that you can walk into this calculation knowing that yes not having excruciating pain that leaves you bedridden is worth it living a life is worth it for you and you can have peace knowing you know i’ve made this decision with my eyes wide open that i know i’m going to suffer these side effects but it’s worth it

That i know i’m going to have moon face but that’s a battle scar that you are taking a medication that is so harmful so poisonous with so many side effects that you’re willing to take that risk because you know it’s worth it to you so have you had this conversation do you know if the benefits outweigh the risks for you and if you don’t know that right now i’d

Encourage you to figure out what exactly are the benefits and what exactly are the risks in your situation at your dose at your length of time you’ve been on it your cumulative glucocorticoid exposure your your overtime amount of prednisone you’ve been taking and if you’re wondering do the benefits truly outweigh the risks i felt that same way and that is

Why i invented neutronized zone because i knew that if i had this that it could change that calculation for me because it gives back so many vital things that can tilt the benefit risk of of the calculation into my favor into the benefits outweighing the risks because it gives back calcium i i mentioned osteoporosis across all of these you have a higher risk

Of osteoporosis because of taking prednisone and so this gives back calcium and vitamin d also it has chromium picolinate that is vital for proper insulin balance for using the sugar in your blood the prednisone is spiking and leading to diabetes if you don’t have enough chromium it’s hard to get the right balance and so this gives back the chromium that

Prednisone is stealing there are so many other amazing benefits that you can get when you try neutronized zone along with prednisone the combination is a match made in heaven i invented it because i was suffering so much while taking prednisone and i needed a way to find the balance of benefits and risks that was worth it for me this is what you can take to

Make the benefits outweigh the risks for you so that when you take prednisone you’re walking into it knowing these benefits are worth it because i’m giving this back to have less risks to feel better on prednisone to not just have these magical potion coming in but to actually truly feel better there are tons of five star reviews that you can check out on

Google on my website on people who’ve taken it for so many different regions reasons for polymyalgia rheumatica for rheumatoid arthritis for neuromoya lattice optica for lupus for itp for oh i can’t even think of them there’s so many reasons people have had to take prednisone and needed this to give it back give back what prednisone has been

Stealing so they can feel well and have the best balance for them that’s what i want for you that’s why i created this that’s why i come every week without fail here to share my message of hope with you that even though there are so many risks the benefits are amazing they’re miracle and you can have more benefits when you take neutronized zone with your

Prednisone signing off as dr megan your prednisone pharmacist you

Transcribed from video
What is the Best Dose for Prednisone? By Dr. Megan – Prednisone PharmacistliveBroadcastDetails{isLiveNowfalsestartTimestamp2021-05-21T140017+0000endTimestamp2021-05-21T141824+0000}