Prednisolone for neuropathy
 

Hi all I have another question, would it be worth taking a course of Prednisolone or some other inflammation suppressing med to dampen down any inflammation to see if it relieves the symptoms of neuropathy? Even if the docs haven't found any autoimmune cause for the neuropathy... It would of course have to be done under a doctors supervision... Just a thought

Mark:

Are you saying Prednisone or Prednisolone??

Prednisolone but I think they both sort of do the same thing..... I think ..... Not 100% sure though, prednisolone is used for MS as well but I guess any of those type of meds if they would maybe help. Would it worth a shot in the dark?

Well, Prednisone helps mine, but that is not to say it would help everyone's...

Cathie

It certainly could help a neuropathy--
 

--that is secondary to inflammatory vasculitic disease or mechanical pressures, by reducing nerve swelling and/or other compressive forces pressures on the nerve. And by modulating the immune response, it could well help neuropathies that act through autoimmune mechanisms, which are often highly inflammatory.

Steroids are actually fairly standard treatment for conditions that can affect nerves. I have a friend with neuropathy secondary to the swelling of polyarteritis nodosa, and her steroid regimen certainly reduces her neuropathy symptoms, though it doesn't completely eliminate them. And I know that many people with radiculopathy (nerve root swelling/irritation/compression) have tried steroid regimens, with varied degrees of success.

But again, this all depends on what's causing the neuropathy--it seems less likely to work for neuropathies that are predominantly smaller fiber, or for those for which inflammation is not a major component (such as toxic neuropathies that disintergrate the axon).

Prednisone is and can be a blessing and a curse...
 

My own opinion [not a medical professional, but one who's read widely about it] seem to indicate that it's useful for short, not prolonged periods of time. By short, I mean, less than 6 or so months? IF it's gonna get to an inflammation and get it down and keep it down it should do it in that time.
Benefits: puts down any infection or inflammation to enable one to function.
Detriments: weight gain, attitude changes, long term calcium and bone and/or joint changes, such as premature or sudden osteoporosis.

I can't speak for others here, I think you can get a sense if you use the 'Search' feature on the top blue bar...click it on and in the blank type in prednisone and see what folks with all sorts of neuro issues have to say about it...pro and con. That in turn, will probably give you a whole bunch of new 'key words' to web up and find all about!

Learn as much as you can about the real FACTS on prednisone and it's clones. The more you know, the more informed YOU will be when or if you decide to take it. Docs sometimes assume you know, forget to tell you, or don't care to tell you about both the benefits and pitfalls of any given medication. Search out the 'prescribing information' of the type of med you are taking and read all the fine print...have questions before you commit Bucks [$$'s] either yours or the insurance company's to your ability to take it and take to it with the best of all outcomes. What I do these days, is ask the doc for samples, as I often use my mail-in pharmacy and that takes up to 2 weeks. The good thing about samples? While it might not really work while using them, I will probably find out RIGHT away if they mess me up either mentally or physically. Example: I was prescribed one antibiotic at one time, and within 30 hours had developed a solid case of projectile vomiting! It was a side effect of the medication...Unfortunately I'd started it on a Friday and it Hit me Saturday...mid-day...had to wait [with infection still raging on] till Monday to call and get thru to doc and a new prescription.... The whole thing falls into one of my top 20 NOT FUN events! You get the picture. Hope this helps! - j

Mark, I asked my doctor to try me on a short course of prednisone just to see if it would help, since my PN was idiopathic. He agreed, and we tried itl. It didnd'thelp me, but that doesn't mean it won't help you. It can be diagnostic -- to find out if inflammation is in the mix. A short course shouldn't cause you any serious problems.

Just wanted to chime in that in cases where the likely cause is inflammation or autoimmune disease, for acute flareups, a neurologist might do a short burst of high dose steroids over a course of a few weeks. I had a flareup where I went completely numb below the elbows and knees, and I went on 60mg of a prednisone-type med, tapering down throughout the two weeks. It didn't make the neuropathy completely go away, but the numbness resolved enough for me to use my arms and legs again.

fanfaire
:cool:

I have been on low dose Prednisone now for CIDP and Mixed Connective Tissue Disease now for over 15 years. I had to up my dose for recent surgery and am still trying to reduce it. This, IVIGG's, pain medication and Klonopin are prescribed to give me at least some relief. Nothing else worked. I have tried very hard to keep my doses on all of the above as low as possible, especially knowing the long term side effects of steroids. The combination of the above has been pretty much a trial and error to figure out what works for me.

I am not promoting them, by any means, but in this case, I felt I had no choice-I was in agonizing pain. With all drugs you risk side effects and with steroids, these are no exception.

Attitude on steroids?? Some people are worse than others. I threatened to cut the plug off of the television today, because the noise from the Cowboy games drives me crazy... But then, I have always been a little feisty anyway... :)
Cathie

Thanks for the response everyone, I think I will go ahead and ask my doctor when I next see them. I have my EMG on 2nd Oct, which is good as I was told I would have to wait until November or even as late as January. As these meds are steroids does that mean if you go to the gym whilst you are on them you will get bigger more quickly? Or would that only happen with certain steroids?

Corticosteroid question.
 

No Mark, corticosteroids such as Prednisolone/Prednisone, Dexamethasone and Hydrocortisone are catabolic steroids, not anabolic steroids. Catabolic steroids tend to break down muscle - not build it up.

The kind of steroids you are talking about, like prednisone, are not the ones implicated in building muscle or causing rages. Those are anabolic steroids. Sorry -- no big muscles.

I was just asking so I could maybe weight train to keep off any weight gain if I was put on a course of Prednisolone/Prednisone.

Well, Prednisone does make you hungry, that is for sure... And if you do gain, it all goes right to your middle...

Cathie

steroids
 

deplete
potassium
calcium
magnesium
zinc
Vit C
Vit D
selenium

Some of the weight gain is fluid retention. They can elevate blood pressure,
cause gastric bleeding, depression, bone loss, increased infections, thinning of hair and skin.

It is very tough to get off them, to normalize again. So whatever improvement you expect, you may inherit alot woes you don't want.

But if they do work then at least it gives some indication of whats going on,doesn't it...?

yes, in the short run...
 

they are not really too harmful.

Steroids in general make people FEEL better, and at one time they were used willy nilly because of this. That is how the data were gathered on them and their effects.

Any inflammatory process including autoimmune will show symptom improvement at least at first. Then the body accomodates to the steroids, and some of that symptom relief may be lost.
The endocrine system is complex and run by a feedback loop. When you take hormones, your body shuts off production of pituitary hormones which run your glands. It shuts them off. So when you go off the steroids, you have to taper, and hopefully return to what you were before.

Some arthritis therapies today use very low dose steroids...like 2.5mg every other day...or pulsed ones, high dose every other day, etc. Especially for the elderly who may have bone issues.

If you see increased symptoms with stress, you can assume you have some inflammatory component in your PN. It may be autoimmune involving antibodies attacking, or just inflammatory cytokines which are chemical.
Other things that work like steroids are fish oil. This specifically reduces inflammatory cytokine production, and also improving your omega-3 to 6 ratio will improve it. Too much omega-6's fuel PGE2 cytokine production. So diet changes and fish oil can accomplish alot. High sugar intake also shifts cytokine production to the inflammatory side-- high insulin does this.

Thanks for that information, now I know that there probably is some sort of inflammation going on. I think I am going to ask my doctor to go on a short course next time I see them. Would a 'short course' of steroids mean a week or two?

a week or two is a short course.
 

And also steroids block allergic responses too.

So that includes:
autoimmune (antibody complexes)
simple inflammation (that is not autoimmune)
allergic responses (including foods and inhalants, and contact with skin, insect bites, drugs, etc)

What sort of dose of Prednisone would be needed for a short term course just to see if it made any difference to the neuropathy symptoms...

prednisone or a Medrol dospak
 

are the two most commonly used.

Medrol (methylprednisolone) is typically given for acute situations. The pak is designed with a built in taper. 21 tablets for 6 days.

Prednisone is a generic name, made by many companies.

The question really is what dose would your doctor recommend?
That would be his/her decision. Anywhere from 2.5mg/day to 10mg I would think for starters. (for prednisone)

Some allergists use 50mg prednisone/day for 3 days pulse with no taper. But that is not a common dose.

No such luck! It's the wrong type of steroid. But only take them if there's a clear indication, okay?

I was on them near a year when I was first diagnosed.It never helped, and it took ages to recovre from them. Now when I take them for a few days for sinus ifnection--which I really do need them for---I go through what I'm going through now--a suppressed pituitary gland 3 months after 5 days of medicine.

Only with a really clear diagnosis, Mark. Not just to give it a try. Too dangerous.

What should I do if my neurologist doesn't run all the tests that are on your website,I wont know whether there is an underlying problem or not,I was going to ask my doctor to put me on a course but now I don't know what to do...

It would be best to have the doctor's consent, but I have taken it without, I can just tell when the liver is acting up.

I believe the difference is Prednisone goes through the kidney. Prednisolone goes through the liver.

Prednisone has to be metabolized by the liver to its active form prednisolone.

In US, Upjohn patented prednisone as Deltasone many decades ago, and that became the preferred form here for humans by habit.

But Vets use prednisolone for most animals, and especially cats, who cannot convert prednisone well to the active form.

Upjohn also made methylprednisolone aka Medrol and patented that, which is still used commonly here for inflammation and transplanted organ rejection prevention. The Medrol Dospak is a carded taper the patient can easily punch out daily for correct use. It is still very common here.

Prednisolone is still used in other countries however for humans.
Here in US it is becoming difficult to find in pharmacies now, which I discovered when our cat Oreo needed it for her cancer chemo. Two pharmacies told me they couldn't even special order it, so we HAD to get ours from our Vet.