YANMD - Predisone/Cholesterol connection...
August 5, 2013 12:35 PM Subscribe
I don't know whether my cholesterol is elevated because of my decadent lifestyle or because I'm on prednisone (or both, I suppose). Anyone with prednisone experience out there?
I'm on prednisone to treat an ulcerative colitis flare.
I started on June 6 at 60 mg (after the new drug, Uceris, did not work for me). The flare didn't come under control for several weeks, and my doctor was threatening hospitalization. Luckily, I was able to begin to taper the prednisone beginning at the end of June. I've been able to taper fairly quickly without getting much pushback on symptoms, although I had to increase to 10 mg from 5 mg last week because symptoms were returning.
I know that prednisone can cause elevated cholesterol, but I don't know whether I've been on it long enough or at a high enough dosage for my blood test last week to have been affected by it.
I was on 40 - 60 mg for 4 or 5 weeks, tapering about 10 mg about weekly. My blood test results from last Wednesday (I was on 10 mg daily at that time) are:
HDL - 63
LDL - 166
Triglycerides - 170
for a total of 263
My worst reading before this was in the 220s and was about 6 years ago. I went totally vegan and got down to 169 quite rapidly without medication. I did start drinking alcohol more frequently when my boyfriend & I got together, five years ago, but my cholesterol is checked regularly and it has never been over 210 again at the most.
My eyesight is also suffering and I think it's the prednisone, because I had my eyes checked in February, while I was still in remission, and it seems too soon for my vision to have changed *that* much unless prodded by the drug.
In the last year, I've started eating meat again, but most of the time I'm eating chicken. I also eat low fat string cheese daily. The food cravings that have arisen from prednisone manifest in a desire for chocolate, but to my recollection, I hadn't had any within several days of the test.
Any thoughts on (a) whether I can blame the miraculous/disastrous drug prednisone, and (b) if it is indeed the prednisone, at what point can I expect the problem to correct itself?
I'm on prednisone to treat an ulcerative colitis flare.
I started on June 6 at 60 mg (after the new drug, Uceris, did not work for me). The flare didn't come under control for several weeks, and my doctor was threatening hospitalization. Luckily, I was able to begin to taper the prednisone beginning at the end of June. I've been able to taper fairly quickly without getting much pushback on symptoms, although I had to increase to 10 mg from 5 mg last week because symptoms were returning.
I know that prednisone can cause elevated cholesterol, but I don't know whether I've been on it long enough or at a high enough dosage for my blood test last week to have been affected by it.
I was on 40 - 60 mg for 4 or 5 weeks, tapering about 10 mg about weekly. My blood test results from last Wednesday (I was on 10 mg daily at that time) are:
HDL - 63
LDL - 166
Triglycerides - 170
for a total of 263
My worst reading before this was in the 220s and was about 6 years ago. I went totally vegan and got down to 169 quite rapidly without medication. I did start drinking alcohol more frequently when my boyfriend & I got together, five years ago, but my cholesterol is checked regularly and it has never been over 210 again at the most.
My eyesight is also suffering and I think it's the prednisone, because I had my eyes checked in February, while I was still in remission, and it seems too soon for my vision to have changed *that* much unless prodded by the drug.
In the last year, I've started eating meat again, but most of the time I'm eating chicken. I also eat low fat string cheese daily. The food cravings that have arisen from prednisone manifest in a desire for chocolate, but to my recollection, I hadn't had any within several days of the test.
Any thoughts on (a) whether I can blame the miraculous/disastrous drug prednisone, and (b) if it is indeed the prednisone, at what point can I expect the problem to correct itself?
Fellow UC sufferer here, hiya.
Active inflammation can cause elevated blood cholesterol. I don't remember the term personally but my first GI, at the time of my diagnosis, tested my cholesterol and it was high (very unusual for me). She explained it was due to the flare and not really reflective of anything else.
I do think it's worth discussing with your doctor, but if it were me I think I would mentally file it away, wait until you're in remission and a couple months off the prednisone, then re-test.
posted by telegraph at 1:06 PM on August 5, 2013
Active inflammation can cause elevated blood cholesterol. I don't remember the term personally but my first GI, at the time of my diagnosis, tested my cholesterol and it was high (very unusual for me). She explained it was due to the flare and not really reflective of anything else.
I do think it's worth discussing with your doctor, but if it were me I think I would mentally file it away, wait until you're in remission and a couple months off the prednisone, then re-test.
posted by telegraph at 1:06 PM on August 5, 2013
although long term use (years) of steroids is associated with higher risk of heart disease, the studies on their effect on blood cholesterol levels have been mixed. Some shows that they make it worse, others find that they actually make the numbers looks better. No one really knows.
posted by Pantalaimon at 3:34 PM on August 5, 2013
posted by Pantalaimon at 3:34 PM on August 5, 2013
I'm on prednisone to treat an ulcerative colitis flare.
I think it could be the ulcerative colitis itself, as well.
I've had my cholesterol measured only once in my life, back when I was hospitalized overnight three years ago with pernicious anemia.
My hematologist walked into my room with a piece of paper in his hand and said "your LDL is 4330." The hospitalist who happened to be there too glanced over at him and said "massive cell death" and the hematologist continued "but you show no sign of heart disease; I guess you don't survive a hematocrit of 10 with a bad heart."
Ulceration also involves cell death, and your cholesterol will probably come down as the flare gets back under control.
posted by jamjam at 3:40 PM on August 5, 2013 [1 favorite]
I think it could be the ulcerative colitis itself, as well.
I've had my cholesterol measured only once in my life, back when I was hospitalized overnight three years ago with pernicious anemia.
My hematologist walked into my room with a piece of paper in his hand and said "your LDL is 4330." The hospitalist who happened to be there too glanced over at him and said "massive cell death" and the hematologist continued "but you show no sign of heart disease; I guess you don't survive a hematocrit of 10 with a bad heart."
Ulceration also involves cell death, and your cholesterol will probably come down as the flare gets back under control.
posted by jamjam at 3:40 PM on August 5, 2013 [1 favorite]
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But I really really think you should be panicking about changes to your vision. Because prednisone could definitely cause that in my understanding. So go and see a doctor about that right this moment.
posted by ambrosen at 1:03 PM on August 5, 2013