Corticosteriods: They Giveth and They Taketh Away

I have a love/hate relationship with this medication. Like so many things in life, Prednisone has its good aspects and then there’s the not so good. I have had to learn to live with them both since, at this point, I cannot tolerate other medications known to be effective with my particular type of inflammatory bowel disease, or the medications simply don’t work. 

Let’s begin with the giving part of it and my favourite. It’s keeping me alive! That’s a big one.

I held off trying Prednisone for a number of years after my lymphocytic colitis diagnosis, being concerned about all the side effects. Instead, I began making changes to my diet, hoping to heal with food. Results with this were minimal but more on that another time. Loperamide was my go-to for getting my gut to behave (relatively speaking) during these years. It was not until diarrhea suddenly became acute; uncontrollable and lasted for weeks landing me in the hospital that I agreed to the Prednisone.

Once I started, I wondered why I had held off for so long. The first days, even weeks, were very giving and wonderful. I felt downright euphoric at times and was given a surge in focus and energy like I never have before.  Oh, what I felt I could accomplish in those days! The energy boost is great especially on the tail end of being drained from weeks of literally being drained but it can make you at times, manic.

On the flip side or ‘taketh away’ of all this energy is not being able to sleep. Insomnia is a chronic problem for me even now after my body has adjusted to the drug. The first few days are always the worst. I sometimes slept as little as 15 mins in a night and couldn’t nap during the day either. You are left feeling wired and tired.

The sleep disruption I’m sure adds to another ‘giving’ nature of corticosteroids; mood swings. So much fun, not only for yourself but those around you. Some people can also become quite aggressive. I’m generally easy going but I have noticed I’m a little less patient in traffic. Ok, ok, there was that one time where my hand stayed on the horn a little longer than it should have. Oops, sorry.

Corticosteroids can give in so many other ways too. There are the puffy hands, feet and the ever wonderful, puffy ‘moonface’. You can also be given a puffy stomach that has entirely nothing to do with weight gain and one heckuva a voracious appetite, which has everything to do with weight gain. Oh my, the appetite! It is endless at times it seems, and the foods you crave tend to be on the sweet side. Not a good combination.

It can also give you thinner skin and even cataracts too! I’m already up against both of those given my middle age. This is not helping the situation.

Taking away, Prednisone depletes your calcium and your potassium that leads to osteoporosis. My bone density has decreased and I am one inch shorter than I was before all this began. Not to give steroids all the glory, since bone loss is also a result of the malabsorption caused by collagenous sprue or any other malabsorption disorder.

The strength in your muscles decreases as well. With long term daily use your muscles can waste away. Basically, with the puffy face, feet, hands, tummy and diminished muscles, I will look like the stick figures I used to draw as a child. Wait… I still draw like that!

There was something else it takes away, just can’t quite place it… Ah yes, memory loss.

That’s about it, I guess with regards to the giving and taking nature of corticosteroids for me personally. Although I am sure there is more than I am aware of.

The effects of inflammatory bowel disease have taken quite a toll on my body and I am very much aware of how the drug that is currently helping me stay alive is taking its own toll. It is a stopgap measure and only one aspect of a holistic approach I am taking towards improving my digestive health.