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High dose cortisone pulse vs. chronic infection ?

Markus83

Senior Member
Messages
277
My neurologist wants me to do a higher cortisone pulse as trial and error therapy. Dosage shall be 80 mg / day prednisone for 5 days.

The neurologist thinks my illness is autoimmune mediated, but there is no labaratory evidence for that. The immunologist says it is most likely a chronic infection of some kind in my case. So I normally would not take the prednisone, but I told the neurologist already that I'll try it. He gives me tremendous support with everything and I don't want to loose him. As he has asked me several time to try prednisone, I finally said yes. But I have a very bad feeling with that. The immunologist said he would not do this prednisone pulse in my case.

So my question is the following: Lets suppose there is a (unknown) chronic infection as underlying cause for my CFS-like illness. How severely would the prednisone pulse at the given dosage (1 mg per kg body weight) affect my immune response (particular cellular immunity)? How likely is it, that the infection will worsen because of the pulse? How long will the immuno-suppression last?
 

pattismith

Senior Member
Messages
3,931
I was very reluctant myself to do this kind of trial, for the same reason you are.

I started it only 10 months ago when I had enough evidences that auto-immunity may be at play in my illness.
last august I started auto-immune thyroiditis (Graves) and had high auto-antibodies at the Celltrend panel.

I was already ill for more than 30 years, but I got new autonomic/sensory symptoms at the same time, with erythromelalgia like symptoms, and frank cardiac arrhythmia.

At this point I agreed to do a small trial with my GP with prednisolone 20 mg per day for some days.

The higher the dosage is, the longer the treatment is, the bigger will be the immunosuppression.

"Immunosuppression
Patients receiving high-dose systemic corticosteroid therapy, such as prednisone, for any period of time are at risk to develop immunosuppression; patients receiving moderate dosages of systemic corticosteroids for short periods or low doses for prolonged periods also may be at risk. When given in combination with other immunosuppressive agents, there is a risk of significant immunosuppression."

https://www.pdr.net/drug-summary/Prednisone-Tablets-prednisone-3516

other ressource:

https://www.nps.org.au/australian-prescriber/articles/corticosteroids-in-autoimmune-diseases
 

Cipher

Administrator
Messages
838
@Markus83. Post regarding Dr. John Chia's experience with prednisone and enterovirus infected ME patients:
He said that prednisone can make patients remarkably better for a short period of time. He talked about two patients who were returned to near full health for two weeks. BUT... when they tapered off they got much worse and ended up in the hospital. He believes it allowed a latent enterovirus to bloom and cause encephalitis.