... has been my response to several people when they heard I was taking steroids.
So let's deal with the biggest source of confusion right away.
Body-builders and people who want to build muscle-mass take
anabolic steroids.
People with inflammatory conditions including
CLIPPERS take
corticosteroids.
It turns out taking corticosteroids can result in weight gain but mostly as fat around the face, neck and stomach, which would probably make me look even less like
Arnold Schwarzneggar. On the plus side I'm unlikely to suffer from "
Roid Rage" or testicular atrophy either. Phew.
Higher!
I got a bit curious about corticosteroids as I kept being told that while effective, they weren't good to be taking long term if you could avoid it - smaller doses for shorter periods are better. I'm currently on 15mg / day Prednisolone which is a low-to-moderate dose but presume at some point in the future an attempt to wean me off it altogether will be made.
Lower!
This dose seems trivial when compared with what I received in hospital - 1g (=1000mg!) / day for 5 days. It turns out this is an established treatment strategy which used to be called the "
big shot" but is more commonly known as Pulse Steroid Therapy (PST). A gramme a day for 5 days is still considered high, even for PST; for some other conditions 0.5g for 3 days is the norm. In the limited studies in CLIPPERS to date the higher dose seems to give the best results. After the pulses a much lower,
gradually reducing dose is given to allow the natural hormone production to readjust.
Stick!
I don't understand how PST works and from what I can tell nobody fully understands it; basically, giving very high doses for short periods has been found more effective at reducing inflammatory symptoms and less toxic than giving moderate doses for much longer. There has been some chatter in the literature about whether pulsed steroids can result in significant bone loss but this doesn't appear to have been investigated fully yet.
I'll keep taking the tablets then.
