Yesterday I decided to try taking a probiotic. I have had an unsettled stomach since starting prednisone plus recently I realized that I have silent acid reflux.
Last night I read the entire label of the probiotic and discovered that it says you should not take it if you are "...undergoing long-term corticosteroid treatment."
Then I did some on-line searching about this and many sites say the same. The reasoning is that it is believed that probiotics increase your immune system. This is just the opposite of what we need as we are taking prednisone to quiet down our immune system.
I assume yogurts are ok because their bacterias are a natural effect of the fermentation process in making the yogurt. From reading the forum I know that many people take yogurt with their prednisone.
Personally I cannot eat dairy and am having trouble finding an unsweeted non-dairy product (prednisone is affecting my ability to digest simple sugars), but there are still some stores I can check out....but I digress.
"The biggest concern in the use of probiotics is in individuals who already have serious illnesses. Studies have found that probiotics can produce a life threatening disease called lactobacillus septicaemia in individuals with weakened immune systems or severe sicknesses."
I imagine that the major problem is in people with severely compromised immune systems, so people on high doses. Especially since I found references from several people with gastroenterology disorders who have been told to take probiotics alongside their pred.
By the way - is it the pred itself or the gastric effect that is messing up your digestion? Would injections of pred help? It is mentioned in the most recent recommendations and there is a lady on the forum who is on injections.
Hi the doctor put me on 80 mg of protonix for my ulcers and reflux and the doctor also told me to take probiotics. I am also interested in what you find out about drug interactions.
Oh dear CJ, we won't be able to eat/drink anything before long. I'm sticking to my bread, cheese and water - oh I have a problem there as well - never mind there always a small glass of red wine?
I was told by my doctor when I was first diagnosed with PMR and prescribed preds that acid reflux can be a problem as can excess acid production and was advised that a ppi (proton pump inhibitor)might be in order, Omeprazol(?) being one such.
I have been doing more on-line reading today and there is no clear cut answer. Many sites say mixing probiotics and prednisone isn't a good idea, and other sites say probiotics help with digestive/GI issues (though many of those people aren't on long term pred). I guess we will have to do our own research and decide/experiment.
EileenH: My digestion issues aren't major enough that I would switch off the pills. And enteric coated aren't available here in BC Canada.
Pam21073: Good to hear that your doctor recommended a probiotic with your prednisone. Did he say when it was best to take it? eg, with your pred or at another time?
Steve1: My symptoms aren't bad enough that I would add a PPI.
Oregonjohn-UK: Yes, wine solves lots of things
I think I may experiment with taking a probiotic sometimes with dinner so it's separated from my prednisone at breakfast. And if I can find an unsweetened non-dairy yogurt I'll take some of that some mornings with my prednisone.
Thanks Mrs CJ for that. I am having terrible troubles with food/drink. I have been on 3 different types of medication for reflux and gastric problems, but none have worked. I have been taking probiotics sometimes - no help. i am getting desperate to resolve the problem for reflux associated throat problems. I have cut out so many foods and........ wine!
Hopefully someone will have some helpful suggestions.
I guess I've become used to the home made probiotic yoghurt every morning. I started about the time I stopped the couple of pieces of toast every day. Part of my super enhanced how to lose weight strategy. At average loss of 207g / week for six months I consider it successful.
As to whether the probiotics made any difference, on top of the *prazole (PPI) stuff, I have a vague impression they settled my stomach a little. On the other hand I didn't detect any negative consequences so I figured I could continue. I save the kippers for lunch.
My limited understanding is there are about 40 strains of probiotics which may be normally resident in one's gut. I don't know which are present in my gut, nor do I know which strains are in my yoghurt culture.
Another bit of my limited understanding relates to why I need pred. I suspect it is mainly to reduce inflammation, to reduce the symptoms of my vasculitis. While I understand that polly whatsit is an auto immune condition I don't know what effect the mild immuno suppressive effect of pred has on the condition. I'm guessing that if suppressing the immue system was a useful treatment in pmr we would be taking appropriate medication. Conversely I also don't know what the potential effect of probiotics potentially strenghtening the immune system has on the pmr inflammation.
My last 2c worth is about how I normally digest (pun intended) reports of potential problems. If they are of the "keep off the grass" combined with "something evil will befall you" variety which don't describe the potential problems I tend to discount the reports. Fear mongering or promotion of some form come to mind. I tend to give brownie points for reports where the effects are described, more for good data, and even more brownie points where a mechanism is logically described and tested. I think its part of critical thinking.
Given the absence of any side effects from my combination of pred (about 10mg reduced to 3mg over a year) and probiotics, and the absence of anything beyond vague anecdote I think I'm sufficiently comfortable with any risk that I'll continue.
Many of us manage well with yoghurt - preferably plain, organic to avoid sugar and rubbish in it. Eating half a meal and then taking your tablets followed by the rest of the meal also helps.
But what is causing the problems? There are many other measures to help avoid the problem - raising the head of the bed, eating more but smaller amounts, not eating too close to bed and cutting carbs are all said to help and there are others. However many pills you take, if the problem is a physical one - such as an incompetent gastric sphincter or hiatus hernia - it will still happen.
There's a difference between pre and probiotics. Bananas are pre-biotics, they make the right sort of environment for the healthy bacteria to flourish. Probiotics are the bacteria themselves and you can get them via certain foods or in a capsule or powder to seed the environment. And symbiotics such as yoghurt and kefit are claimed to do both although sceptics there claim there aren't enough bacteria present to make a difference. I think Julian's 40 varieties is a rather low estimate to be honest - and there are millions and millions of individuals.
Probiotics are used in mainsteam medicine to repopulate the gut in certain situations - such as post-viral bowel syndromes or where high antibiotic use has killed the good as well as the bad bacteria.
There are lots of suggestions online if you search on acid reflux. Recently there were a couple topics on this forum.....scan down the topics and look for Silent Acid Reflux and that topic has the link to the other one that has many more responses. Hope something in them will give you some ideas. I know that my daily dose of prednisone triggers my acid reflux and I've pretty much accepted that I will have it until I can get my dose down further (currently on 4 mg) or get off it.
I don't know if they work. It's probably different for each of us. I would prefer to take no vitamins or supplements but with PMR that probably won't be possible for me. Maybe bananas will help you!
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