The Dangerous Mistake Most People Make Quitting Steroids

Introduction to Prednisone Tapering 0:00

You have been taking prednisone for rheumatoid arthritis? You went to the internet and start searching about the side effects. the high blood pressure, the higher blood sugar and the bone loss. You are scared and you thought, let me just stop the prednisone. But here's the truth. Suddenly stopping prednison could land you into the emergency room or even worse. In this video, I'm going to tell you about the true on why you should not suddenly stop predniison and create a better plan on how to taper that steroid.

At the end, I'll also give you a simple checklist on how to safely do the prednisone taper. Please stick around. Before I dive deeper, do me a favor. If you have ever been worried about the steroid side effects, please drop a comment below saying ME. I read every comment. Let's also hear from all of you on HOW you are handling this steroide. Hi, all of you rheumatoid arthritis warriors. This is Dr. Anta Sumedhi, your rheuomatoids arthritis coach at The Room Doc, as well as a practicing rheumeatologist here at Empower Arthritis and Rheumatology Center.

Today, I'm going over a very important topic in rheuma arthritis management that also includes other autoimmune diseases too.

Patient Story: Why Stopping Suddenly Is Dangerous 1:12

on how to safely taper steroids and what are the advantages and disadvantages of suddenly stopping the prednisone. Before I go further, don't forget to like and subscribe to our video and also accept our gifts. That includes a free copy of our book, the Holistic Rheumatoid Arthritis Guidebook, as well as a FREE smoothie that you can prepare every morning to fight against rheumataid arthritis so that YOU don' t need to go to those steroids. Now let me start with the story of one of my patients. She is 52 who has history of rheumatoid arthritis for several years and she came to me on 10 mg per annusone for years.

One day she thought about suddenly stopping the perannusones and so she did. But unfortunately she landed in the ER after 3 days of stopping pernuson. to the ER with low blood pressure. She even could not speak. she was having a lot of other symptoms. Now can you guess what she has? So she developed what we call adenyl crisis due to suddenly stopping the pregnancy. So let me help you learn about how you can safely taper the steroids so that you don't land up in the er or even more serious problem in your health.

Let me start with the first question. Who needs a steroid taper and who does not need a taper? And starting with the first question, who doesn't need the steroidal taper. If you have been taking steroids for less than three to four weeks, you usually don't NEED to taper, You can stop the prednisone without needing the taper So your adeno gland, which typically make the cortisol, is still fully functioning. So when you stop the prednisone, it will make up for the cortisone level.

Who Needs a Taper and Why 2:51

The magic number is three to four weeks. But even for this, always ask your doctor on how to safely taper your steroid. Don't do it by yourself. So the most important question, if you are taking steroids for more than three to four weeks, then you definitely need to slowly taper the steroid. And here is the reason. So our body typically make a natural hormone called cortisol. You can think of cortisol as a nasal hormone made by one of the gland called the adeno gland. These are two glands on top of your kidney.

They typically make this cortisol hormone to support your body to function. And when you're taking steroid, the outside steroids, this adenoid gland does not function very well. You can even see in the picture on the right side, that the adenogland has become smaller and the smaller adenoside gland is not making enough cortisol. That's why you need to give enough time to the adrenal gland to make enough cortical before you stop the steroids. What is the risk? Why can't I just stop the prenatal? And I call we to have a safer landing.

If you're taking long term steroids, we need to slowly taper so that you have safer landings of coming off of the steroids. And suddenly stopping could be risky, like our patient we talked earlier. And let me also try to make it a little more simple. So you can think of your adenogland as a factory that make cortisol and your anal gland make this cortisol every day. And cortisol helps in handling stress, maintaining your blood pressure and even fighting infections. Your factory follows a good schedule.

It usually makes the cortisol typically high level in the morning, so it has a routine. Every morning it makes higher level of cortisol. When you take this external corticosteroid in the form of like prednisone or methylprednisolone, or any other form, of coronic steroid, your body thinks that the factory does not need to produce any cortisol. So your factory, the adrenal gland, go to sleep.

Adrenal Crisis vs. Steroid Withdrawal 4:54

And when your adrenal is in sleep, it is not making any cortisone. When suddenly stop the predniestone that you are taking, then you don't have any steroid in your body. That's how the adenyl crisis happens. Your body is not able to handle that lack of cortisol causing severe health concerns. Now here are some of the danger of suddenly stopping the steroids and we call that adeno crisis and it could be a medical emergency which could take you to the ER or even worse. And here's some important symptoms of adenylo crisis.

The number one being severe weakness and fatigue, very low blood pressure, nausea and vomiting and even confusion and passing out. That's why it's a very risky situation if you suddenly stop your pregnancy. The other question is how long does it take to recover when you are slowly tapering your steroid? Your steroid withdrawal can take up to many weeks to months. It varies from one patient to the other patients. Some of you might be able to come off within few months, but it can even take off to two years to fully get back to normal.

So your adenogland, the factory which make cortisol take a lot of time to recover. And the rule of the game is, the longer you are on the steroid and the higher the dose, The longer it might take to recover from the adenyl insufficiency. When you were slowly coming down on a prednisone, you might also get symptoms of what we call steroidal withdrawal. Now here are some of the important symptoms of steroid withdrawal that includes joint pit and muscle pain, headaches, mood changes, feeling very tired, trouble sleeping and mild flare up of your disease.

So these are the symptoms steroidal withdrawal. Now let me differentiate between these two important ideas. One is steroid withdrawal and the other one is the adrenal crisis. Those are two separate conditions. In steroidal withdrawal, it's mild symptoms. It's uncomfortable but it is not dangerous. Your body is just trying to adjust to a lower level of steroid. That's why you are feeding those mild symptoms. And it typically gets better with time. But the adrenal crisis is a medical emergency. You have severe symptoms, severe weakness, vomiting, confusion and very low blood pressure.

Even it could be life threatening. So it's very important to understand these two concepts of steroid withdrawal with our mild symptoms and the adenyl crisis with are more severe symptoms,

Safe Tapering Plan and Monitoring 7:27

which will need immediate medical attention. Now, let me give you some safe steroidal withdrawal plan. So step one is a quick drop. If you are taking very high dose of steroids, typically more than 50 to 60 milligram, your doctor will rapidly decrease the level of prednisone and they come down to a lower level. Now the step two becomes the slow and steady, where your Doctor will slowly decrease from that lower-level of the steroid. The step three is the checking in. Your doctor might also measure the levels of cortisol in your body, typically in the early morning.

That will tell us whether your adrenal gland is already waking up or not. So here are these three important steps. The step 1 is the quick drop, the step 2 is slow and steady and the Step 3 is checking in, checking the level of cortisol to tell us whether your adenoid gland is already waking up or not. In this journey of coming off of the steroid, always use your doctors, your primary care doctor, and your rheumatologist as your partner. They will help you guide on how to safely decrease the perinatal.

Now the goal, your goal and your doctor goal is the same, is to get you off of the parenteral. But we have to do it very safely. In rheumatoid arthritis, we so many different medications. We call them disease-modifying anti-aromatic drugs or biologics. that will help you decrease your prednisone and also control your rheumatoid RFI so we can safely do both. We can taper the steroid, we also can control our disease. But we do have a good plan. So always create a plan with your Rheumatologist. Always watch out for those symptoms of steroidal withdrawal and even adrenal crisis.

And also have regular checkup with doctors. Checking your cortisol level could be helpful. And always work with your rheumatologist to adjust your Rheumatoid Arthritis medication so that you don't go into a flare when you are decreasing your prednisone. So it's very important to have a continuous communication with the rheumeatologists on how you're feeling as you were keeping the prednison and also monitoring your disease activity. Now, as I mentioned earlier, here is the easy checklist for you that will help you decrease your prednisone safely without causing health crisis.

Checklist and Take-Home Message 9:54

1. Never stop subtly without talking to your doctors first. Number two, keep a diary of your symptoms to understand both the symptoms of steroid withdrawal as well as the disease flare. Number three, be patient. It takes time for us to safely decrease your pregnancy. So have patience. Four, follow your plan exactly as your doctor has told you. And the number fifth, if you are taking steroids for a long period of time, typically more than three to four weeks, Wear a medical breast so that people are aware if in case of emergency you need extra steroid or you are on prenatal.

So wearing a breasted could be a lifesaver for you. And if you have any questions, always call your doctor. Don't taper your steroids suddenly without consulting to your doctors. Here's the take home message. So tapering steroid is like a landing a plane. You cannot just drop from the sky. Your body need a slow and safe landing. Always work with your doctors. you are the pilot, but you have a coach. your rheumatologist and your primary care doctor. So use them for your safe, landing when you're trying to decrease your prenatal.

Thank you all of you rheumatoid arthritis warrior for watching this video. If you like the video please give us a thumbs up. Subscribe to our channel so that you can get these type of contents to help you understand better about rheuma to arthritis. And also don't forget to accept our gifts. The two gifts that we have one is a free copy of the book. as well as a recipe of the anti-inflammatory smoothie that you can prepare every morning. And if you follow those, you may not even need to be on steroids.

I'll see you in the next video. Bye bye.