What Does It Feel Like to Take Prednisone for Inflammation?
Key takeaways:
Prednisone is a corticosteroid used to treat a variety of inflammatory conditions. It works by calming down an overactive immune system, which can reduce swelling.
Taking prednisone for a short period of time can cause side effects like changes in appetite and mood, sweating, and trouble sleeping.
People taking it long term can experience weight gain, high blood pressure, cataracts, and osteoporosis. Thinner skin and getting sick more often are also common complaints.
Prednisone is a synthetic corticosteroid (“steroid”) that’s used to treat many conditions related to inflammation — including allergies, asthma, certain cancers, and some types of arthritis and autoimmune disorders. Some people only take it for a short period of time — a few days or weeks. But others may need to take it for months or even years.
While it works quickly to relieve things like swelling and rashes, it can be rough on the stomach and make it hard to fall asleep. And the longer you take it, the greater the risk of long-term side effects, like osteoporosis and cataracts.
People who take it sing its praises in one breath and curse it in the next. Here’s how three people describe their experiences with prednisone.
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Both ‘brutal’ and ‘life-saving’
Delaney Nothaft played tennis for a Division 1 university before her body started betraying her.
“I hadn’t been feeling very good for months,” she says. “I wasn’t able to practice or play, wasn’t feeling myself. I had a lot of shortness of breath. They really couldn’t figure out what was wrong with me.
“One day in my senior year of college, I started developing double vision and drooping of the eyelids. That’s when they put everything together.”
The 24-year-old student in Tempe, Arizona, was diagnosed with myasthenia gravis, an autoimmune neuromuscular disease. Her other symptoms include difficulty with speech, swallowing, and breathing.
“I have periods of being OK and periods of being really sick,” she says.
She has taken prednisone for the last 3 years to cope with the symptoms. She’s at 10 mg a day now and takes a higher dose during flare-ups.
She has a love-hate relationship with the medication.
“Being on steroids, there’s kind of two traumas that are happening,” she says. “There’s the trauma of the disease that steroids are treating, and then the steroids are trauma themselves.”
This includes a number of side effects associated with taking prednisone long term. Delaney has had rapid weight gain, rounding of the face (“moon face,” she calls it), cataracts, osteoporosis, thinning of the skin, bruising, and frequent infections.
Her physical side effects are accompanied by anxiety, depression, and insomnia.
“It is a brutal drug,” she says.
Yet, she is thankful for it. One of her doctors called prednisone a “necessary evil,” she recalls.
“I am talking a lot of trash about prednisone right now, but it is a life-saving medication,” Delaney says. Before there were steroids, about 40% of people with her condition died. “Now, that number is less than 5%. So, I’m really grateful to prednisone,” she says. “I will continue to take it. I will continue to listen to my doctors and work with them.”
That is among her advice to others.
“There are things that [your physician] can do to help mitigate some of the discomfort that you’re feeling,” she says. “Work with your physician, and then also just extend yourself some self-love. You wouldn’t want to judge any other people out there that may be experiencing these symptoms. So don’t judge yourself, either.”
Comedian doesn’t find side effects funny
Matt Wohlfarth vividly remembers the day he worked as a baggage handler and forgot to take his prednisone.
“I had 300 bags going to Cancun, and I called my boss and said, ‘I can’t move a muscle. I’m frozen,’” he says. “That is how bad the pain was, you know? All because I missed and messed up with my dosage.”
Matt, a Pittsburgh salesman by day and comedian by night, was diagnosed with rheumatoid arthritis about 20 years ago. Traveling nationally as a comedian, he noticed he was having difficulty doing the second show of a night. His elbow would lock up, forcing him to move the mic to his other hand, and his feet felt like “razor blades.”
For years, he took prednisone off and on. About 6 years ago, he took it daily for 3 years straight. “I lost my insurance, and that was the cheapest alternative,” he says.
He admits he did not always take it as directed. “I’d take my medicine for a while, start feeling good, and then stop,” he says.
“It’s really good at controlling the swelling. It makes you feel good, like you have great energy. It makes life a little normal for you.”
But he did not like the side effects of long-term use.
“I could cut my skin really easy. I had paper-thin skin,” he says. “Then you get the bruising under your hands. The blood pools there.”
In addition to the daily cuts and bruising, Matt says his head and face “got big.”
“They call it ‘pie face,’ or ‘moon face,’” he says, echoing Delaney’s comment.
Matt cautions those taking prednisone to take the lowest effective dose for the shortest time possible. The more you take, the more pronounced the side effects, he says. It is also hard to wean your body off higher doses.
“I always tried to take the least amount I needed,” he says. “Your body grows accustomed to it a little bit.”
Matt has since switched to Rinvoq (upadacitinib), although he still keeps prednisone around in case he has a severe flare-up.
He says he’s learned to live with his rheumatoid arthritis.
“It’s like a boxing match,” he says. “Some days you win. Some days it wins.”
Prednisone necessary for life-threatening condition
A car accident began a life-long struggle with inflammatory bowel disease (IBD) for Abigail VanHoose. In addition to a broken hand and sprained ankle, she experienced severe pain in her side.
“They said the trauma of the accident brought it [IBD] out,” says Abigail, a 28-year-old chef and blogger in Concord, North Carolina. “It was already in my genes, so it was going to come out eventually, but the car accident is what made it come out sooner rather than later.”
IBD refers to two conditions — Crohn's disease and ulcerative colitis — which are characterized by chronic inflammation of the gastrointestinal tract.
Abigail has been living with IBD since 2014. It means flare-ups with severe abdominal pain, increased urgency and frequency of stool, bloody stool, fatigue, fever, weight loss, hair loss, and joint pain.
The symptoms often keep Abigail from working, sleeping, and eating.
“When I say urgency and frequency [of going to the bathroom], for me personally, when I'm in a flare-up, I’m going to the bathroom 30-plus times a day,” she says.
It’s more than uncomfortable. It’s serious and sometimes life-threatening. During her last flare-up, in July 2022, she spent 37 days in the hospital, lost 30 pounds in 2 weeks, and almost lost her colon.
From the beginning, she has taken prednisone to help with the one or two flare-ups she has each year from stress or overexerting herself. She takes 30 mg or 40 mg daily for a couple of weeks before tapering off. During her last flare-up, it was 80 mg daily.
Prednisone prevents inflammation and further ulceration of the colon. But it comes with serious side effects for Abigail: severe mood swings, joint pain, rapid heartbeat, night sweats, cystic acne, anxiety, upset stomach, and moon face.
“It's a lot, and you know, long term, I would say, with prednisone, you have to be careful with things like bone loss,” she says. “So, it's not only side effects while you’re taking it, but also things down the road from taking so much of it for a long period of time.”
While the prednisone is necessary during flare-ups, Abigail is hopeful she can avoid the flare-ups with a new medicine, Rinvoq. She previously used Remicade (infliximab), but her body developed resistance to the medication.
She helps others with IBD through her blog, which showcases 200 or so recipes as well as IBD research information and patient advocacy.
“With IBD, it is not one-size-fits-all,” she says. “Everybody processes [it] differently.”
What does the pharmacist say?
Alyssa Billingsley, PharmD
Director, Pharmacy Content
Prednisone is a common steroid medication that’s used to treat a variety of inflammatory conditions — from skin rashes to rheumatoid arthritis flare-ups. It works by suppressing your immune system. This can be helpful for autoimmune disorders where your immune system is attacking healthy parts of your body.
Some people only take prednisone for short periods of time. But even with short-term use, prednisone can cause changes in your appetite and mood, sweating, and insomnia. Your blood sugar levels can also go up. Typically, these side effects should resolve after you finish your course of prednisone.
But if you have a chronic condition, your healthcare provider may have you take prednisone for longer — sometimes months or years. When taken long term, prednisone treatment can result in side effects like weight gain, cataracts, and osteoporosis. High blood pressure is also possible. And because it suppresses your immune system, you may get sick more often, too.
Because of these risks, your healthcare provider will typically have you take the lowest prednisone dose for the shortest time possible. Be sure to keep up with your regular check-ups and discuss any side effects you’re experiencing to help your provider catch potential issues early.
Coping with prednisone side effects isn’t easy. But it’s important to stick with treatment. Don’t stop taking it cold turkey — this can result in withdrawal symptoms that make you feel even worse. Your healthcare provider can help you taper off prednisone slowly and safely.
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