Wednesday, August 25, 2010

Steroids Eat Your Stomach For Breakfast - Challenges of Prednisone Therapy

The above statement was uttered by my Neurologist as he prescribed yet another dose of steroids for my intractable Migraine issues. It was uttered again when I was re-diagnosed with autoimmune disease.

Prednisone is hard on the body, but it is especially hard on the digestive system - particularly the stomach. When you add to the fact that those with autoimmunity often are forced to utilize high doses of NSAIDS for long periods of time - and the fact that NSAIDS also "eat stomachs for breakfast" - well, the results can be quite serious.

Why are steroids hard on the stomach?

Pred and other steroids are stress hormones. They are produced when our bodies need to deal with some sort of mental, emotional or physiological stress (like an illness or injury) Taking these medicines for long periods of time make our bodies act like we are in a constant state of extreme stress. Stress also causes increased stomach acid, and that's where the connection comes in...

The treatment...

Physicians worried about your stomach when you're taking a steroid drug will often prescribe a medicine like Prilosec (omeprazole) to avoid any problems. However, even with these medicines, it is common for long-term steroid users to have stomach upset ranging from reflux to ulcers. Having this side effect can happen very, very quickly. If you are a steroid patient and you are vomiting "coffee grounds", blood, or are having uncharacteristically severe abdominal pain during your therapy, get in to see your doctor right away. sometimes the cause.

Omeprazole is a good medicine for helping your stomach. It too has side effects however, and one of the worst is that it eventually can cause B12 deficiency. B12 levels below 400 are associated with neurological damage which, over time can become permanent.

How does this happen?

B12 is bound tightly to animal based protein. It must be broken from those bonds by stomach acid. If there is insufficient acid present, the B12 will remain bound to the protein and cannot be absorbed. These medicines stop your stomach acid, but they also stop another important secretion - Intrinsic Factor (IF). This is the special gastric liquid that binds to the B12 after it has been broken away from the protein. IF carries the B12 thru the wall of beginning of the small intestine and into the blood stream where it is picked up by the liver and stored. Without IF, B12 can't be absorbed.

The B12 treatment:

B12 can be supplemented by patients taking steroids, but it is not necessarily recommended to take these supplements orally in pill form. The best way to get B12 into your system is via injection or sublingually.

We all know what an injection is - it utilizes a needle that punctures the skin and either goes into the tissue below the skin or into the muscle. B12 can be injected either way. It is then stored by the liver and used as the body needs it.

Sublingually means that the B12 is placed on the tissue under the tongue and it is absorbed directly into the bloodstream from this vessel rich area. Sublingual B12 is thought to be as effective and easier to take than B12.

For more information on B12 and B12 injections, click here: B12 injection basics

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Comment by myQutekelly on August 25, 2010 at 6:40pm
Thanks for this - shared! :)
Comment by Ellen S on August 26, 2010 at 10:01am
Thanks so much Kelly!!

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