Expert: Kevin Smith - 9/2/2009

Question
hello, kevin-

over the course of the past 2 months i was prescribed
5 days of prednazone twice and 2 doses of dexamethasone
once for asthma related symtoms- while on these medications
i felt absolutely fantastic- after they wore off i once again
felt like absolute dookie- these medications not only helped
my asthma related inflammation but other body aches and pains
as well- i was told by the doctors who prescribed them to me that
that they would not prescribe them to me for long term use but
as a rescue- neither gave any in depth explanation as to why,
just more or less said if taken long term that steroids can screw
up more than they help- i'm wondering if in your life experiences
or knowledge of others experiences you found such claims about
steroids to be true or mostly bologna- if true, have you or others
discovered healthier alternatives to dealing with asthma related
inflammation?

most sincerely, teresa


Answer
Hi there Teresa,

I can honestly say, if there is one thing I've had experience with, it's prednisone - I'm currently on 20mg/daily until further notice because it's simply the only thing that keeps me relatively symptom-free under general conditions. Over the years, I've been on some pretty whooping doses of it, and usually average around 6-8 courses over two weeks a year.

Prednisone, because it's a steroid, can play absolute havoc with your system. It's a pure life-saver at times when nothing else is working, but there can be, and will be, a price to pay for long-term use. For me, personally, since I've been taken large doses fairly frequently for over 25 years now, I have osteoporosis, some liver damage, eye issues, am sterile, gynecomastia, etc etc - and most of that is likely influenced strongly by the steroid use - then there are the more 'temporary' issues like crazy appetite and major water-retention, etc that one deals with.

Would I go back and change it - nope, as I'm alive because of it - pure and simple.

As for healthier alternatives, my first thought would be to be on an inhaled steroid, such as Pulmicort or a combo-steroid drug like Symbicort or Flovent. While these are still steroids, their side-effects and long-term effects are not nearly as bad as oral corticosteroids like prednisone. Many people find a 'sweet-spot' dosing of these drugs that keep them quite healthy.

Other non-steroid possibilities could include long-acting broncodilators such a Serevent (SALMETEROL) for asthma-control.

I hope this helps out some - let me know if you have any other questions, or just want to share your experiences!!