Breastfeeding on Prednisone

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Below is a collection of Information I have gathered from Blog posts, person comments and Medical articles from online.  While there seems to be no definitive Yes or No answer, as with many things to do with ITP, I did think this offered a great platform to begin your own research and make up your own mind about what is right for you and your baby. Continue reading

Calcium and ITP

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Feature image from PINTEREST

Natural Calcium

Calcium is the fifth most abundant element by mass in the earths crust.  It is also the fifth most abundant ion dissolved in seawater.  Calcium is essential for all living organisms; in particular their cell physiology, and humans are no exception.  As a major material used in the mineralization of bones, calcium is the most abundant metal on mass in the human body.  Without enough Calcium in your system you are in trouble.  Did you know that Prednisone leaches calcium from your bones?

Taking Prednisone? Take Calcium too

If you are taking any amount of Prednisone on a daily basis then you absolutely need to be increasing your calcium intake, either through diet or with a supplement.  There seems to be a grey area in the Medical profession at the moment about how much prednisone requires a Calcium and Vitamin D supplementation.  All I can say about this is that any amount of Prednisone is too much and every possible precaution should be taken to avoid developing Steroid-Induced Osteoporosis.

Steroid-Induced Osteoporosis

Osteoporosis is a weakening of the bones, which causes them to lose their density and become brittle and more susceptible to fracture.  Your bones are the organs that produce your blood.  Your bones make your platelets!  Your bones are not something that can be replaced with metal if they are broken or too weak.  Long-Term steroid use weakens your bones, as the Prednisone will leach Calcium from them.

Calcium Absorption

Calcium is absorbed in the small intestine.  This absorption is aided by the presences of Vitamin D in your system at the time of the Calcium uptake.  Most people on Prednisone will need between 1000 to 1500 mg of calcium per day.

The Top 5 ways to increase you Calcium, Naturally

    •  
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      Full cream milk

      Milk (Dairy ) So the best source of Dietary Calcium is of course Dairy.  Australians are very lucky with the quality and quantity of Dairy products available here.   We are able to access a variety of milk, yoghurt, cheeses, cream and curds.  If you are looking for more calcium, then this is where you find it. However, if like me, you have switched to an anti inflammatory diet such as the Paleo Diet, then you will need to look for non dairy sources of Calcium.  I still consume a bit of milk cause I love the Vitamin D + Calcium combo, but a small amount of milk is not enough.

    • help with itp
      sun dried little fish

      Tiny fish (with the bones)  These tiny fish would include Anchovies, White Bait or Sardines.  Canned salmon and other fish are also sold with the bones included, but you would need to read the label.  Eating these fish will provide you with a nice dose of fish oil, probably a bit of Vitamin D, and a whole lot of Calcium.  What better food to eat for bone health than another animal’s healthy bones.  If you are looking for the next best source of Calcium after dairy, then this is it.

  • Seaweed Sushi rolls, Japanese – get the fatty fish and the seed weed together.  The only chance I get to eat seaweed is in Japanese and Korean restaurants.  If anyone knows any great Nori recipes please let me know.
itp vitamins and supplements
Chia seeds
  • Seeds  If you are a vegetarian or Vegan, then the Calcium in seeds will be a great natural healthy source.  Seeds can sometimes be overlooked because they are so small, but it is because of their size that they can easily be incorporated into any dish.  They are easy to sprinkle over salad or add to sauces and bakes,  mash up with vegies, or include in a stir-fry – actually everything could benefit from a little sprinkling of seeds.  Seeds high in Calcium include Chia Seeds, Flax Seeds or Linseeds, depending on where you are from and Sesame Seeds or Tahini will work just as well.
  • itp vitamins and supplements
    roasted almonds

    Almonds  Almonds are the Paleo Dieters dream.  These tasty little nuts may be used for sweet and savory dishes, blended into a baking meal or eaten by the handful between lunch and dinner.  Aim to always have a supply of Almonds in your house, just stay clear of the salted kind – Salted Almonds are moreish and a huge no no for people taking Prednisone.  To read more about staying away from Salt, click here.

 

Prednisone – An Immunosuppressant

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There is a particularly hilarious episode of the Television Series (Smash Season 1 Episode 6, Chemistry) where one of the main characters is prescribed Prednisone to treat a throat inflammation.  She recovers in record time and has the energy and enthusiasm to return the next day to the stage.

‘She is probably on Prednisone – that drug is a miracle…If you don’t kind the mood swings, insomnia, hair growth and hallucinations and weight gain.

Yes, she can certainly still sing, but really the young girl goes a bit mad.

I love this episode.  Not only does it highlight the side effects and problems with taking steriods as a short term, reactionary solution, it also brings to light the relaxed and quite scarey attitude that most people have towards a very harsh and damaging drug.

‘First dose six pills – I’m having cold sweats, head aches since like four in the morning and I just feel so panicky.  I’m not in good shape.’

Prednisone is an Anti Inflammatory Drug

Prednisone is particularly effective as an immunosuppressant, and affects virtually all of the immune system. It can, therefore, be used in autoimmune diseases, inflammatory diseases (such as severe asthma, severe allergies, severe poison ivy dermatitis, systemic lupus erythematosus, ulcerative colitis, rheumatoid arthritis, Bell’s Palsy, Crohn’s disease, pemphigus and sarcoidosis), various kidney diseases including nephrotic syndrome, and to prevent and treat rejection in organ transplantation.

Intravenous application may be employed for cerebral inflammation, as in the period attacks caused by multiple sclerosis.

Furthermore, the pharmaceutical industry uses prednisone tablets for the calibration of dissolution testing equipment according to the United States Pharmacopeia (USP).

Discovering Prednisone

Prednisone, itp, ITP - low platelet count, low Platelets, ITP disease, immune system disease, itp blood, immune thrombocytopenia, itp,  The chemical Prednisone was discovered by Arthur Nobile in the early 1950’s.  Arthur Noble was an American microbiologist how is best known for his isolation and reproduction of the steroids prednisone and prednisolone – It is his most natable achievement in his career.

The first commercially feasible synthesis of prednisone was carried out in 1955 in the laboratories of Schering Corporation, which later became Schering-Plough Corporation, by Arthur Nobile and coworkers.  They discovered that cortisone could be microbiologically oxidized to prednisone by the bacterium Corynebacterium simplex. The same process was used to prepare prednisolone from hydrocortisone.

The enhanced adrenocorticoid activity of these compounds over cortisone and hydrocortisone was demonstrated in mice.

Prednisone and prednisolone were introduced in 1955 by Schering and Upjohn, under the brand names Meticorten and Delta-Cortef, respectively.  These prescription medicines are now available from a number of manufacturers as generic drugs.

Side Effects of Prednisone

This medicine may also reduce the sex drive. Prednisone has also been used in the treatment of migraine headaches and cluster headaches.  Prednisone also may often cause rapid weight gain in those who are taking it.  This list is not meant t scare you, it should be used to remind you of possible side effects to look for when taking Prednisone.  

To read more about Prednisone go to Mediline Plus.

  • headache
  • dizziness
  • difficulty falling asleep or staying asleep
  • inappropriate happiness
  • extreme changes in mood
  • changes in personality
  • bulging eyes
  • acne
  • thin, fragile skin
  • red or purple blotches or lines under the skin
  • slowed healing of cuts and bruises
  • increased hair growth
  • changes in the way fat is spread around the body
  • extreme tiredness
  • weak muscles
  • irregular or absent menstrual periods
  • decreased sexual desire
  • heartburn
  • increased sweating

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

  • vision problems
  • eye pain, redness, or tearing
  • sore throat, fever, chills, cough, or other signs of infection
  • seizures
  • depression
  • loss of contact with reality
  • confusion
  • muscle twitching or tightening
  • shaking of the hands that you cannot control
  • numbness, burning, or tingling in the face, arms, legs, feet, or hands
  • upset stomach
  • vomiting
  • lightheadedness
  • irregular heartbeat
  • sudden weight gain
  • shortness of breath, especially during the night
  • dry, hacking cough
  • swelling or pain in the stomach
  • swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
  • difficulty breathing or swallowing
  • rash
  • hives
  • itching

 

Dependency

Adrenal suppression occurs if prednisone is taken for longer than 7 days.  For this reason, prednisone should not be stopped abruptly if taken for longer than seven days; rather the dosage must be reduced slowly. This reduction may be over a few days if the course of prednisone was short, but may take weeks or months if the patient had been on long-term treatment. Abrupt withdrawal may lead to an Addisonian crisis, which may be life-threatening. For those on chronic therapy, alternate-day dosing may preserve adrenal function, thereby reducing side-effects (see “Dosing Considerations”).

Tapering off Prednisone

One of the most common symptoms of prednisone withdrawal is a feeling of weakness or severe fatigue. This is because the immune system is weakened. It may also result in body aches and a low grade fever as though a cold were coming on. Joint pain is also common. Also on the list of prednisone withdrawal side effects is depression. This is because withdrawal from the drug causes hormonal changes in the body.

Please note that the longer you are on prednisone, the worse you can expect the prednisone withdrawal symptoms to be should you cease taking the medication suddenly. 

More Information about taking Prednisone.

Mediline Plus – Prednisone Fact Sheet

Platelet Disorder Support Association – Corticosteriods

Australian Rheumatology Download for Prednisone & Prednisolone

 

Grapefruit – Is There a Problem?

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Grapefruit? What’s the Problem?

The other day I found myself with a grapefruit in my hand and an old wives tale in my head.  I don’t know why it came to me, but something was telling me not to eat the Grapefruit; something about grapefruit making the pill not work, like St John’s wort?

Then I doubted myself.  How can a grapefruit be an evil kind of citrus when all the rest are fine?

What was I going to do with the Grapefruit tree in my back yard, plumb and ladened with the most burdensome of citrus?  I started to ask a few friends if they had heard of this medication mixing myth.

I Started to Hear Conflicting Stories –

  • A friend of mine told me her mother could not drink Grapefruit juice while she was being treated for Breast Cancer – Apparently the nurses where quite insistent.
  • Another friend told me to eat plenty of Grapefruit as it is listed as a great food to eat on the alkaline diet, with mangos, limes, lemons and papaya.
  • ‘Grapefruits?  Oh yes, you should eat one every day – Very good for the fat burning’ they told me.
  • ‘Grapefruit? Oh no! Stay away from that one.

My current contraceptive pill warns me to stay away from St John’s Wart, but there is not mention of Grapefruit on the instructions –

Is it just an old wives tale?

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Related Search Results for Grapefruit.

I decided to find out weather or not the humble fat busting little sour drum could really cause that much damage.  I had to do some research.

I googled ‘Grapefruit and Medications’ Wow!

There is a lot of information out there to confirm that Grapefruits do in fact effect a lot of prescription medications.

 

‘Today, more than 30 commonly prescribed drugs carry a warning against mixing their use and grapefruits or grapefruit juice. This is not innocuous, because so many Americans have grapefruit for breakfast at a time when they also take their medications.'(1)

Here is the confusing part – Grapefruits do not interact with every drug.  

But WHY?

Reactions between Grapefruit and prescription drugs was first documented in 1989 by a Canadian Medical Scientist,who discovered that when he took felodipine with grapefruit juice his blood-concentration of the drug was four times as high as it should have been. In other words, a standard dose combined with grapefruit juice was four times as potent as it was without grapefruit juice. (2)

‘Grapefruit juice blocks special enzymes in the wall of the small intestine that actually destroys many medications and prevents their absorption into the body. Thus, smaller amounts of the drugs get into the body than are ingested. When the action of this enzyme is blocked, more of the drugs get into the body and the blood levels of these medications increase. This can lead to toxic side effects from the medications.’ (3)

What I found was that grapefruits seem to have the most disastrous effects on the drugs that people would probably keep quite private.  Drugs and medications used to treat mental health are the most susceptible to the enzyme dissolving grapefruit juice.  You just never know what people are taking…

CitruaJust Grapefruit?

What about other citrus?

Well it looks like it is just Grapefruits.  There is an emzyme in grapefruits that are not found in any other fruit at all.  Weird.  but true.

The truth is that Grapefruits might not have any effect on the medications and drug you are taking – But really? they aren’t that nice.  I am going to just steer clear I think.

 

 Other Medication-Effecting Foods

While researching I found this list that outlines others foods that may also effect medication and prescription drugs – Please note that this is only a small sample of medication-effecting foods and should not be taken as the only risk.

Grapefruit juice: Some statin drugs to lower cholesterol, such as simvastatin (Zocor), atorvastatin (Lipitor), and pravastatin (Pravachol); some blood pressure-lowering drugs, such as Nifediac and Afeditab ; some organ transplant rejection drugs, such as Sandimmune and Neoral (both cyclosporine); some anti-anxiety drugs, such as BuSpar (buspirone); some anti-arrhythmia drugs, such as Cordarone and Nexterone (both amiodarone); some antihistamines, such as Allegra (fexofenadine); the anti-malaria drugs Quinerva or Quinite (quinine); and Halcion (triazolam), a medication used to treat insomnia.

Licorice: The sweetening compound glycyrrhizin in black licorice may reduce the effects of some blood pressure drugs or urine-producing drugs including Hydrodiuril (hydrochlorothiazide) and Aldactone (spironolactone). It may increase the toxicity risks from Lanoxin (digoxin), used to treat congestive heart failure and abnormal heart rhythms.

Chocolate: Antidepressant Monoamine Oxidase (MAO) inhibitors (such as phenelzine (Nardil, Nardelzine) and tranylcypromine (Parnate) are just one category of drugs that shouldn’t be consumed with excessive amounts of chocolate and other caffeinated foods. Caffeine can also interact with stimulant drugs such as Ritalin (methylphenidate), increasing their effect, or by decreasing the effect of sedative-hypnotics such as Ambien (zolpidem). Using bronchodilators with caffeinated foods and drinks can increase the chance of side effects, such as excitability, nervousness, and rapid heart beat.

Potassium-rich foods (such as bananas, oranges, and green leafy vegetables): Can add to high potassium levels in the body caused by ACE (Angiotensin Converting Enzyme) inhibitors including captopril (Capoten) and enalapril (Vasotec) prescribed to lower blood pressure or treat heart failure. Too much potassium can cause an irregular heartbeat and heart palpitations.

St. John’s Wort (Hypericum perforatum): Can reduce concentrations of medications in the blood, including digoxin (Lanoxin), used to treat congestive heart failure and abnormal heart rhythms; the cholesterol-lowering drug lovastatin (Mevacor and Altocor), and the erectile dysfunction drug sildenafil (Viagra).

Vitamin E: Taken with a blood-thinning medication such as warfarin (Coumadin) can increase anti-clotting activity and may cause an increased risk of bleeding.

Ginseng: May increase the risk of bleeding when taken with anticoagulants (blood thinners such as warfarin and heparin). Can also increase the bleeding effects of aspirin and non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, and ketoprofen. Combined with MAO inhibitors such as Nardil or Parnate may cause headache, trouble sleeping, nervousness and hyperactivity.

Ginkgo biloba: High doses can decrease the effectiveness of anticonvulsant therapy in patients taking seizure-control medicines Tegretol, Equetro or Carbatrol (carbamazepine), and Depakote (valproic acid). (4)

 

References

Grapefruit and Prescription Drugs: Mix Carefully – By Mark Bloom HealthDay Reporter, (1)(2) 

Grapefruit Juice Can Interact With Medicines! – Original Medical Author: William C. Shiel, Jr, MD, FACP, FACR Medical Editor: Jay W. Marks, MD, (3)

Grapefruit not only food that can Effect Medication – Michelle Healy, USA TODAY (4)

Your Hair Has Changed, Brush of Comb?

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Feature image from ITPANDME

The immune suppressants, corticosteriods and chemical therapy used to treat ITP is doing damage to your body, that is the point.  It is meant to effect your body.

Your hair will most likely become fragile, break easily, dry out faster, hang limply and look pretty crappy.  This is a fact.  This is because taking corticosteroids including prednisone puts you body in a heightened state of stress which draws energy away from non essential body functions, such as hair growth.  Your skin and nails will also suffer because of this medication.

Below are some simple steps that you can take to ensure that you hair is in the best condition, as you undergo treatment for your Autoimmune Disorder.  Taking steroids seriously damages and depletes the quality, strength and length of you hair.

Combing Vs Brushing

When should you Brush?  When should you Comb?  Should you be BRUSHING OR COMBING your hair?  Do you know the difference between brushing and combing your hair?

A comb performs three functions for your hair.  Combing your hair is for detangling, styling and separating pieces of hair.  Use a comb when you need to detangle, style and part your hair.

Brushing your hair is a means of cleaning it, and keeping it healthy.  Brushing your hair removes dust and fibres as well as stimulating your scalp.  Brushing your hair using a boar hair brush keeps your hair healthy, shiny, and clean.  Brushing your hair moves and massages the naturally accuring oil Sebum.

Another way to remember the difference between brushing and combing your hair is to think about the time of the day.  Pick up your comb in the morning to comb  and style, and detangle your hair and grab your brush at night time, for some pre-sleeping hair care cleaning brushing styles.

How to Brush your Hair

The best way ever to brush your hair is to use a BOAR HAIR bristle brush.   The boar hair bristles are packed so tightly together that the hair is actually smoothed and cleaned as you brush it.  The tight bristles remove dust, lint, dried skin and other foreign items from you hair.

When your hair is cleaner, it actually looks better, because it is all shiny and smooth.  The boar hairs are smooth at the end, and while your brushing the hairs massage you scalp and stimulates the oil production in your skin.  Slowly brushing over and over will and evenly distribute the natural oil from your stimulated scalp down the hair shaft, moisturising the whole strand.

With this in mind, be very mindful of how you brush.

  • Make sure your hair is dry and detangled before you start.
  • Divide the hair into small sections on your scalp and work with just a small amount of hair at a time.
  • Start at the end of the hair, brushing the tips lightly, moving slowly up the hair strand towards your scalp.
  • Go slowly, and carefully.  Work your way around your head until it is all nice and clean.  Once you get to the scalp, make sure you make plenty of contact with your scalp, massaging all over.

For a deeper, natural moisturising treatment, continue to brush your hair until it becomes noticeably oily.  Braid your hair and leave the oil in overnight.  Wash it out in the morning before you leave the house.

A Boar Hair Brush

You need to get one of these.  And you need to pay money for a good one and make sure it is 100% boar hair.  I use a DeVille BOAR BRISTLE brush by Spornette and it is the best brush I have owned.  It has been with me for a year now and still looks fantastic.  PURCHASE a boar hair brush.

Boar hair bristle brushes are made from all natural ingredients.  This means that your need to take special care of your brush.  Read here to find out how to take care of your Boar Hair Brush.

For the best way to WASH your hair read more here.

 

Travel Insurance for people with ITP

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Can I get Travel Insurance if I have ITP?

While planning an overseas trip, I became confused about what my options where for travel insurance.  Can I get travel insurance while I have ITP?

I tried to read through the dense documentation on the insurance website, but that just made me more confused.  There was no information within the documentation about problems with a low platelet count, however, the insurance company seemed to be very concerned about my taking of immune suppressants.

My understanding was that I would not be insured for anything while traveling – Not because I had ITP but because I was taking immune suppressing steroids.

With that reasoning, I could jus stop taking my medication.  I could get travel insurance if I was not being medicated?  Sounds stupid! I am safer on the drugs (apparently)  Should I cancel my trip?

I called the insurance company and spoke to a real person about everything that was confusing me.  I learnt that with my insurance company ‘Teachers Health’, and many others, I would be covered for things such as accidents, car crashes and trees falling on my head.  I would be covered if my bag was stolen or I was mugged in the street.

I would not be covered for any medical expenses directly attributed to having ITP.  It was amazing to just call the company and explain yourself.  It was wonderful to have a real person explain all the details back to me.

‘Will I be covered for a broken leg, even if having ITP will make my broken legs a life threatening injury?’

‘Yes,’ he said.

‘Will I be covered for replacement medication if my bags are stolen, even if I only need to have the medication because I have ITP in the first place?’

‘Yes,’ he said.

‘Will I be covered for spontaneous internal bleeding for no apparent reason?’

No.

The most important thing, he said, was that I was telling the insurance company about my medical condition before I left.  I was registering with them that I had ITP.  He said that if I were to lie about having ITP, then my whole insurance policy would be void.

That means – If I did not tell my insurance company I had ITP before I left and I traveled to Indonesia and had my bag stolen with all my money, passport and identification – Boom – Void!!  I would have received nothing!  Cause I was a liar, and they hate liars.

Will my Medication be Covered while I Travel?

I was surprised and pleased to find out that any medication I needed to take on the trip would be covered by my insurance because it falls under the category of luggage/personal items/possessions.  So if I loose my script or my pills while I am over seas, my travel insurance will cover the cost to replace it in whichever country I am in.  Wonderful.

The best advice when looking for travel insurance that I can give, is to call them and talk to a person.  Offer each insurance company a few examples of potential problems and see what they say.  Since booking my trip, I have had great coverage and service from the Teachers Health Insurance Provider.

Has anyone had more  luck with Travel Insurance from Australia?

Keep reading about TRAVELING WITH ITP.  If you are super worried then you should read about how to manage FEAR WHILE TRAVELING with ITP.