Prednisone and cholesterol levels

My GP had me on a statin from the very beginning after prednisone was started. As far as I recall, my cholesterol numbers were never elevated before being on prednisone. I took a statin for at least 10 years while being treated with prednisone for PMR.

My cholesterol numbers were all over the place while I took the statin. In general, my numbers were borderline high most of time. Stopping the statin was never considered until I came off prednisone.

When I was off prednisone, my rheumatologist was worried that my CK level was too high in conjunction with my total cholesterol level being too low. My rheumatologist was concerned about statin induced myopathy.

"Statin-Associated Muscle Symptoms
SAMSs are by far the most prevalent and important adverse event, with up to 72% of all statin adverse events being muscle related. These can present as myalgia, myopathy, myositis with elevated CK (creatinine kinase)."

My rheumatologist stopped the statin but my GP restarted the statin when my cholesterol level got too high. This went back and forth a couple of times until my rhematologist deferred to my GP to manage of my cholesterol level. My CK level remained elevated but showed a slight improvement when the stain was stopped.

My GP eventually reduced my statin dose to next to nothing. The conclusion being that I was very sensitive to statins so I didn't need much.

My HbA1c was borderline while on prednisone. My GP didn't think it needed to be treated but considered starting Metformin once or twice. My GP just encouraged me to exercise more and watch what I eat.

An endocrinologist intervened after I got off prednisone when I was being evaluated for adrenal insufficiency caused by long term prednisone use. My endocrinologist checked my insulin level and it was very high. My endocrinologist said I should have been on Metformin the entire time I was taking prednisone because it helps to prevent insulin resistance. Overall, my endocrinologist was worried about prednisone induced metabolic syndrome. My endocrinologist stressed that diet and exercise will help the most.

"Clinical observations have linked excess glucocorticoid levels with profound metabolic disturbances of intermediate metabolism resulting in abdominal obesity, insulin resistance and dyslipidaemia."

The following link discusses this topic.
https://www.frontiersin.org/articles/10.3389/fendo.2020.00059/full
Maybe just read the discussion at the end of the link.

Yes, 3 different type of my Cholesterols went way up since I started taking Prednisone. Cholesterol went from 161 to a 255 LDL went from 71 to a 146 and non HDL went from 89 to a 158. Also my Glucose went from a 70 to a 124.

I was on 10mg pred for PMR from Oct. 9 until February 23rd when I was increased to 40mg due to GCA diagnosis. I have seen my BP alarmingly increase from my normal 110/60 to an inconsistent 180/90 range! Also, my Cholesterol has been trending upward. My recent bloodwork April 20 shows a total Cholesterol of 320! However; my manual BP that day was 110/60- I did say the elevated BP is inconsistent. My research shows that prednisone can cause increased BP as well as elevated cholesterol. My PCP has ordered a Cardiac Calcium Score CT. I am tapering my prednisone now that I am on the Tyenne autopen injections and am now down to 15mg. Also with my recent bloodwork, my ESR and CRP are down to 1 and 2 respectively! I am so pleased that it appears the Tyenne is working for me so far (2 injections) and 1 Actemra infusions prior to the Tyenne.
Like many of you, I have an am weight routine 5-6 days per week and yoga practice 3-4 nights. I have been a vegetarian that eats dairy and fish since 1979. I also avoid all refined sugar, no carbonated beverages, no fast food since 1979. I am 66yo, 5'5" and weigh 109#.
I pray all of us on this autoimmune disease wild mouse ride will find the best Rheumy and be our own self educated advocates. This Mayo Clinic Forum is a great blessing! Thanks to all who share and respond!

Don't let anyone brush off an "inconsistent" blood pressure of 180/90 when your normal is 110/60. I had the experience of getting a reading of 210/110 on my home blood pressure machine. I thought my machine malfunctioned so decided to check it again at the hospital where I worked. I asked a nurse to check it and the 210/110 I got at home was accurate. I was taken to the emergency room and the triage nurse got the same reading. I was hooked up to telemetry with every 15 minute blood pressures. It took maybe an hour for my blood pressure to drift back down to my normal 120/80.

A doctor came in and asked me what I was doing to get the high blood pressure readings. I tried to explain that my primary care doctor wanted me to check my blood pressure more frequently because of an abnormal EKG. The emergency room doctor suggested that I not check my blood pressure so often because that was causing me to have anxiety and sent me home. I'm a calm person and it takes more than a high blood pressure reading to make me anxious.

My primary care doctor got a report and wanted me to have more testing done. Another EKG showed that I had left ventricular hypertrophy (LVH) which is usually caused by chronic high pressure.
https://www.mayoclinic.org/diseases-conditions/left-ventricular-hypertrophy/symptoms-causes/syc-20374314
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My blood pressure was labile on Prednisone ... 210/110 sometimes and 120/80 the next. A cardiologist said my blood pressure wasn't being regulated well because of prednisone and started me on 3 blood pressure medications.
https://www.drugs.com/medical-answers/prednisone-raise-blood-pressure-3562473/
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I wound up taking atorvastatin for 10 years for similar reasons related to my cholesterol level. It took me 12 years to get off Prednisone which was when Actemra was tried. Now I'm off prednisone, off all my blood pressure medications and off atorvastatin.

I hear you, and appreciate you. I have learned so much from your research posts. You have had a rough go with the prednisone.....12 years, I can't imagine.
Thank you. I'll post my Cardiac Calcium Score results. I wonder if elevated triglycerides has been observed in others on our forum?
Another discussion.
Godspeed.