Prednisone and cholesterol levels

Posted by jth4d @jth4d, May 14, 2020

My cholesterol has shot up since taking prednisone. Has anyone else experienced this? My triglycerides are really high. I haven’t gained weight. I exercise/walk. My diet is low carb…no desserts, mostly egg whites, vegetables and protein. I have a small glass of wine with dinner…I can stop that. I have heard 3 tsp of Metamucil can lower cholesterol. Currently I am taking 15 mg of prednisone daily and my inflammatory markers have returned to normal. Will this resolve itself when I am on a really low dose?

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Is your blood sugar elevated as well? Prednisone can raise blood sugar, which in turn can raise triglcerides, which can raise total cholesterol. I would check with your primary care physician and have them compare current lipid profile and blood sugar with one taken before you started prednisone. I worked as a dietitian for 30 years before retirement and knew some things to try, but needed more info than total cholesterol.

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A blood sugar was not part of the exam. I have asked if it were possible to check that. My ratio has always been good, but this result doesn’t include that…I don’t understand why. Thanks for your help.

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Was it a fasting sample? Looks like all the change was in triglycerides and VLDL (which are high in triglcerides). Looks like your HDL is great and your LDL hasn’t changed. Prednisone can raise blood sugar.

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@virginiaj

Was it a fasting sample? Looks like all the change was in triglycerides and VLDL (which are high in triglcerides). Looks like your HDL is great and your LDL hasn’t changed. Prednisone can raise blood sugar.

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I believe prednisone has caused my blood sugar to rise to tipping over into pre diabetic level. Can't be sure of course but seems too much of a coincidence to be otherwise.

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@virginiaj

Was it a fasting sample? Looks like all the change was in triglycerides and VLDL (which are high in triglcerides). Looks like your HDL is great and your LDL hasn’t changed. Prednisone can raise blood sugar.

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No the sample was taken in the afternoon

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I’d ask your primary physician if you could get a fasting blood sugar and fasting lipid profile. Triglyceride and blood sugar levels change all day long.

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@jth4d, I agree with @virginiaj. My Mayo primary care doctor always does my annual labs with a fasting blood sugar and fasting lipid profile. I have to limit the types of food I eat for my previous evening meal and eat nothing after 7 pm. They usually schedule my fasting labs first thing in the morning so I can eat afterwards. Here's some information I found that may be helpful.

Cholesterol test: https://www.mayoclinic.org/tests-procedures/cholesterol-test/about/pac-20384601
Eating to Lower Triglycerides (PDF): https://www.uwhealth.org/healthfacts/nutrition/361.pdf

I stopped drinking all alcohol due to other health problems and it is one of the things that can raise triglycerides and sugar levels.

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What’s your experience? Do your physicians approach prednisolone triggered elevated cholesterol with diet & exercise OR do they push the cholesterol numbers down with drugs (statins) OR ???????

I’m tapering down from 40 mg/day prednisone for erythema nodosum. If my body allows, I should be off the prednisone sometime in May.

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Here's cholesterol numbers:

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Your HDL looks great, but the triglycerides are very high.

I read that, in general a sign of good metabolic health is a ratio of triglycerides/HDL less than 2.

After I reduced my sugar and process carb intake to very moderate levels, my blood work showed marked improvement in this ratio. (In my case, the HDL went up about 50%. My triglycerides were already low).

Unfortunately, I understand prednisone raises blood sugar, which also then tends to raise triglycerides.

Walking, even just 10-15 minutes, after meals can really help lower blood sugar, and may help.

I've seen personal measurements where people lower their blood sugar levels by 20 mg/dL after just 20 minutes of walking, which is very significant.

I agree with the other commenters that a fasting lipid panel and fasting blood glucose would be revealing.

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