Any benefits to taking prednisone 5 mg for long Covid symptoms ?

Posted by radapanich @radapanich, Aug 30, 2023

An immunologist in NYC who works with long Covid patients prescribed prednisone 5 mg for my long Covid 19 symptoms: brain fog, fatigue , joint and muscle pain. I am already on low dose naltrexone (LDN), aspirin 84 mg and statin Lipitor 10mg. She said that all of those drugs can be helpful to address , micro blood clots, chronic inflammation associated with long Covid. Does anyone have experiences with using prednisone 5 mg daily? She also mentioned antivirals like Paxlovid , but stated that there were side effects. A few people on the forum mentioned Adderal for fatigue ? Comments and thoughts greatly appreciated !

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I’m still not completely diagnosed. Though I’m RA positive now, I did not respond to treatment. We initially tried prednisone at 5 mg per day. I’m hyper sensitive, so I had to split the dose into 2. I’ve read that it can help with inflammation. It did not work for me, but we are all wired differently. I’m trying to get a physician who will prescribe paxlovid for the 15 day trial because my new arthritic condition responded to it so well even though it was used for covid. I was willing to try 5 mg of prednisone because it is a low dose. I’m in a Facebook group for people with autoimmune disorders and their goal is to get off of prednisone because of its side effects. But most of those doses were really high. It could give you some relief and if it doesn’t work, getting off of the low dose was not hard at all. I’m not a physician, but I gave it a try. I would try it. Lisa

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Doesn’t Prednisone weaken your immune system so you would be more susceptible to infections??

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The immunologist stated that prednisone 5 mg is a very low dose. It is not immunosuppressive at that dose, i.e. it does not make you more susceptible to infections. There is a huge range in doses, as high as 100 mg or more, for autoimmune conditions or following g organ transplants to prevent rejection, in which immunosuppressive doses are required. Update from yesterday: prednisone takes effect very rapidly. I took my first dose yesterday. Already today 24 hours later, I feel significant improvement in terms of muscle pain, joint pain, energy, overall well-being. Very low doses of prednisone are well tolerated. Of course, check in with your physician, if you are diabetic, pre diabetic or have other issues where prednisone is contraindicated. The immunologist I saw specializes in post acute Covid 19 syndrome. Fear of prednisone is so common that there is term “corticophobia”. People confuse low anti-inflammatory doses with high immunosuppressive doses which DO have serious side effects.

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To radapanich - a couple of months into my long covid journey, my PCP prescribed Medrol Pak for chest congestion & SOB. It’s a 5 day course of methyprednisolone where you take 6 tablets the first day and decrease it by 1 tablet every day. On the 3rd day, my blood pressure shot up to 190/100. By the time I got to the ER, it was 210/110. Scared me to death - afraid I was going to stroke out. I was trending toward hypertension anyway so now I’m on Amlodipine which controls my BP nicely. The ER doc said prednisone can elevate the BP but usually not to that extreme. Anyway, that was just my reaction to it and I wish I could take it again to help with my inflammation symptoms. So just monitor yourself carefully and good luck. Hope you feel better on it.

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@britelite

To radapanich - a couple of months into my long covid journey, my PCP prescribed Medrol Pak for chest congestion & SOB. It’s a 5 day course of methyprednisolone where you take 6 tablets the first day and decrease it by 1 tablet every day. On the 3rd day, my blood pressure shot up to 190/100. By the time I got to the ER, it was 210/110. Scared me to death - afraid I was going to stroke out. I was trending toward hypertension anyway so now I’m on Amlodipine which controls my BP nicely. The ER doc said prednisone can elevate the BP but usually not to that extreme. Anyway, that was just my reaction to it and I wish I could take it again to help with my inflammation symptoms. So just monitor yourself carefully and good luck. Hope you feel better on it.

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Medrol Pal at 6 tabs per day is 24 mg per day. Assuming that the Medrol was a 4 mg tablet, which is standard for Medrol Pak, that would be 5 x times higher dose than 5 mg . I am so sorry that you went through the frightening experience. I am glad that it resolved. Idiosyncratic drug reactions do occur and our bodies respond to drugs differently. Hopefully you will find a medication that works well for you. The post acute Covid specialist / immunologist advised using aspirin 84 mg, Lipitor (statin) 10 mg, an antiviral Paxlovid, prednisone 5 mg. The first two drugs are for control of possible microclots, one of the potential mechanisms of long Covid. She said that the antivirals do have side effects. I take Lipitor and aspirin anyway because I had a stroke previously, and low dose naltrexone 4.5 mg (a ordered by my PCP from Mayo pharmacy), which helped with brain fog. Best of luck with finding an effective treatment. Because primary care physicians may not be aware of all the ongoing research , be your own advocate, guide them (gently) toward studies and mention Mayo Clinic studies, which haven’t been published yet in medical literature.

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Interesting. I recently had a ruptured disc in my back and had to take 20 mg prednisone three times a day for a week
At end my back was fine BUT my long Covid GI symptoms disappeared!! After a year of nausea and stomach distress. After a year of pain and many trials of OTC drugs and doctors.
Just gone !! Has to be the prednisone. So there !!

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UPDATE: After seven days if very low dose prednisone 5 mg once daily, my muscle and John. Aches are 90 % better. I have more energy. The post extertional fatigue is much better. As stated above, it was prescribed by an immunologist who specializes in post acute Covid syndrome at Mt. Sinai hospital in NYC.

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@radapanich

UPDATE: After seven days if very low dose prednisone 5 mg once daily, my muscle and John. Aches are 90 % better. I have more energy. The post extertional fatigue is much better. As stated above, it was prescribed by an immunologist who specializes in post acute Covid syndrome at Mt. Sinai hospital in NYC.

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Do you mind sharing how long your physician plans to keep you on prednisone 5mg? I recently had great results on relatively low doses of steroids with a quick taper, but I’m wondering if a longer course at a stable dosage would be better. Thanks in advance, and I’m glad you found some relief!

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@jrvs2020

Do you mind sharing how long your physician plans to keep you on prednisone 5mg? I recently had great results on relatively low doses of steroids with a quick taper, but I’m wondering if a longer course at a stable dosage would be better. Thanks in advance, and I’m glad you found some relief!

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I too was prescribed low dose steroids for PASC. I took methylprednisolone bc of problems I have w Prednisone. It was a short tapering low dose which worked like turning an engine switch to 'on.' She prescribed refills to take as needed, based on criteria we discussed. This week, medical study publications stated low cortisol levels are a basic definitive finding in PASC (long COVID). So, a corticosteroid is the perfect treatment match for that particular problem. Tho, there are more w PASC. There now is the science to back the treatment.

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This week, medical publications reported a PASC study that confirmed low cortisol levels are a biomarker of Long COVID. So therefore supplementation is the medical treatment for that. Low dose is the protocol.

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