GLP-1 Drugs Effects on PMR

I started a GLP-1 called Wegovy soon after being referred to an endocrinologist who helped me taper off prednisone. Wegovy helped me lose about half of my Prednisone related weight gain. Now my endocrinologist is considering Zepbound for some "additional benefits."

I like my endocrinologist because I'm being educated about the effects that prednisone has on hormones throughout the body. I'm starting to learn how hormones control every body system. Hormones are an extremely complex area of medicine. My endocrinologist says prednisone has "profound effects" on the endocrine system.

I started seeing an endocrinologist when my cortisol level was too low for me to taper off Prednisone. Cortisol wasn't the only abnormal hormone level that was discovered. Now my endocrinologist is trying to restore my hormone imbalances back to normal. My endocrinologist said some things could have been done when I was still taking Prednisone. However, tapering off Prednisone is usually the "first step."

I once saw a panel discussion of rheumatologists discussing GLP-1 medications. They seemed to think they should be the ones prescribing GLP-1 medications since they were the doctors prescribing the most prednisone! I thought that was funny because I don't recall my rheumatologist ever being concerned enough to check my hormone levels.

Thanks, Mike. I always find your post fact filled with information and interesting. You didn’t comment, though on whether you thought taking the GLP-1 had any impact on the inflammation, pain and stiffness caused by PMR.

@christopherc

That gets complicated and I don't know the answer to that question. The way my endocrinologist explains it was hard for me to understand. I think obesity contributes to inflammation and prednisone caused me to be obese.

While Prednisone is effective at lowering inflammation, it is strongly associated with causing weight gain that leads to obesity. Prednisone exacerbates obesity-related metabolic issues. The relationship between these factors is complicated. Obesity often requires higher doses of anti-inflammatory steroids, which in turn can lead to further weight gain and metabolic syndrome. My endocrinologist says all of this is hormone driven. He has consistently said "preventative measures" should have been taken if I was going to be on Prednisone for a long time. I did have preventive measures after having other side effects from prednisone but nobody cared too much about my hormones.

It sounds better when my endocrinologist says I have Prednisone induced metabolic syndrome.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9772659/
---------------------
I struggle with being called obese. It depends on what angle you see me from. I just have a large belly and everything else is skinny. I'm starting to get some muscle tone back and that might help my metabolism. On my medical problem list it now says "obesity-non specified" whatever that means but I blamed prednisone. Now that I have been off Prednisone for 5 years, I take personal responsibility. However, my endocrinologist says it still isn't my fault and some of it might be irreversible.

Don't ever believe anyone who says prednisone side effects are easy to manage when you know how. The truth of the matter is --- nobody knows how.

Last week I asked my board certified rheumatologist about GLP-1s to help me lose the weight I have gained from prednisone (83 year old male, 6 feet tall, now weigh 250 lbs). He said that there was no reason not to take GLP-1s and that Zepbound seemed to be the best among them for PMR patients. I hope to start Zepbound in two weeks and would welcome reports from those who have tried it.

I’m hoping for your desired results. After you’ve been on Zepbound please let us know if it appears to have helped with your PMR pain and or stiffness.

@dadcue I started zepbound one year ago and the benefits have been amazing in many ways. It has helped reduce my inflammation markers. It has helped my CPAP numbers to less than 1 event per hour. It has reduced my tooth plaque by about 75%. It has helped my feeling of being in control of a healthy diet not tempted by sight or smell or thoughts of my past craves. It has let me make time for other crafts I like. And also plan healthy meals. The only negative which I can manage is it slows down the colon digestion process so I need to careful with constipation issues. Less weight less to carry around so some less pain. But I still have PMR issues but easier to manage those also. My cardiologist my pulmonologist my internist my rheumatologist all gave it a thumbs up. I’ve lost 45 pounds and I’m 78 and I could lose another maybe 10. So far I’m satisfied with the zepbound - the only negative so far with my combination of medication is the Actemra; my cholesterol went up from normal to 315. But I’ll work on that. I do not want to take statins. If anyone knows anything about Repatha please let me know as my cardiologist has recommended this. Thank you all. ☺️

@randersonccc

I'm so happy to read this. It validates some of the positives I have experienced since I tapered off Prednisone. I worked my way up to Wegovy with some other medications that I no longer take. That is why my endocrinologist wants me to try Zepbound for "additional benefits."

All of the things you described happened to me after Actemra allowed me to taper off Prednisone. My cholesterol level decreased when I was on Actemra alone. I took a atorvastatin for 10 years when I was on Prednisone. When Prednisone was stopped my cholesterol level was too low. My rheumatologist stopped atorvastatin because my CK level was increasing so he was worried about statin induced myopathy. My cholesterol level came down so much that I don't take atorvastatin anymore. I have also stopped 3 blood pressure medications!

I need to lose more weight. I call the extra weight the last bastion of my Prednisone side effects.

I still use CPAP some nights but not every night. I don't have the dreams where I can't breathe anymore. I doubt that I need CPAP.

@Thanks for the reply and all the information. I’m glad to hear that outbound has done so many great things for your health. It does sound like a miracle drug. Hopefully you and others taking it will be able to report significant reduction on the inflammation pain and stiffness caused by PMR enabling people to get off of prednisone and stay off it.

Hi @randersonccc, my cholesterol went up with Actemra to 278 and I managed to get it down by about 40 points but my cardiologist put me on Repatha because I can’t take statins. My cholesterol is now testing normal after just 3 injections. I have not had any side effects so far and will pray the same for you! ❤️

@randersonccc I tried three different statins but all caused a lot of pain so switched to Repatha. It worked like a dream but I had to stop because United Healthcare stopped covering it.