How long do prednisone side effects last? Is it months, days, or years?
Each side effect lasts a different amount of time, and depends on the dose, the duration of prednisone use, and your underlying condition. In this article, find out what factors to consider in determining how long to expect side effects to last.
The real question is: when am I finally going to feel better? What am I going to feel like myself again?
The Story of Admiral Stockdale
To help understand the concepts I will explain about how long prednisone side effects last, first I will share the story of Admiral Stockdale. He was a very high-ranking officer in World War II and a Naval Admiral. He was captured by the Japanese and they tortured him over 20 times. 20 times! Admiral Stockdale was in concentration camps for eight years. It was terrible.
In this book, Good to Great, the author, Jim Collins, interviewed Admiral Stockdale to understand how he could survive that much torture and come out to tell the tale. So I want to read directly from this book just one snippet because it tells it way better than I ever could.
“I never lost faith in the end of the story,” he said when I asked him. “I never doubted not only that I would get out, but also that I would prevail in the end and turn the experience into the defining event of my life, which, in retrospect, I would not trade.”
I didn’t say anything for many minutes, and we continued the slow walk toward the faculty club, Stockdale limping and arc-swinging his stiff leg that had never fully recovered from repeated torture. Finally, after about a hundred meters of silence, I asked, “Who didn’t make it out?”
“Oh, that’s easy,” he said. “The optimists.”
“The optimists? I don’t understand,” I said, now completely confused, given what he’d said a hundred meters earlier.
“The optimists. Oh, they were the ones who said, ‘We’re going to be out by Christmas.’ And Christmas would come, and Christmas would go. Then they’d say, ‘We’re going to be out by Easter.’ And Easter would come, and Easter would go. And then Thanksgiving, and then it would be Christmas again. And they died of a broken heart.”
Another long pause, and more walking. Then he turned to me and said,
“This is a very important lesson. You must never confuse faith that you will prevail in the end—which you can never afford to lose—with the discipline to confront the most brutal facts of your current reality, whatever they might be.”
Relating it to Prednisone
So it is with prednisone. Prednisone is its own special type of torture. Prednisone is a miracle. It saves lives. It saved mine, but it is its own special type of torture because it comes with so many side effects!
And so the question is: when are you going to feel better again?
How long do these prednisone side effects last? I usually get these timing questions about three topics:
- Mental/Psychiatric side effects: when is the anxiety from prednisone going to go away?
- Adrenal: when is my adrenal system going to return after prednisone?
- Weight: when is my moon face or weight gain going to disappear after prednisone?
Before I can answer those questions, first we need to understand that there are factors that come into play. Then I will cover each of those topics in depth.
Factors that Affect Side Effect Timing
1. Prednisone Dose
First of all, the dose. What dose you’re on, depends on how bad those side effects are. It can kind of affect how long they’ll last. If you’re on really super high doses of prednisone it might last a really long time because you have to slowly get back down (taper).
Whereas if you are only on a slow, steady, low dose, your body is a lot closer to its normal cortisol levels and it can sometimes recover faster.
2. Duration: How Long You Take Prednisone
The other thing that matters is how long you’re taking it. So if you’re just taking it for five days, you’ll probably recover pretty quickly.
Some side effects do last a long time, even if you only take it for five days. Because one key thing to understand is there is no dose too low or time too short to be on prednisone for there to be no side effects. Your doctor might be saying, “oh, you’re only on it for five days. You won’t have any side effects.”
And that’s just not true!
There’s too much evidence showing that even one dose causes side effects.
Some side effects last a really long time. A few are permanent and irreversible. Some side effects go away as the dose goes down.
Which side effects are permanent and irreversible? Which prednisone side effects just don’t go away immediately?
Those are just some of the examples.
Read more about Irreversible Prednisone Side Effects
Now that we understand the dose and duration effect, we will turn to answering the most common questions about how long prednisone side effects last.
1. Mental Health Side Effects
First of all, we’ll talk about mental health. Usually the higher the dose, the more likely you are to suffer mental health side effects like anxiety, depression, paranoia, and just really not feeling like yourself at all.
Because it’s not you. It’s the drug!
You’re not crazy. It’s just the drug.
Usually the lower the dose, the less of that kind of a side effect you have.
When will the anxiety from prednisone go away?
Often the anxiety goes away quickly, within a few days of stopping prednisone. But sometimes it takes weeks, months, even up to a year for the anxiety to go away.
When will the steroid dementia from prednisone go away?
Often just stopping the prednisone is enough to stop the steroid dementia. Usually it’s really fast. But there are case reports that it can take up to a year for the steroid dementia to go away after you stop taking prednisone.
Read more about Coping with Mood Changes from Prednisone. Or watch me explain the psychiatric side effects of prednisone below.
2. Adrenal Gland
Second is your adrenal gland. Prednisone is replacing your cortisol that communicates with your adrenal cortex, right above your kidney, to your hypothalamus in your brain. It’s that signal; it’s all being interfered with by the prednisone.
Usually, in most people, that signal starts to catch up and kicks into place the lower you go; the closer you get to 2.5 milligrams, the more it’ll just kick in. For 90% of people, it just kicks in once you’ve tapered really slowly.
But for some people, it never kicks in and that’s called adrenal insufficiency.
For the 90% mentioned, when does the adrenal system it kick in?
Usually, it’s within a week or two, after going down to 2.5 milligrams and then off, it’s usually pretty quick that it comes back. But for 10% or maybe 1% (somewhere in that range, nobody really knows) it doesn’t kick back in.
If you have adrenal insufficiency from prednisone, it can be requiring you to be on prednisone for life. I know–it’s terrible!
What to watch out for is prednisone withdrawal syndrome symptoms! You’ll feel like you’ve been run over by a bus. You will experience joint pain, achy, nausea, weight changes, insomnia, and a lot more!
Read this article to understand Prednisone Withdrawal Syndrome better.
3. Moon Face and Weight Gain
Moon Face: When Does it Go Away?
To understand how this happens, the moon face occurs when you are taking prednisone and prescribed to take it at a higher dosage. The higher the dose, the rounder face. The lower dose, the moon face starts to go away.
- Higher dose = Rounder face
- Lower dose = Moon face starts to go away
For example, if you’re on a really high dose of prednisone and your face gets puffier as time goes by and it will usually go away once you’re below 10 milligrams or 5 milligrams.
When you go off prednisone, it’s usually gone! But for some people, it takes longer. It’s really dependent on each person. For some people, it takes a couple of months after you stopped taking prednisone for the moon face to go away.
The weight gain caused by prednisone goes the same way. The higher the dose, the more weight gain. The closer you get to normal cortisol levels, the less weight gain there is.
As my doctor told me, weight gain it doesn’t just disappear when you stop taking prednisone. It’s real weight. Those are real pounds. They don’t just fall off when you stop taking it!
You have actually have to lose the weight! Whatever you’ve done in the past, whatever it takes is what you need to do to lose it.
Prednisone Diet Options
You can try the keto diet, whether it’s intermittent fasting, whether it’s paleo, whether it’s whole foods, plant-based, whether it’s one meal a day, whatever you have found that works for your health conditions, and your diet type.
Good news: most of those side effects (the top 3 above: mental health, adrenal, and weight) go away once you’re off prednisone.
But there are a few that are irreversible! And the one that I want you to know about the most is osteoporosis, because it’s not talked about enough.
4. Prednisone Osteoporosis
Osteoporosis is when your bones are thin and brittle and they can break and make you hunch over! Did you know that in the span of 1 to 3 months on taking prednisone you are already experiencing bone loss? The amount of overall exposure to prednisone increases your risk for osteoporosis.
You need to be taking calcium and vitamin D every day while on prednisone. The reason is you need to build back up the bone mass to avoid breaking your bones.
You do not want to be breaking bones when you’re way too young, right? You don’t want to look hunched over like my old grandma before your time. So be sure to be taking calcium and vitamin D every day, according to the doctor’s guidelines.
Introducing Nutranize Zone
Based on my experience taking prednisone, I created this product called Nutranize Zone.
It has calcium and vitamin D and the other nutrients that prednisone steals. I designed it to reduce your suffering by replenishing your nutrients so that you can recover from prednisone.
So if you take this with prednisone, you fight back against how prednisone is stealing calcium and vitamin D. You’ll follow those evidence-based guidelines from rheumatologists, and you’ll be giving your immune system the best chance possible!
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