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How Prednisone Side Effects Change 9+ Blood 💉 Tests

How Prednisone Side Effects Change 9+ Blood 💉 Tests

How does prednisone change your blood? 💊🩸 Prednisone changes at least 9 blood tests. See examples from my own actual lab results. Learn how prednisone makes these changes and what this means for your health. In this article, I am going to show you how my blood tests and lab values changed while on prednisone which may correlate to certain side effects.

Which Blood Tests & Lab Values Does Prednisone Change?

  • Sodium
  • Potassium
  • Calcium
  • Blood Glucose
  • Protein
  • White blood cells
  • Neutrophils
  • Eosinophils
  • Platelets

If you’ve already been following me for a while you may have seen the nutrients which are depleted by prednisone as shown below. It shows that prednisone depletes calcium, chromium, and other vitamins. We’re going to focus on a few of those and show how prednisone changed my personal lab values.

Prednisone Nutrient Defeciency

Two Types of Labs

You’ll see some of the results from two types of lab tests I received. First is CMP, which stands for Comprehensive Metabolic Panel, showing the electrolytes and other nutrients floating around in the blood. The second is CBC, which stands for Complete Blood Count, showing the numbers of each of the different cells in the blood. I only included results that showed a significant change; the rest of the lab results from those two tests remained the same.

High Sodium from Prednisone

  • Bloating
  • Water retention
  • High blood pressure

The first lab value changed by prednisone is sodium which is also known as salt. High sodium causes bloating and water retention, which leads to high blood pressure. High sodium is also known as hypernatremia. The normal range of sodium is 137 to 146. You can see on my lab result that my sodium is technically in a normal range.

That might be true for some of these other labs that you’ll see going forward, that the lab result is technically within the range of normal, but it’s not my normal! It’s definitely not my optimal level.

You can see in the chart before I took prednisone, before 2017, it was lower. And after I took prednisone, the numbers drop off or back to normal.


You can see in red the time when I used prednisone. The “S” on the sodium chart during that time shows that sodium shot way up. And then while I was on chemo is where that big dip happened in April 2018.

What we learn from this is that sodium is retained. We hold on to sodium while we’re on prednisone. Sodium levels go higher while on prednisone.

Low Potassium from Prednisone

  • Cell fluid
  • Nerves
  • Muscles
  • Kidneys

Another lab value changed by prednisone is Potassium. Prednisone causes low potassium, also known as hypokalemia.

Nutrients Depleted by prednisone

Because the sodium is going up, prednisone causes your potassium to go down and potassium is really important all over your whole body, from the heart, to inside cells, to muscle contractions. The normal range of potassium in your blood is 3.5 to 5.

You can see my normal is hovering around 4.0 before I took prednisone. And after I took prednisone, it was up in the fours, but right there in November 2017, while I was in the highest doses of prednisone, that’s when the potassium levels were the lowest.

So we need potassium-containing foods while on prednisone. (Unless you have kidney problems: then you need to be careful and work with your doctor closely to ensure your potassium stays normal).

How Sodium & Potassium Link Leads to Survival

Sodium and potassium are linked. So whenever sodium goes up, potassium goes down. At least that’s what’s supposed to happen with our kidneys monitoring each of them, causing the potassium drops.

This makes sense because our bodies normally produce cortisol from the adrenal gland, which is right on top of the kidneys (the renal organ). Prednisone is replacing our body’s normal secretion of cortisol. Cortisol normally directly affects the kidneys, causing high sodium and low potassium.

Cortisol is normally only released when we are under extreme stress, such as being attacked by a tiger. These changes directly lead to high blood pressure, which is helpful when we need to run quickly from a tiger. However, high blood pressure long-term is harmful and one of the top side effects of prednisone. High blood pressure can lead to heart disease, which is one of the irreversible side effects of prednisone.

Low Calcium from Prednisone

  • Bones
  • Teeth
  • Heart contraction

Calcium is the next lab value prednisone affects, leading to low calcium or hypocalcemia. As you know, calcium is very important for bones and teeth, for muscle contraction–especially for your heart. The normal range for calcium is 8.4 to 10.4.

My calcium levels did remain in the normal range here, but not my normal. My normal is in the higher nines and it falls to the lower nines when I was on prednisone. Prednisone caused my calcium levels to decrease to suboptimal levels.

how prednisone affects calcium level

Why does low calcium matter?

It matters because calcium is being decreased. Calcium is the #1 nutrient that we should pay attention to when on prednisone. The depletion of calcium directly leads to osteoporosis. Since prednisone is the #1 drug that leads to osteoporosis, this is a big problem.

That’s why the American College of Rheumatologists recommend that everyone taking prednisone to be on calcium and vitamin D.

I knew that in a “textbook way” that prednisone depletes calcium. But I didn’t realize that this was completely true for me, personally: that my own blood calcium had dropped. I knew this fact from school but did not really know it from my own personal experience. It showed up in my own medical record that prednisone is depleting calcium.

It really astonished me the first time I looked back. “Oh my goodness, I do truly have evidence of having low calcium while being on prednisone.”

To cope with prednisone depleting calcium, my body really made up for that lack by pulling calcium out of my bones. Prednisone also made my kidneys pee out calcium, blocked my gut from absorbing it, and all of those ways prednisone depleted calcium that I’ve explained further in this article.

Find out more in the one called the Silent Side Effect of Prednisone – Osteoporosis.

This is why it’s very important that you take calcium while on prednisone.

High Glucose from Prednisone

  • Energy
  • Requires Insulin
  • Metabolism

Glucose is probably the next most important lab value changed by prednisone. Those previous lab values above were nutrients and minerals and now we are switching to other lab results.

This lab result often shows up on your lab results as “Gluc” and which means your blood sugar. Prednisone usually causes elevated levels of blood glucose, also known as hyperglycemia.

how prednisone affects glucose level

Normal values of blood glucose are less than a hundred. This is showing between 70 to 100. I don’t have diabetes and I don’t have any reasons why my blood sugar would be high. I wasn’t sick–that would be another possible reason that my blood sugar would go up. My diagnosis is just a bleeding disorder. I didn’t have an infection.

I don’t have high blood glucose for any other reason. The only reason that it is possible because I took prednisone. And so you can see that this is completely legitimately a high value. Above 100 is high. For all of my pregnancies, I passed the glucose tolerance test just fine, and didn’t have diabetes while pregnant either.

So even when I was on heaviest, my body could handle glucose. My insulin was adequate. Only while I was on prednisone did I have high glucose.

So, what does this mean?

Having high blood glucose is what leads to weight gain.

This is the #1 problem that people complain about while on prednisone. So we really need to do whatever we can to keep our blood glucose steady especially cutting out refined sugar, like table sugar or any food that comes in a box. Just cut those things out of your diet.

Low Total Protein from Prednisone

Prednisone is mimicking cortisol, a catabolic hormone in our bodies. That means prednisone breaks down muscles and bones to have the fuel to survive right NOW, this emergency moment, of running away from a tiger. But that’s not good long-term. When the muscles break down, you can see it on my labs as low protein. If you’d seen me while I on high-dose prednisone, you might have noticed my skinny arms and legs, especially in contrast to my round face and belly.

Immune System

Next, we are going to talk about the immune system, as shown by lab results from the CBC. A lot of people take prednisone because there’s something going on with their immune system. They might have an autoimmune condition where their immune system is attacking their own body and that’s what happened to me.

I took prednisone for a bleeding disorder called ITP because my body was attacking my own blood cells. Prednisone causes your blood results to look like the image below.

A purple-colored painless lesion on my arm called purpura, the “P” in ITP.
Dr. Megan on her prednisone journey

High White Blood Cells from Prednisone

White Blood Cells (WBC) is another lab value changed by prednisone, and like glucose, prednisone makes WBC go high. The normal range for WBC is basically less than 10, and high WBC is also known as leukocytosis. You may notice that over and over again my WBC was above 10. So my WBC was very high and normally if you have that high of lab results that means you have an infection.

White Blood Cell during prednisone

If the doctor is concerned that you have an infection, he will test your blood. If your WBC is high and you have a fever, then you might have a bacterial infection, so they might prescribe antibiotics.

But in this case, you’re on prednisone. Your immune system is being hijacked. Having these high white blood cell counts doesn’t mean that you have an infection.

Why are my White Blood Cells so high?

It’s because of neutrophils. When analyzing your lab results, your doctor will move on from WBC to neutrophils and figure out that it’s not actually an infection.


how prednisone affects neutrophils

These are a type of white blood cell and prednisone is causing them to not be as sticky as they normally would be. Neutrophils usually hold onto endothelium, the inside of your blood vessels. Normally they hide and are not showing up in your blood count because they’re stuck to the sides so they’re not floating around.

Whereas prednisone makes them so they don’t stick. Those little tiny baby neutrophils will float around in the blood which is not normal. These extra, immature neutrophils make your white blood cell count look high.

So in my lab result, you would see that the neutrophils are so high–way more than the average which is 6.8.

Interestingly, you can follow my prednisone tapers. When neutrophils were high, so were my prednisone doses. When the neutrophils dropped back down, it followed the lower dose of prednisone my doctor prescribed in the taper. Just check out that roller coaster of prednisone doses I endured!

Low Eosinophils from Prednisone

These are another type of immune cells. Eosinophils are often really high for the people who have a certain type of allergies like asthma or atopic dermatitis (eczema). This will also appear in your lab value result. If they take prednisone it makes their eosinophils drop, which is great!

However, taking prednisone means a risk for experiencing side effects. There are some great drugs that came out that basically target the eosinophils if it is high, which might be a good alternative if this is why you are taking prednisone.

how prednisone affects eosonophils

High Platelets from Prednisone

Finally, we get to see my story, the reason I took prednisone. Platelets are one of the lab values changed by prednisone. A normal range is 150 to 400. At my diagnosis, it shows below 3 platelets out of 150! I was about to bleed to death. If I got into an accident on my way to the hospital they wouldn’t be able to stop me from bleeding and I would have just died. Thankfully, I made it to the hospital just fine. They gave me the news that I going to stay there for a week because they diagnosed me with an autoimmune condition called ITP.

how prednisone affects platelets
how prednisone affects platelets

So they started me on prednisone in the hospital. You can see below my platelets crashed each time they took the prednisone away.

The doctor gave me super high doses and then slowly take them away. Then we restarted at a higher dose, going over the roller coaster again, and I would get down, tapering my dose on prednisone and then, BAM! My platelets would crash! They would drop way below normal over and over and over again.

how prednisone affects platelets

Almost 9 months of trying prednisone to keep my platelets up… Each time it basically got worse; my body stopped responding to prednisone. They had to restart at higher and higher doses each time. Eventually, I had to resort to chemotherapy.

how prednisone affects platelets

The chemotherapy designed for blood cell cancers they prescribed is called rituximab (Rituxan). It stopped my immune system from killing my own platelets. Each time that I would have chemo is represented by the little green dots. My doctor told me I had a 1 in 3 chance it would keep my platelets up for a full year. Thankfully, I reached one full year! I’m officially beyond that first benchmark.

From year 1 on out, I have an ongoing 1/3 chance it will be a permanent cure for the rest of my life. Back in April 2018, I had a 1 in 9 chance of being cured. I’m hoping that it will last forever and I will never have to go back on prednisone again.

The chemo worked and I have tapered off of prednisone! Chemo is what made me better and pulled me into remission. Check out my normal platelets below.

platelet levels while on prednisone

People who don’t have platelet disorders can also have high platelets while on prednisone. It’s not unique to me to have high platelets because that can happen to you. You could also have low platelets from prednisone.

Many things with prednisone are like that. You can have high or you can have low types of the same side effect. For example, possible side effects include both high blood pressure and low blood pressure (but not at the same time).

Finding Answers to Prednisone Problems

Following my lab results gave me answers to many of the questions I had. I wanted to know:

  • Why I felt hungry all the time? It’s because I had high blood sugar and insulin resistance.
  • Why I felt bloated? It’s because of high sodium.
  • Why my legs and arms got skinny? It’s because of low protein.
  • Was prednisone really causing me osteoporosis even in my 30s? Yes, I had low calcium.

How often should I check my blood?

I recommend having your blood tested at least once a year while at the very least while you’re on prednisone. Just to ensure there’s nothing out of whack. Find out all the things that need to be checked while you are on prednisone with the Prednisone Checklist.

Free Prednisone Checklist

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Get in The Zone

This all started when I was a young mother taking high doses of prednisone trying to overcome my autoimmune condition that was flaring so bad I was dripping blood onto the floor when they had to check my labs.

I really wanted to stop suffering prednisone side effects so I wouldn’t have to stare at the ceiling for one more night.

I wanted to be able to just take a nap so I could recover and I could have the energy to play with my children again.

The thing is I was taking high-dose prednisone along with chemo and the combination made me have terrible insomnia. That meant I wasn’t able to just take a nap so I could recover, let alone have the energy to play with my children again.

To make things worse, I felt terrible because I was always irritable and exhausted from not sleeping. I felt even worse about the situation because it was making me cranky and miserable to be around and my kids were afraid of me. I felt like there was no hope of ever feeling like myself again.

The problem was that I was taking prednisone and spent all day the day before getting chemotherapy at the infusion center. My husband had to sleep in another room because I had such bad insomnia from prednisone, which meant that even when I laid down with my toddler to take a nap, I was exhausted but still couldn’t sleep.


Then, as if by chance, something amazing happened…

That’s when I had an epiphany while staring at the ceiling, failing to fall asleep, all about prednisone side effects and the nutrients involved in causing them!

It was now crystal clear to me how to make the good effects outweigh the side effects of prednisone, because I saw even if I had to take prednisone forever, I had a way to not be miserable the whole time.

I also learned that you don’t just have to suffer while on prednisone, you need to give back the nutrients that prednisone steals instead.

As a result I created this business to help people suffering side effects.

balance in prednisone with nutranize

After I did that, I started having hope that I wouldn’t be miserable forever.

Suddenly, I was recovering from chemo and prednisone and my autoimmune condition went into remission! Plus now I had motivation from a mission that could change the world.

That’s when I realized that the secret to not suffering so much from prednisone side effects was that nutrient depletion causes side effects.

My plan was to start researching all I could about prednisone side effects and nutrient depletion.

So I started asking pharmacist and doctor friends to login to paid databases and send me the actual studies so I could read them myself. But I didn’t stop there.

I then compiled a list of all the side effects of prednisone and which nutrients were related.

After that, I created a special formula of nutrients to give back these nutrients prednisone steals.

But there was still a problem…

I wanted to make it myself using my skills as a pharmacist, since I had made many thousands of capsules in a specialized compounding pharmacy. Then I realized how complicated the regulations for dietary supplement manufacturing are, from testing the individual powders, to blending them, to testing the final product.

I ended up getting so frustrated that I decided to have someone make it for me instead. I spent months interviewing manufacturers until I found the best supplement manufacturer in the industry with the highest standards for quality and used pharmaceutical-grade ingredients. They created the actual bottles filled with capsules of my formula to make my dream a reality! The first and only supplement for people on prednisone was done.

I chose to call it “Nutranize® Zone™: neutralizing the negative through nutrition.”

I thought if I could create something that would make it possible to take prednisone but have the good effects outweigh the misery, I’d be really happy.

After exactly one year from my epiphany until the manufacturer finally shipped the final product, I launched Nutranize Zone.

I can now give back the nutrients that prednisone steals so that whenever I’m stuck on it again (whenever my autoimmune condition flares again) I can feel confident that I’m going to be okay and not suffer so much.

Then I started to let other Prednisone Warriors use Nutranize Zone.

As a result of all this I was able to achieve the following:

  • published over 100 YouTube videos and blog articles with tips of how to overcome side effects
  • created the first and only supplement for people on prednisone that replenishes the nutrients that prednisone steals
  • help people on prednisone finally feel like themselves again
  • hundreds of prednisone warriors have reduced their suffering by replenishing their nutrients so that they can recover from prednisone

After creating Nutranize Zone, I was not only able to use my doctor of pharmacy training to really help people feel better and not just be stuck behind a pharmacy counter counting by fives, I’ve also been able to stop worrying about my autoimmune condition coming out of remission, because I now know that if it does and I have to take prednisone, I won’t suffer like I did before.

When I was researching to make this dietary supplement called Zone, I knew in all of these textbooks that prednisone is actually causing all of this nutrient depletion but I didn’t realize that it was true for me until I looked back and did all of these analyses of my labs in my own medical record.

And in the end, all of this means I’m now able to have peace with my health and have the energy to play with my kids again.

Nutranize Zone for Prednisone

Go to Nutranize.com and get the supplement that is made especially for you!

  • Get back in The Zone of proper nutrition after taking prednisone.
  • Feel like yourself again!

Dr. Megan Milne, PharmD, BCACP

Dr. Megan Milne, PharmD, BCACP, is an award-winning clinical pharmacist board certified in the types of conditions people take prednisone for. Dr. Megan had to take prednisone herself for an autoimmune condition so understands what it feels like to suffer prednisone side effects and made it her mission to counteract them as the Prednisone Pharmacist.

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