Treating MS With Steroids

There are two sides to treating Multiple
Sclerosis and though the goals may seem like they are pretty much the same
thing (reducing symptoms) they really aren’t. First there is the management of
the course of the disease itself through the use of Disease Modifying Drugs
(DMD’s). Hopefully when a DMD is working well you will not experience many
symptoms that can’t be managed with things like prescription medication or life
style changes. Secondly there is the management of the symptoms that appear
when having a flare-up or relapse. When this happens, how do you “make it
go away” so you can go back to feeling stable on your DMD?
STEROIDS
This is the most typical course of action; it’s
what you do if you are playing it by the books. Now what do I mean when I
say steroids? Well, not what you’re probably thinking, not the horse hormones
that bodybuilders illegally use to build muscle mass. No, I am talking about medical steroids that are used to reduce
inflammation, the main cause of flair ups in Multiple Sclerosis. When you are
experiencing a flare up (or a relapse) your body is experiencing inflammation
in the central nervous system; this inflammation damages the myelin sheath
along your nerves (creating new lesions/plaques), which ultimately may cause
more symptoms. The damage inflammation causes slows down (or even disrupts) the
transmission of nerve impulses, which is what causes all the symptoms of MS. So
in other words, inflammation is bad for MS! Ending the body’s
inflammatory response can eliminate symptoms whether this means all of
your symptoms, most of your symptoms, or some of
your symptoms; everyone is different. Steroids are used to reduce that
inflammation.
TYPES OF
STEROIDS
There are three types of steroids that are
generally used to treat Multiple Sclerosis that I will be talking about and
they include oral medication, intravenous (IV) medication, and injections.
Oral Medication –
Prednisone
Prednisone is an artificial steroid that comes
in oral tablets of various dosages from 1mg to 20mg tablets. They taste
horrible… Your neurologist will come up with a taper plan for taking
Prednisone meaning, you may start off on 60mg for a week, then 50mg the next
week, then 40mg, then 30mg, and so on until you are off the medication. Some
people can taper off Prednisone faster than others so it will be up to you and
your doctor to determine the appropriate taper rate.
Common Side Effects
  • Insomnia
  •  Mood swings
  • Increased appetite
  • Weight gain
  • Acne, increased sweating, dry
    skin, thinning skin, bruising or discoloration
  • Slow wound healing
  • Headache, dizziness, spinning
    sensation
  • Nausea, stomach pain, bloating
  • Changes in the shape or location
    of body fat (especially in your arms, legs, face, neck, breasts, and
    waist). This is sometimes called “moon face”.
Intravenous (IV)
Medication – Solu-Medrol (Methylprednisolone)
Solu-Medrol is another artificial steroid that
is administered via an IV. It is usually given at 1,000mg (1 gram) over the
course of an hour for 3-5 days depending on how well you tolerate the
medication and what your doctor believes is best for you. Sometimes your doctor
may have you taper off Solu-Medrol with oral Prednisone tablets after your
infusion since both medications are basically the same thing.
Common Side Effects
  • Insomnia
  • Mood swings
  • Headache
  • Mild muscle pain/weakness
  • Stomach discomfort/bloating
  • Metallic taste during infusion
 InjectionHP Acthar Gel
Acthar was actually used before Prednisone and Solu-Medrol became available. It is self
administered with either a subcutaneous (under the skin) needle or an
intramuscular (into the muscle) needle usually at about 1ml a day for 10 days.
Acthar is usually used for people who react poorly to Prednisone or Solu-Medrol
or who no longer respond to these steroids. It is hardly ever used anymore because
it is not synthetic (Acthar is a medication that uses a hormone called ACTH
that naturally appears in the body to engage the production of cortisol, the
stress hormone) which means it is not cheap. 
Acthar comes in a vial that must
be kept refrigerated in between uses and each 5ml vial runs at about roughly
$28,000 USD (The New York Times, 2012) so if your doing 10ml a
month (2 vials) that equals about $56,000 USD a month! Compared to around $960
USD for 5 days of Solu-Medrol (JAAC) or the even cheaper oral Prednisone you
can easily find online for as low as 48 cents per 20mg tablet,
it is no wonder no one wants to prescribe Acthar anymore!
Common Side Effects
  • Mood changes
  • Acne, dry skin, thinning skin,
    bruising or discoloration
  • Slow wound healing
  • Increased sweating
  • Headache, dizziness, spinning
    sensation
  • Upset stomach
  • Changes in the shape or location
    of body fat (especially in your arms, legs, face, neck, breasts, and
    waist).
I have used Acthar for
quite a while (since it might not be a great idea to take steroids while on Tysabri) and I have
never experienced any side effects whatsoever. Even with Prednisone and
Solu-Medrol I experienced most of the common side effects so I personally
love Acthar. 
My first “MS Specialist” in Colorado said he has never seen any research that
shows it actually works (despite my testimony) and therefore sees no point in
charging the insurance company so much money. He refused to prescribe it. I plan to send him a copy of this
document; 

3 thoughts on “Treating MS With Steroids

  • May 16, 2014 at 7:14 pm
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    Acthar can also make you have low potassium, which can cause lots of problems. If you are not aware of this side effect, it might appear to be just MS related because the symptoms are all things that can happen from MS.

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  • September 9, 2014 at 2:19 pm
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    I took a series of 3 Solumedrol IV injections over 5 days to help with the simultaneous tingles and numbness going down my left side.
    After about 3 weeks the numbness and tingles faded away, only to be replaced by a sporadic Restless Arm Syndrome that drove me completely crazy until I started taking Arnica for it. In my experience the Solumedrol treatment wasn't just unhelpful. It was also a waste of time, energy and money. And the major side effect in my case was nausea.

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  • September 9, 2014 at 5:23 pm
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    Wow, I have ALWAYS wondered if you could get that restless sensations anywhere besides your legs, now I know. If you look at the Acthar website, it specifically says "for people who can not tolerate or no longer respond to steroids". If you don't mind needles that may be for you, it worked great for me but my current Neuro doesn't think it works and wouldn't prescribe it. I don't plan to go back and see him but I am going to mail him that abstract about how it can help etc. lol so uneducated for an "MS Specialist".

    Reply

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