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Old 05-24-2012, 12:21 PM
apruden apruden is offline
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Join Date: Jan 2012
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Steroids and decreased immune system

Due to a flare I was on steriods (combo of oral and IV) for over 2 months in January/February/March. Still now, at the end of May, I am constantly getting sick. My PCP told me that I probably am having issues due to decreased immune system from all the steriods I was on.

Has anyone else experienced this before and how long did it last? I don't recall ever having this before, but I had never been put on so many doses of steroids back-to-back like I was this time.
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Old 05-24-2012, 03:26 PM

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Aparently, Steroids supress the immune system. I assume this is part of what they do for us when when our autoimmunity flairs.

So I assume it's possible. No treatment is without side effects. I think you have to rest and recover.

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Old 05-25-2012, 02:50 AM
Redwings Redwings is offline

Join Date: Mar 2009
Location: California, USA
Posts: 2,449
Hi apruden:
It's well known that steroids reduce inflammation and, in the process, suppress the immune system. Warnings about high-dose steroids, and lists of side effects, acknowledge that people taking steroids are more susceptible to infection because of the immunosuppressive effects. It's not unexpected, then, that someone who has taken high-dose or long-term steroids might develop infections.

The question that's much harder to answer is "how long does it last"? The steroids themselves leave the body within two to three days. But how quickly a body recovers its immune functions can be very individual. Many people who have been on high-dose steroids never develop infection at all. Many who did develop an infection recovered with treatment and didn't develop another one after a couple of months. A couple of months was enough time for their immune function to return to baseline.

At one extreme of the bell curve are people who haven't recovered their immune function after a couple of months of being off steroids. That could be you, apruden. Because it isn't typical, there isn't a timetable for recovery.

At the other extreme of the bell curve are people like me. After doses of chemotherapy agents that were expected to suppress my immune system for six to twelve months, my immune system recovered after only three to four [I]weeks[/I]. I found out about my unusually fast recovery by several true, [I]raging[/I] inflammatory relapses about a month after chemo. Each time, it was like throwing gasoline on a fire.

In addition, any MS DMD that modulates or suppresses the immune system (e.g., interferons, Gilenya, Tysabri) can affect your post-steroid susceptibility to infection.

There are blood tests of immune components that can give an indication of your immune status. Knowing how far away from ideal your immune components are can give an indication of how far you have to go to return to normal, although they can't predict how long it will take for that to happen. If you're interested in that, you'll have to convince your doctor(s) that there could be value in knowing your status. In some conditions and with some medications, such tests are routine to verify that the immune system is sufficiently suppressed. On the other hand, my doctors never tested my immune component status at all, and were clueless about why I relapsed so quickly after chemo.

In summary, there isn't an absolute answer for why you're still developing (or failing to recover from) infections after steroid treatment. No one else's experience can be predictive of yorus. In the meantime, you'll have to be extracareful to avoid sources of infection. And you can consider talking with your doctors (whether neuro of GP) about blood testing that can give a picture of your current immune status. I hope you feel better soon.
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