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🤔 Nootropics: "Smart Drugs"

Old 11-11-19, 12:06 AM
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Originally Posted by Seattle Forrest
Prednisolone is a corticosteroid. You need a script. It's more effective for pain than IV morphine, I've had both within the last few months. It works by turning inflammation off. It doesn't make you foggy, the side effects are being more hungry and obsessively cleaning you house. It should be easy to get from your doctor if you're in pain, it's not an opiod, it's not recreational, it's not addictive.

But you can't take too much or for too long, or you'll develop Cushing's syndrome until months after you stop taking it. Your doctor will make sure you stay on the safe side.
Have you gone off it yet?
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Old 11-11-19, 12:09 AM
  #27  
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Originally Posted by KraneXL
Relief from pain...without the mental fog and loss of clarity and focus that come with it.

This is likely something only someone who is experiencing or has experienced chronic pain can relate to. But most medications powerful enough to suppress the pain, will also suppress your higher brain function.

The feeling for me is as if you're thinking in slow motion. Not a very comfortable experience I assure you. One reason why I refer to them as my ******** pills. My doctor was not amused.

Well, I've used Ginkgo Biloba (although not much in recent months because it has a negative interaction with another medication I take), and it may have given me slightly more energy, possibly. But did nothing at all for pain.

So you can probably scratch that one off your list.

And do be careful with interactions.
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Old 11-11-19, 12:14 AM
  #28  
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Prednisone/prednisolone isn't a pain reliever, not in the sense of opiates. It's primarily a powerful anti-inflammatory. If inflammation is the primary cause of the pain, then sure, prednisone will help. But not all pain is related to inflammation and prednisone won't help.

It's usually prescribed for problems such as acute respiratory inflammation related to severe allergic reactions, bronchitis, pneumonia, pleurisy, COPD, etc. A side effect is pain relief from reducing the inflammation.

And few docs will prescribe prednisone just for pain. It's too risky, especially in repeated refills -- few doctors nowadays will prescribe more than a single course, usually an injection followed by a 4 or 5 day oral course. If that doesn't work they usually won't authorize a refill because it's pointless. At my age -- only 62 but with a dysfunctional thyroid and osteopenia -- my docs are very cautious about corticosteroids/glucocorticoids.

And prednisone can provoke 'roid rage in some folks, especially older men. I've seen it many times, as a caregiver for family members and working in hospitals. My mom was among the few women I've known who reacted badly to prednisone -- she'd become very irritable and irrational. Mom already suffered from bipolar disorder and, for her last decade, dementia, so her mood was always precarious.

I already use Fluticasone nasal inhaler, which barely does anything for my chronic sinus pain. The problem is in the sinuses above the nose and it's so congested the inhaler doesn't reach. Next step is waiting for an ENT referral. I've already had full head scans.

Prednisone and local injections of anti-inflammatories helped me only on three occasions: twice for severe respiratory inflammation; once for shoulder pain after it was broken last year. After two rounds of anti-inflammatory injections and oral prednisone in 2018, my docs wouldn't authorize refills due to the increased risk and low efficacy.
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Old 11-11-19, 12:23 AM
  #29  
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Originally Posted by canklecat
Prednisone/prednisolone isn't a pain reliever, not in the sense of opiates. It's primarily a powerful anti-inflammatory. If inflammation is the primary cause of the pain, then sure, prednisone will help. But not all pain is related to inflammation and prednisone won't help.

It's usually prescribed for problems such as acute respiratory inflammation related to severe allergic reactions, bronchitis, pneumonia, pleurisy, COPD, etc. A side effect is pain relief from reducing the inflammation.

And few docs will prescribe prednisone just for pain. It's too risky, especially in repeated refills -- few doctors nowadays will prescribe more than a single course, usually an injection followed by a 4 or 5 day oral course. If that doesn't work they usually won't authorize a refill because it's pointless. At my age -- only 62 but with a dysfunctional thyroid and osteopenia -- my docs are very cautious about corticosteroids/glucocorticoids.

And prednisone can provoke 'roid rage in some folks, especially older men. I've seen it many times, as a caregiver for family members and working in hospitals. My mom was among the few women I've known who reacted badly to prednisone -- she'd become very irritable and irrational. Mom already suffered from bipolar disorder and, for her last decade, dementia, so her mood was always precarious.

I already use Fluticasone nasal inhaler, which barely does anything for my chronic sinus pain. The problem is in the sinuses above the nose and it's so congested the inhaler doesn't reach. Next step is waiting for an ENT referral. I've already had full head scans.

Prednisone and local injections of anti-inflammatories helped me only on three occasions: twice for severe respiratory inflammation; once for shoulder pain after it was broken last year. After two rounds of anti-inflammatory injections and oral prednisone in 2018, my docs wouldn't authorize refills due to the increased risk and low efficacy.
I mentioned in the Weekend Rides thread being bit by a spider and having complication with the medication they gave me and with going off that medication.

That medication was Panafcortelone which contains prednisolone as the active ingredient.

Funny this should come up just now!!

I was put on twice the normal dosage for 3 days to reduce the inflammation in my arm and it successfully did that. But meanwhile, I had all sorts of side effects for those 3 days.

I was so relieved when the 3 days were up and I went off. That was Friday.

And then, to my surprise, I had a couple days of even more side effects to the point where I couldn't move. My muscles and joints were so incredibly weak and painful that movement was agonising. My muscles also cramped at the slightest movement. And I was unbelievably tired. I ended up sleeping most of this past weekend because I couldn't do much more.

Today, Monday, I'm starting to feel more like myself again.


I'll be very hesitant to take anything with prednisolone again. If I went through that after 3 days of it ... I hate to think what I might have gone through if I stayed on longer.
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Old 11-11-19, 12:38 AM
  #30  
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Regarding chronic pain in joints and connective tissue near the skin surface (aching shoulder, knees, hands, etc.)... I know I've mentioned this before but try Ted's Pain Cream. It's an effective topical analgesic for chronic pain from old injuries that have technically healed but still hurt.

Combine that with a good massager, appropriate for the painful area, and it's pretty effective. I use a percussion massager for the soft tissue around my shoulder, but it's uncomfortable directly over bone. Most of the affordable percussion massagers have dual heads, each the size of golf balls, which fit on either side of the spine, or around the shoulder blade without touching bone. Kind of a shiatsu effect -- pressure directly on the painful areas. A more conventional massager with softer attachments would be better around knees, wrists, etc., or for soft tissue that's still too sensitive and painful for a percussion massager.

CBD is useful for some moderate pain and associated anxiety, but it's still expensive for what it does. I get it from a company that offers significant discounts to veterans and disabled folks. Otherwise I wouldn't buy it for the relatively subtle effect. It's nowhere near as effective as even the mildest prescription opiates -- tramadol and hydrocodone. Eventually CBD will become much more affordable and easier to find so it'll be moot. I use it because it doesn't make me drowsy like my prescription pain meds.

I've already mentioned kratom before too. It's remarkably effective and affordable. A bit controversial due to misguided government agency statements and poorly researched pop media paranoia hype. But it's legal in most of the US. It's greatly exaggerated for recreational use, kinda like how teenagers will chug a six pack of Red Bull for a buzz, then end up sick. Happened to one of my cousin's daughters when the kid was in high school -- she ended up with seizures because she was literally living on nothing but Red Bull and candy. As soon as she straightened out her diet the problem vanished.

Use kratom like normal people would normally drink coffee or tea and ibuprofen or aspirin -- moderately, and stopping when it provides the desired effect. And kratom is pretty comparable to drinking a cup or two of coffee and more effective than ibuprofen but not as effective as prescription opiates. Don't take more kratom hoping it will be stronger than coffee or provide more pain relief than NSAIDs. It doesn't work that way, same as drinking a gallon of coffee all at once doesn't make us hyper-alert, and swallowing a fistful of acetaminophen or ibuprofen will only risk liver damage and stomach irritation, not more pain relief. Kratom is very mild stuff taken in appropriately small doses.

I'm betting -- well, hoping -- researchers will isolate the effective components and provide those in better controlled recommended dosage levels to eliminate the guesswork. Meanwhile, just consider it like coffee or tea and a few NSAIDs for moderate pain. It tastes bitter so mask the flavor with hot chocolate, whey protein mixes, or buy the compressed tablets from Etha Natural Botanicals. Etha lab tests and pasteurizes kratom powders (mostly from Indonesia), then compresses it into tables for easier swallowing without the bitter flavor. Etha costs a little more but it's a good company. But I usually buy the powders from Mitragaia, also a reliable company with very fast shipping -- usually 2-3 days from order time during business hours. Considering it's a one or two person operation they're very efficient.
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Old 11-11-19, 12:43 AM
  #31  
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Originally Posted by Machka
I mentioned in the Weekend Rides thread being bit by a spider and having complication with the medication they gave me and with going off that medication.

That medication was Panafcortelone which contains prednisolone as the active ingredient.

Funny this should come up just now!!

I was put on twice the normal dosage for 3 days to reduce the inflammation in my arm and it successfully did that. But meanwhile, I had all sorts of side effects for those 3 days.

I was so relieved when the 3 days were up and I went off. That was Friday.

And then, to my surprise, I had a couple days of even more side effects to the point where I couldn't move. My muscles and joints were so incredibly weak and painful that movement was agonising. My muscles also cramped at the slightest movement. And I was unbelievably tired. I ended up sleeping most of this past weekend because I couldn't do much more.

Today, Monday, I'm starting to feel more like myself again.


I'll be very hesitant to take anything with prednisolone again. If I went through that after 3 days of it ... I hate to think what I might have gone through if I stayed on longer.
Yup, those are side effects from some corticosteroids. As patients and consumers we're so overwhelmed with warnings about medications that we tend to tune them out. But with some meds, side effects aren't just possible. They're probable.

I've been lucky with prednisone -- no side effects. But I understand why my docs won't authorize refills if the first round didn't work.
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Old 11-11-19, 12:54 AM
  #32  
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Incidentally, for some respiratory irritation like asthma, and for improved circulation and associated benefits -- including mental clarity, there are some fairly ordinary supplements worth trying.

I've had good results from bromelain, an enzyme from pineapple. It's mostly used as a digestive enzyme but it can also provide some relief from asthma and upper respiratory irritation. I've had no side effects. By all accounts it's very safe.

L-arginine, a "non-essential" amino acid may offer some boosts in energy, which can help with cognitive clarity. It also helps with production of nitric oxide, which the body must make on the fly as needed. L-arginine is a fairly common additive in many protein powders. If I buy a brand that doesn't, I'll add a 1,000 mg l-arginine tablet to the mix. It dissolves easily in liquid and seems relatively flavorless.

Niacin (vitamin B3) and related supplements are touted as a miracle supplement every few years. It was highly touted in the late 1960s-early '70s by Rodale Press and counterculture health mags. My grandparents took what my granddad called "stinging pills" because the large doses of niacin can cause capillary flushing with beet red skin and tingling or stinging skin. It can also loosen mucus, causing a sudden runny nose. It's harmless and lasts only a few minutes. More recently I've seen retired volleyball pro Gabrielle Reece promoting some supplement that's basically a fancy version of vitamin B3 at a high price. Generic niacin is cheap and works well for me -- kinda feels the same as the effect of 15 minutes of moderate aerobic exercise for getting the body and mind going. Some other varieties reportedly have fewer side effects with capillary flushing.

Anyway, those three are all considered safe in reasonable doses. Some side effects have been reported with massive doses that I'd never take anyway -- like 6 grams or more of each a day. That's always the risk with some folks who think if one is good, ten is ten times better. Nope.
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Old 11-11-19, 01:11 AM
  #33  
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Originally Posted by canklecat
Yup, those are side effects from some corticosteroids. As patients and consumers we're so overwhelmed with warnings about medications that we tend to tune them out. But with some meds, side effects aren't just possible. They're probable.

I've been lucky with prednisone -- no side effects. But I understand why my docs won't authorize refills if the first round didn't work.
I was also very cranky, irritable, and "down" on Friday ... a "black" day. Dark thoughts, emotional.

Low blood pressure & trouble standing. My head would swim.
Low blood sugar.

It was not good.

I did wonder why my Dr was quite emphatic about 3 days and only 3 days. Now I'm glad she was that emphatic!!

-----------------------------

Incidentally, I have headaches just about all the time. Drs tend to ignore me when I say that or just tell me that I need to reduce stress.

Things that may help:
My eyes seem to change quite frequently, so I've got to keep on top of my glasses prescription.
I also use eye drops on dry days.
My sleep was quite bad for a while, so I've created a cocoon of silence which helps with that.
Exercise is supposed to help, and sometimes it does.
I've reduced the amount of caffeine I use because caffeine doesn't make pain go away at all ... makes it worse.
Dehydration makes the headache worse, so I drink quite a bit of water.
Sinus problems are part of my headaches and after 5 years on a waiting list, I will finally see a specialist in December!!
I've been diagnosed with TMJ ... evidently I grind my teeth, and it shows with my dental issues. I should start using a mouth guard at night.
And I've been diagnosed with reasonably large brain cyst, but apparently it's not causing me any problems ... I've been told.

All that and I can say that prednisone did absolutely nothing for my headache!! It was actually a bit worse.

Last edited by Machka; 11-11-19 at 01:22 AM.
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Old 11-11-19, 01:37 AM
  #34  
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Originally Posted by canklecat
Incidentally, for some respiratory irritation like asthma, and for improved circulation and associated benefits -- including mental clarity, there are some fairly ordinary supplements worth trying.

I've had good results from bromelain, an enzyme from pineapple. It's mostly used as a digestive enzyme but it can also provide some relief from asthma and upper respiratory irritation. I've had no side effects. By all accounts it's very safe.

L-arginine, a "non-essential" amino acid may offer some boosts in energy, which can help with cognitive clarity. It also helps with production of nitric oxide, which the body must make on the fly as needed. L-arginine is a fairly common additive in many protein powders. If I buy a brand that doesn't, I'll add a 1,000 mg l-arginine tablet to the mix. It dissolves easily in liquid and seems relatively flavorless.

Niacin (vitamin B3) and related supplements are touted as a miracle supplement every few years. It was highly touted in the late 1960s-early '70s by Rodale Press and counterculture health mags. My grandparents took what my granddad called "stinging pills" because the large doses of niacin can cause capillary flushing with beet red skin and tingling or stinging skin. It can also loosen mucus, causing a sudden runny nose. It's harmless and lasts only a few minutes. More recently I've seen retired volleyball pro Gabrielle Reece promoting some supplement that's basically a fancy version of vitamin B3 at a high price. Generic niacin is cheap and works well for me -- kinda feels the same as the effect of 15 minutes of moderate aerobic exercise for getting the body and mind going. Some other varieties reportedly have fewer side effects with capillary flushing.

Anyway, those three are all considered safe in reasonable doses. Some side effects have been reported with massive doses that I'd never take anyway -- like 6 grams or more of each a day. That's always the risk with some folks who think if one is good, ten is ten times better. Nope.
It sounds like you may be more of an expert on pain as I am? Anyway, I tried most of those on your list and agree with your finding. I get the typical flush from Niacin and L-arginine as a supplement gives me bloating and diarrhea. Neither had any effect on pain relief.
Originally Posted by canklecat Prednisone/prednisolone isn't a pain reliever, not in the sense of opiates. It's primarily a powerful anti-inflammatory.
I will ask my doctor about Prednisone though, as I could use a break, even if it is temporary. I've had those near insanity days where I felt like walking out into traffic. Hopefully, it will tide me over and keep me out of the emergency room.

In the mean time, I've have a list of nootropics sitting in my cart for a week now with one more day to decide. I just figured I'd get as much feedback as I could before I decide to delete it or push purchase.
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Old 11-11-19, 01:39 AM
  #35  
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Yep, sinus pressure/pain and headaches are the worst in terms of getting attention from medical professionals. Even doctors tend to regard invisible ailments as unimportant, malingering or ploys to fish for prescription opiates (which never really helped my headaches anyway). I never even found a good neurologist in years of trying to control my chronic headaches. I had to do it on my own, sifting through a lot of bad advice, junk science and voodoo in pursuit of practical solutions.

I've been with the VA for health care for a year now and they've been much more responsive, including to complaints about pain because it's so common with veterans. And most injuries with pain for military folks are from training or routine duties, not combat. Many people don't realize how dangerous the military occupation can be, peacetime and wartime. So the VA is more attuned to the problem now, partly in response to dramatic increase in suicides because so many veterans left suicide notes or spoke to loved ones about the constant pain.

And they were quick to respond after my cancer diagnosis, getting it with surgery so chemo wasn't necessary. But the issues with neck pain from multiple injuries and headaches and sinus problems are taking longer. They did the diagnostics months ago but there hasn't been any followup, so I called last week to request a followup or referral to ortho and ENT.

Considering how bad the VA health care system was 20 years ago, they're doing remarkably well now, at least in my area.
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Old 11-11-19, 01:39 AM
  #36  
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Originally Posted by Machka
I was also very cranky, irritable, and "down" on Friday ... a "black" day. Dark thoughts, emotional.

Low blood pressure & trouble standing. My head would swim.
Low blood sugar.

It was not good.

I did wonder why my Dr was quite emphatic about 3 days and only 3 days. Now I'm glad she was that emphatic!!

-----------------------------

Incidentally, I have headaches just about all the time. Drs tend to ignore me when I say that or just tell me that I need to reduce stress.

Things that may help:
My eyes seem to change quite frequently, so I've got to keep on top of my glasses prescription.
I also use eye drops on dry days.
My sleep was quite bad for a while, so I've created a cocoon of silence which helps with that.
Exercise is supposed to help, and sometimes it does.
I've reduced the amount of caffeine I use because caffeine doesn't make pain go away at all ... makes it worse.
Dehydration makes the headache worse, so I drink quite a bit of water.
Sinus problems are part of my headaches and after 5 years on a waiting list, I will finally see a specialist in December!!
I've been diagnosed with TMJ ... evidently I grind my teeth, and it shows with my dental issues. I should start using a mouth guard at night.
And I've been diagnosed with reasonably large brain cyst, but apparently it's not causing me any problems ... I've been told.

All that and I can say that prednisone did absolutely nothing for my headache!! It was actually a bit worse.
I'm that way everyday, hence the thread. I can still absorb it when I'm around others but it take a great deal of concentration. Not the way I want to spend my days.
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Old 11-11-19, 02:01 AM
  #37  
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Originally Posted by KraneXL
It sounds like you may be more of an expert on pain as I am?
I'm only an expert on my own pain. Mostly because too many medical professionals disregard pain. If it's not detectable with X-rays, MRIs or CT scans, it isn't real to them.

Anyway, I tried most of those on your list and agree with your finding. I get the typical flush from Niacin and L-arginine as a supplement gives me bloating and diarrhea. Neither had any effect on pain relief.
Supplements like niacin, l-arginine and others only help with my energy level. Anything that gets me up and exercising, even just walking, can help with managing chronic pain and better sleep.

I will ask my doctor about Prednisone though, as I could use a break, even if it is temporary. I've had those near insanity days where I felt like walking out into traffic. Hopefully, it will tide me over and keep me out of the emergency room.
Tell them that. Nowadays any conscientious medical professional should know to take seriously patient comments about wanting to die to end the pain. Hopefully they'll understand that people suffering from severe chronic pain aren't necessarily depressed or suicidal. They just want relief from pain so they can function more normally. Fix the pain and for many folks, the depression and thoughts about dying or simply "not waking up" tend to be resolved too.

In the mean time, I've have a list of nootropics sitting in my cart for a week now with one more day to decide. I just figured I'd get as much feedback as I could before I decide to delete it or push purchase.
I know the drill. I waffle and hem and haw a lot over buying supplements and non-traditional meds. It's expensive and usually I can try only one new thing a month. Some were an expensive waste of money, like CBD isolates, while full spectrum CBD with 0.3% THC worked pretty well. A prescription med for nausea last year (related to cancer) was a waste of money, while full spectrum CBD was more effective at reducing nausea and getting me back to eating solid food and a balanced diet.

Most of the usual stuff for bone and joint health health was a waste of money for me: glucosamine, chondroitin, shark cartilage, vitamin D, calcium, iron supplements ... zero difference in perceived pain or blood tests. But MSM may have helped, although I'll need to try it again.

The supplement GABA seemed to help as well. Reportedly it's related to prescription gabapentin, which did nothing for me. Part of the problem with gabapentin is it's still not entirely clear how it works, and since the anti-opiate hysteria too many doctors, PAs and nurse practitioners are prescribing gabapentin for everything including chronic pain, when there's no medical evidence that it helps with most types of pain (other than neuropathic pain). But they're more worried about disciplinary action for daring to practice medicine without the gummint's approval.

For me, caffeine is as much medicine as it is part of my favorite beverage. But it is addictive and if I go more than 12 hours without coffee or some form of caffeine I'll get a headache. One cup of joe and not only is the withdrawal headache gone, but other chronic pain is relieved. But for me it's an acceptable dependency because I don't need to beg for it and reduce myself to groveling and humiliation in front of other patients. Heck, it's just the opposite. Grocery stores and coffee shops are happy to indulge my need for a tasty boutique fix of my beverage/drug of choice.

On a YouTube channel by a bicycle racer and commentator, he said most racers and serious cyclists he knows are caffeine junkies. I suspect it's for the same reason. Besides the energy jolt it's effective for pain, including enhancing the effect of NSAIDs.
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Old 11-11-19, 02:02 AM
  #38  
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Originally Posted by KraneXL
I'm that way everyday, hence the thread. I can still absorb it when I'm around others but it take a great deal of concentration. Not the way I want to spend my days.
Have you considered an antidepressant?
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Old 11-11-19, 02:05 AM
  #39  
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Originally Posted by KraneXL
It sounds like you may be more of an expert on pain as I am? Anyway, I tried most of those on your list and agree with your finding. I get the typical flush from Niacin and L-arginine as a supplement gives me bloating and diarrhea. Neither had any effect on pain relief. I will ask my doctor about Prednisone though, as I could use a break, even if it is temporary. I've had those near insanity days where I felt like walking out into traffic. Hopefully, it will tide me over and keep me out of the emergency room.
Or ... it could making you feel much, much worse. Like it did with me.
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Old 11-11-19, 11:36 AM
  #40  
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Originally Posted by KraneXL
Its a long story involving one major injury and multiple smaller ones. But suffice it to say that many doctors have been unable to find a long-term solution up to this point. I'm a living, breathing example that medical science can't solve every malady and still has a long way to go.Not in my case. I've given them a chance. In fact, multiple chances. So far, my doctors recommendations have bee sadly, wanting.
And yet they have no compunctions giving out brain scrabbling medication. Its all about my quality of life (chronic pain leaves you depressed), which is rapidly diminishing, and moving me toward the next level of desperation.
Well, that's all quite intentionally vague. I don't have the software to diagram it out, and that's not suitable for a forum anyway. So . . .

1) Chronic pain of the sort you seem to be suffering is either from an injury, or an auto-immune disease.
2) If it were possibly from an auto-immune disease one would think a doctor would have referred you to a rheumatologist who would have diagnosed from sedimentation and other tests and treated you.
3) So it's probably an injury.
4) Injury pain will have a source: inflammation, torn soft tissue, or.nerve pressure.
5) Inflammation pain is usually treated with NSAIDs. They work for acute pain but are not good for chronic. For that, one wants anti-inflammatory supplements if anything.
6) Many soft tissue injuries can be surgically repaired. If that's the case, get it done. If that's not the case, see below.
7) IME for nerve pressure and non-surgical soft tissue injuries there is no chemical fix. Chemicals mask the pain, but suppress the resolution of it.
8) The fix is PT and stretching, what type of each depending on the source of the pain.
9) This is why we have an opiod epidemic. People want a chemical fix, but there is no chemical fix, just a swirl around the drain.
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Old 11-11-19, 11:46 AM
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Originally Posted by ThermionicScott
Some of the greatest minds in history were also on everything they could try. I won't bother to argue whether it helped or hurt, though.
My first thought - the song that is the ultimate celebration of Les Paul's great invention, the electric guitar, was recorded by great musicians, all on a variety of brain enhancing substances. Layla, as recorded by Derek and the Dominos.

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Old 11-11-19, 12:17 PM
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Originally Posted by canklecat
Prednisone/prednisolone isn't a pain reliever, not in the sense of opiates. It's primarily a powerful anti-inflammatory. If inflammation is the primary cause of the pain, then sure, prednisone will help. But not all pain is related to inflammation and prednisone won't help.

It's usually prescribed for problems such as acute respiratory inflammation related to severe allergic reactions, bronchitis, pneumonia, pleurisy, COPD, etc. A side effect is pain relief from reducing the inflammation.

And few docs will prescribe prednisone just for pain. It's too risky, especially in repeated refills -- few doctors nowadays will prescribe more than a single course, usually an injection followed by a 4 or 5 day oral course. If that doesn't work they usually won't authorize a refill because it's pointless. At my age -- only 62 but with a dysfunctional thyroid and osteopenia -- my docs are very cautious about corticosteroids/glucocorticoids.

And prednisone can provoke 'roid rage in some folks, especially older men. I've seen it many times, as a caregiver for family members and working in hospitals. My mom was among the few women I've known who reacted badly to prednisone -- she'd become very irritable and irrational. Mom already suffered from bipolar disorder and, for her last decade, dementia, so her mood was always precarious.

I already use Fluticasone nasal inhaler, which barely does anything for my chronic sinus pain. The problem is in the sinuses above the nose and it's so congested the inhaler doesn't reach. Next step is waiting for an ENT referral. I've already had full head scans.

Prednisone and local injections of anti-inflammatories helped me only on three occasions: twice for severe respiratory inflammation; once for shoulder pain after it was broken last year. After two rounds of anti-inflammatory injections and oral prednisone in 2018, my docs wouldn't authorize refills due to the increased risk and low efficacy.
My one time on prednisone I developed red spots and itching all over my body. 10 day course and I was about halfway through on the Friday the symptoms started so I gritted my teeth (figuratively) and finished the course but I now declare it as an allergy.

I use fluticasone and azelastine (antihistamine) nasal sprays (~1/4 squirt every 5 days if needed). Thanks to a naturopathic liver cleansing (not fun!), going dairy free and using N-acetyl Cysteine daily, I no longer need the daily full squirt plus per nostril of both of those (I used the better but far more expensive Nasonex for decades before my wallet drove me to generic fluticasone). The changes I've made at the advice of the nurse I've been seeing as my GP has been life changing. I now have sinuses that, while not perfect, I could not have imagined just a couple of years ago. I slept for decades with my mouth open just so I could breath, after taking that big doses of powerfu inhalents every night before bed. Now my passages stay nearly clear with just saline spray.

Yes, going cheese free hurts. Love good cheddar! And I live in the state where quality cheddar is available in every store in every county. Most of those stores have world class good cheddar for $8/pound! Now I try not to look.

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Old 11-11-19, 12:27 PM
  #43  
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Originally Posted by Machka
Have you gone off it yet?
I finished a (my second) 12 day course of oral prednisolone on Saturday.

It was almost 100% effective in combating pain from tendinitis. My mood and sociability were improved, not surprisingly, constant pain can make you sour. The side effects I've dealt with are that my apartment is really clean, and I've been hungry almost constantly.

When I asked for a refill, the doctor said "yeah we can do one more course" so that's probably all for me.

I'm not at all worried about bone loss because I lift weights three times a week.
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Old 11-11-19, 01:02 PM
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Originally Posted by Seattle Forrest
I finished a (my second) 12 day course of oral prednisolone on Saturday.

It was almost 100% effective in combating pain from tendinitis. My mood and sociability were improved, not surprisingly, constant pain can make you sour. The side effects I've dealt with are that my apartment is really clean, and I've been hungry almost constantly.

When I asked for a refill, the doctor said "yeah we can do one more course" so that's probably all for me.

I'm not at all worried about bone loss because I lift weights three times a week.
I had to take a longer course of it. My rheumatologist ordered a hip and spine scan on a DXA machine, and, sure enough, I'm osteoporotic. Been lifting weights most of my life, gym member since '79, lift as heavy as I can, to failure. But then there's all the cycling! Worst thing ever for bone density. Apparently it's not so much that it's not weight bearing, it's the sweating. She's treating me for it.
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Old 11-11-19, 01:21 PM
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Yeah, you hike and backpack too, as do I, and that should help. We both ski, also. Maybe I'll do more running when I heal.

Do you have a family history of osteoporosis? I'm sure there's a genetic component to susceptibility. I've heard the same many times about road cycling being terrible for bone density, interestingly MTB isn't nearly so harmful because of all the impact. But it's rare for me to MTB, I have to travel to the eastern slope and rent one.

I wish I could take a longer course of pred!
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Old 11-11-19, 02:31 PM
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Regarding cycling and alleged bone density problems, I'm skeptical. I want to see more studies of the general population. So far the only study I've read was of professional and serious amateur cyclists. The results could have been skewed by many factors: diet, unusually low body fat, sheer number of hours on the bike, caffeine (many of us are caffeine junkies -- besides coffee it's in my gels and energy bars), surreptitious use of PEDs -- especially steroids -- while lying to researchers about using them. We already know it happens in most professional and even some amateur sports.

Low impact leg exercises like lunges, stair climbs, etc., are generally regarded as good. Cycling mimics those. There's no way the body is telling itself "Hey, you're riding a bike! I'm gonna leach your calcium!"

Same with perspiration. I'm not buying the theory that sweating robs bone density.

These may be associated with the underlying causes, but for now I'm not seeing persuasive evidence that distinguishes between causal and casual.

In my case, osteopenia is almost certainly related to the failure of my thyroid and parathyroid. And it runs in the family. Most of them were or are sedentary, although my grandparents and earlier ancestors were hardworking folks in manual labor -- farmers, ranchers, construction, rail workers, etc. My parents generation and my contemporaries are mostly sedentary, and also smoked a lot, consumed way too much junk food to the point of diabetes and heart disease. I'm among the few who remained reasonably active most of my life. It didn't fend off the family curse of thyroid disease and associated health problems. But it did help avoid the obesity, diabetes, COPD and heart disease.

Ironically, after my mom's osteoporosis worsened to the point that her femur snapped spontaneously while walking, her doctor said mom's weight loss over the previous decade may have contributed to bone density loss -- merely because she was carrying less weight around. The doc didn't imply that there was anything wrong with mom dropping gradually from around 185 to 130 with a health diet. But being mostly sedentary, doing little walking and no other exercising, she probably lost bone density gradually commensurate with her weight loss.

And obesity causes other problems that offset any gains in bone density -- joint wear and chronic pain, diabetes, etc.

I'm open to reading other studies, if anyone has links. PubMed or similar journals, not pop culture junk media health articles on sites with "Natural" in the title. Too many pop culture health sites misinterpret research findings, or take something out of context, or omit mentioning the extremely limited sampling group.
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Old 11-11-19, 09:52 PM
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Originally Posted by Seattle Forrest
Yeah, you hike and backpack too, as do I, and that should help. We both ski, also. Maybe I'll do more running when I heal.

Do you have a family history of osteoporosis? I'm sure there's a genetic component to susceptibility. I've heard the same many times about road cycling being terrible for bone density, interestingly MTB isn't nearly so harmful because of all the impact. But it's rare for me to MTB, I have to travel to the eastern slope and rent one.

I wish I could take a longer course of pred!
Yes, my mom was osteoporotic, especially spinal. Not an athlete. In a convoluted way, she died of it. OTOH, I'm one of a very small number of cyclists whom I know who never broke a bone cycling. The only bone I've ever broken was from a leader fall when I broke my coccyx landing on a conical rock. Walked up stairs backwards for 6 weeks.

Here's a good discussion of the complex ways in which exercise affects bone density: https://www.frontiersin.org/articles...019.00060/full
It's too complicated to excerpt a quote here. Read at least the first page.

In any case, it seems that, as canklecat opined, bone loss is not from calcium loss through sweat, but rather through the simple fact of hard exercise without a powerful bone stress component.

Another factor is simply age.
With advancing age, the amount of bone resorbed by the osteoclasts is not fully restored with bone deposited by the osteoblasts and this imbalance leads to bone loss. Thus, aging and osteoporosis are intimately linked.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659822/

In any case, denial is not just a river in Africa. If you've not been tested, you're as ignorant of your mineral bone density as I was. I'm getting medication, more dietary calcium, more consistent weight work and will get another DXA scan in a couple years.
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Old 11-16-19, 07:40 PM
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Originally Posted by Machka
I was also very cranky, irritable, and "down" on Friday ... a "black" day. Dark thoughts, emotional.

Low blood pressure & trouble standing. My head would swim.
Low blood sugar.

It was not good.

I did wonder why my Dr was quite emphatic about 3 days and only 3 days. Now I'm glad she was that emphatic!!



All that and I can say that prednisone did absolutely nothing for my headache!! It was actually a bit worse.


I've been to my regular Dr who informed me that it takes a month for cortisol levels to return to normal after the dose I was on. I'll continue to experience some of the above symptoms till then.
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Old 11-16-19, 11:14 PM
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I'd love to do one more course of them, but I'm pretty sure I can't.
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Old 11-17-19, 08:57 AM
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Originally Posted by Machka
I've been to my regular Dr who informed me that it takes a month for cortisol levels to return to normal after the dose I was on. I'll continue to experience some of the above symptoms till then.
This is kinda what fueled my whole interest in nootropics from the start. This is the first time in my life that I've taken brain numbing pain killers that leave me wondering why I got up to go into the next room. Before that I could read and remember two chapters. Now I sometimes struggles to get through two pages. Its frightening.

Worst part is, none of what I've tried so far completely relived my pain, not to mentions the time it takes to build up, and weeks it takes to clear your system before you can try something else if it doesn't work.

My own rehab has been doing wonders but every so often I relapse and it keeps me up all night. I need to be ready with something that really works in times of an emergency. The first thing I'll discuss with my new doctor when I see him.
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