steroid burst vs. steroid taper

[momslove]

Over the years we have treated DD with long-term antibiotics, probiotics, SSRI, levothyroxine, anti-fungal meds, and periodic anti-viral med. Also have done CBT/ERP. Her disabling symptoms are anxiety and beastly OCD. Fatigue is also a factor, but it doesn't get in her way in the same way the OCD does.

 

Thinking we need to reduce inflammation...???

DD16 has shown no noticeable benefit from use of ibuprofen. She showed no noticeable benefit from a trial of CBD oil twice daily for about 5 weeks. She also showed no change during 2 steroid bursts (5 days). Is there any reason to believe that use of steroids over a longer period of time and tapering could benefit her? Are there any clinical or lab indicators that would point us in any direction to reduce inflammation?

 

I read a number of old posts about steroids, but it seems there hasn't always been a distinction between the burst and the taper.

[msimon3]

We tried both. The 5-day burst seemed inconclusive, so we then followed up with a taper. We saw symptoms go to nearly zero by the end of the taper, and then bounce back aggressively once the taper was over. That process was key in confirming the symptoms we saw were immune related.

[dasu]

My son did 1 month steroid taper and got somewhat better on week 2 then slid right back for week 3 and thereafter? What does that mean?

[cobbiemommy]

High dose tapers have worked wonders in the past, while bursts have only produced so-so results.

[4Nikki]

Well... aren't kinda of the same thing? A Steriod Treatment. One is the same dosage over a period of time, while the other is a dosage that is reduced over a period of time. The difference is one is more of a abrupt stop while the other gradual stop to the system. I would think it just matter how sensitive your child is to receiving.

[momslove]

4nikki, you may be right.

 

I've been reading more about this as it's written about asthma and COPD and see that steroids are sometimes tapered even when only used for 5 days.

 

I guess my question might really be, could a response to a steroid treatment be different/better if the steroid is used for a longer time than 5 days?

[Kayanne]

Steroids are tapered if you use them longer than approximately 7 days--your body stops making it's own cortisol and relies on the medication. You have to slowly drop the dose to coax your adrenal glands into producing it again. A sudden stop after 7 days at a full dose may cause severe steroid withdrawl. That is the real difference between a burst and a taper.

 

My daughter has always had month-long tapers that brought her back to us with sustained results. We never saw any improvement until close to end of the month. At least for her, it seems the autoimmune reaction needed something longer than a burst.