ME/CFS patient (Hamsterman) — normally bedbound with severe ME/CFS found a one-off dose of 20 mg of prednisolone taken 30 minutes before a major exertion completely prevents PEM. He found taking prednisolone just before exercise allowed him to do a full workout at the gym without getting any PEM repercussion whatsoever. But he cautions that these doses of prednisolone should not be used daily, only occasionally, as the immunosuppressive effects of daily prednisolone will likely allow underlying viral infections to proliferate


As an example of the difference, hamsterman found that the corticosteroid drug prednisolone 20 mg is an excellent PEM shielder for both physical and mental exertion, but found that such corticosteroid drugs do not work at all as PEM relievers


User Patrick found that prednisone at a dose of 20 mg taken a just before a mentally exerting event (such as socializing) was effective at relieving ME/CFS symptoms. Sometimes he would take another 20 mg later in the day. Other ME/CFS patients have vouched this works effectively and reliably (though others report ill effects from this corticosteroid drug). Note that this dosing is only used as a one-off, not regularly every day.


User hamsterman found hydrocortisone at a one-off dose of 80 mg (or alternatively and equivalently prednisolone 20 mg) taken 30 minutes before a mentally or physically exerting event very effective for preventing PEM due to physical and mental exertion "I tested it hydrocortisone with 80 mgs (equiv. to 20 mgs prednisone), and used it 30 minutes prior to 4 different situations which always cause PEM 1) Doctors visit, 2) engaging chat with friend 3) cardio workout 4) another chat with a different friend. Each time, no PEM."


Just as with prednisone, its useless if taken after the exertion, it does nothing if you are already experiencing PEM, and is not meant to be taken daily


But unlike prednisone, hydrocortisone doesn't stay in the system for very long, so after a couple hours or so, it is no longer active. But this can be an advantage, since it can be used more strategically... and more often.... potentially multiple times per week,

Correction: hamsterman told me he was actually using prednisolone and not prednisone as he stated in the quote above. The former takes effect faster


User gregh286 found prednisone will block PEM from appearing.


How long for the corticosteroid PEM shield to kick in? Prednisone takes around 2.6 hours for the drug to reach peak levels in the bloodstream, whereas prednisolone is faster, taking only around 1.3 hours. Hydrocortisone takes around 1 to 2 hours. Ref: 1


So when taking any of these corticosteroids in advance to prevent PEM from a physical or mental exertion you are about to perform, give these drugs enough time to kick in before starting the exertion, else your PEM shield will not be in place. CAUTION: note that there are also timed release versions of prednisone, which only slowly release the drug into your system over several hours, so it might be best to avoid these.


What is the dose equivalence of different corticosteroids? Difference corticosteroid drugs have different strengths: hydrocortisone 80 mg = prednisone 20 mg = prednisolone 20 mg = methylprednisolone 16 mg = triamcinolone 16 mg = dexamethasone 3 mg = betamethasone 2.4 mg. Source: here.


How long does the corticosteroid PEM shield last? In terms of how long the "PEM shield" lasts, the plasma half-life of prednisone and prednisolone is 3 to 4 hours, and the plasma half-life of hydrocortisone is 2 hours. So once your "PEM shield" is active it will last for say one or two half-lives, ie, your PEM shield may last about 4 to 8 hours for prednisone and prednisolone, and last around 2 to 4 hours for hydrocortisone.


When taking prednisone 20 mg, hamsterman found its PEM protection lasted for as long as 8 hours; but when he tried exercising 13 hours after his prednisone, then he crashed. So for a single 20 mg dose of prednisone, around 8 hours would seem the limit of its protective effects. Of course you could take a second 20 mg dose at the 8 hour point, and get another 8 hours of protection.


Efficacy of the corticosteroid PEM shield. This is how effective hamsterman found a one-off dose of prednisolone 20 mg to be at completely eliminating PEM from a major physical workout at the gym "Just as a side note, I've been using Prednisone once a week for about a year, and I've found its absolutely impossible to induce PEM while I'm on these corticosteroids. I've really taken this to the limit.... doing crazy cardio... things that would normally cause severe multi-week PEM... and each time... nothing. I've also accidentally done a 'double-blind' test, when I accidentally took the wrong medication, and had severe PEM afterwards."


Interestingly enough, after doing this intense cardiovascular exercise once weekly for a year, courtesy of the PEM shielding provided by corticosteroids, hamsterman was able to completely cure his POTS (see here). But his ME/CFS has not improved through exercise. POTS is known to responds well to exercise, whereas ME/CFS does not

Prednisone is particularly effective as an **immunosuppressant** and affects virtually all of the immune system


"...This is remarkable, glad to hear you are getting some life back! I wish it had been that simple for me. I took Prednisone for awhile, I did feel better on it at first, but after a month the good effects all wore off and and I really didn't want to keep raising the dose and take the risks ass'd with it.


After I stopped it my pain and fatigue were a lot worse than before I started it and took me many months to get back to baseline.

I took 5mg Prednisone in the AM. It did make me feel better, but can't say that it came close to curing me, then all effects seemed to wear off completely..."


"...I have been following the Jeffries protocol since February and noticed huge improvements on 20 mg h/c every day but I was still getting hypoglycemic drops and didn't feel good on getting up. My doctor switched me to Prednisone 2.5mg 9 pm and the same dose 8 am.


This has made a HUGE difference and I can say that I no longer have cfs.


The reason is that Prednisone is longer acting, the problem I had with the h/c is that it gives you constant highs and lows even at 20 mg a day whereas the Prednisone doesn't do this.


I can do a huge amount each day with only short sit downs to recover. By the evening I am sometimes quite tired but usually can take my dog out for a 30 minute walk. I sleep through the night nearly every night and this hasn't happened for 10 years.

In addition to the 5mg Prednisone I have to take 2 grains of Armour for my thyroid. These 2 meds have given me my life back and everyday I can lead a more or less normal life (I have high antithyroglobulin antibodies).


*Dr. Jeffries proved with thousands of patients over 30 years or more that there were no ill effects as long as one stuck under 20 mg hydrocortisone. In fact he found that his patients on this dose were healthier than his other patients. After all if our bodies are not making enough cortisol all we are doing is bringing it back up to a normal level


My bp still falls if I do too much (41/120) but with 5 minutes of sitting down it recovers to a normal reading of 65/120.

Even if there is a small risk of problems later on I am prepared to take that risk to have my life back now. Who knows maybe in another 6 months time when I have chelated more mercury out of my brain, my adrenals and thyroid might even start to work better and I will drop my dose to 2.5mg a day



Page Synopsis: This is one of the prevailing theories. I'm not sure if I subscribe to it, but the proceedures are simple and non invasive so it couldn't hurt to try (and employ empirical evidence

Skill Level  3

Relevance:2 Technical Level:5


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