Prednisone Side Effects: Bone Loss, Blood Sugar, Mood Swings & How to Protect Yourself

What Prednisone Really Does to Bones, Blood Sugar, and Mood

Prednisone is a heavy hitter, prescribed to fight inflammation and treat all sorts of issues—think asthma flare-ups, arthritis, lupus, severe allergies, and even skin conditions. It can work wonders, but you pay a price. If you’re like me, juggling life in Bristol with an energetic kid like Dillon and a dog whose idea of exercise is sprinting after pigeons, the side effects can absolutely interrupt your day-to-day. But instead of just rattling off medical jargon, let’s get real about what happens.

First, prednisone side effects hit people in some predictable ways. The big three concerns: bone loss, blood sugar spikes, and mood changes. Folks can read the warnings on the leaflet, but living with these is a different beast. Bones start to weaken for a simple reason: prednisone slows the cells that build bone (osteoblasts) and speeds up those that break it down (osteoclasts). Even if you’re just on it for a few months, your risk for osteoporosis jumps.

The numbers are sobering. Researchers at the University of Bristol found that long-term prednisone users are almost twice as likely to experience fractures, even on moderate doses. And no, you don’t have to be elderly—young, active adults see this risk, too. Think about it: aches, creaks, or a slow-healing broken wrist after roughhousing with your dog could point to bones already weakened by the meds.

Blood sugar is another story. Prednisone sends glucose levels north—often fast. The drug tells the liver to pump out more glucose, then blocks insulin from doing its job. This is why people with diabetes often dread a round of steroids, and some folks without diabetes might find themselves facing prediabetes-level sugars after a while. I’ve heard stories of people suddenly needing new pants because they drop or gain weight so quickly, thanks to blood sugar that’s all over the map.

Then comes the emotional side. Prednisone is famous for its ‘roid rage moments—mood swings that make even the most patient parent feel volcanic. Sobbing at silly commercials? Yelling at your laptop in the middle of the night? It’s not you—it’s the medication rewiring how your brain’s stress response works. The Royal College of Psychiatrists has flagged this in their patient guidance, saying patients often describe an emotional rollercoaster, from wild anxiety to random bursts of energy, or crashing sadness.

Some side effects are subtle. Sleep gets rough; not just tossing and turning, but vivid dreams and that never-quite-tired feeling during the day. Appetite? Prednisone can turn the average fridge raid into an Olympic sport. Visible swelling (moon face), random skin infections, and slower wound healing all add up. And as a parent running after Dillon, being slowed down by these is the last thing you want.

One more kick: prednisone can interact with loads of common meds. Blood thinners, diabetes pills, and even regular painkillers like ibuprofen may clash. It’s not always flagged up as much as it should be, but it’s something to bring up with your doctor or pharmacist.

To give you a clearer sense, here’s a quick breakdown I made based on recent NHS numbers:

So, why do doctors still prescribe it? Simple: it usually works where nothing else does. But that doesn’t mean you have to accept these side effects as the price of getting better. Your bones, blood sugar, and mood aren’t just medical footnotes—they’re what make it possible to keep up with school runs, family walks on the Downs, or knacker the dog playing fetch when the rain lets up. You deserve all the tools you can get.

Counteracting Bone Loss, Blood Sugar Problems, and Mood Swings

Let’s start with bones. Fighting bone loss takes more than chugging a glass of milk. Prednisone lowers calcium absorption and vitamin D levels, so diet and supplements are your best friends. NHS specialists recommend at least 1,000 milligrams of calcium and 800 IUs of vitamin D daily. If you’re lactose intolerant or just don’t fancy cheese on everything, options like sardines (bones included!), broccoli, and fortified oat milk get you there. Vitamin D isn’t just a buzzword, either—it helps your body absorb calcium more effectively, so get outside for daylight if you can, or grab a supplement.

Weight-bearing exercise is non-negotiable. Walking Oscar or going for short jogs—even up and down the stairs with Dillon—helps maintain bone density. British researchers have shown that activities like brisk walking, gentle squats, and resistance training can offset bone loss even during steroid therapy. If the gym isn’t your thing, try some resistance bands at home. They’re cheap, effective, and don’t require fancy equipment.

Now, blood sugar. Let’s skip the sugar lectures; I get it, life’s short and chocolate is delicious. But on prednisone, even a few biscuits can jack your glucose. That means focusing on high-fibre foods (think wholegrain toast, lentils, apples with skin on) and protein at every meal—chicken, beans, or Greek yoghurt. Spacing out meals so you’re not starving and then stuffing yourself helps even more. If you’ve already got diabetes, your GP may want to check your blood sugars more often or tweak your meds.

Mood changes catch almost everyone off-guard. The trick is noticing your triggers and having a game plan. If you feel a rage bubble up, pause before reacting. Step outside, grab a drink of water, or text a friend (yes, really). Mindfulness apps, breathing exercises, or a ten-minute walk with Oscar can slice the edge off a spiraling mood. Sleep helps too, although prednisone doesn’t make that easy. Avoid caffeine in the afternoon, and try a wind-down routine—dull, but it can break the cycle of late-night overthinking.

Medicines to soften side effects are worth a chat with your provider. Some people need a short stint of anti-anxiety meds, melatonin for sleep, or even bone-building drugs like bisphosphonates if their risk is high. But don’t just grab over-the-counter stuff blindly, as some can mess with how prednisone works.

I’ve picked up a handful of practical tips from doctors, patients, and personal trial-and-error:

• If you’re prescribed a high dose, ask about “steroid-sparing” alternatives or whether your dose can be lowered after a few weeks.
• Take prednisone in the morning, with food, to mimic your natural cortisol cycle and soften mood swings or insomnia.
• Track your blood pressure and glucose, even if you’re not high risk—sometimes issues sneak up fast.
• If you get hard bruises or infections, flag it up immediately. Your immune system is nudged down a notch or two during treatment.

Now, when is it worth considering alternatives? Maybe you’re hitting a wall with side effects, or you just want to see what’s next on the science front. The latest review on prednisone alternative options offers a run-down on what actually stacks up, what’s wishful thinking, and which treatments are coming closer to reality. Options like methotrexate, biologics, and newer immune modulators don’t have the same risks for brittle bones or blood sugar spikes, but each has its own quirks.

For anyone dealing with what feels like a medication clash or an impossible choice, here’s a reminder from The British Medical Journal:

“Long-term steroid therapy can only be justified if protective measures are put in place to safeguard bone health, mental wellbeing, and metabolic balance.”

Stay Ahead of Prednisone Side Effects: Daily Measures That Add Up

No one wants to give up on the power of prednisone, but you definitely don’t have to accept the side effects lying down. Small daily habits can pad the gap between feeling rubbish and living your life—even if it’s just arguing with your kid about bedtime or getting Oscar to stop eating socks.

Set up a morning routine: take your med with breakfast, log the dose on your phone, and have a glass of water ready. Bonus points for a 15-minute dog walk after, for mood and bone health. It sounds basic, but habits like this make the difference. Even those short walks improve joint mobility and make you less likely to feel stiff or slow later in the day.

Meal planning helps too. Prep easy, healthy snacks—sliced veggies, mixed nuts, boiled eggs—so you’re not reaching straight for the biscuit tin when prednisone-induced hunger hits. Regular, nutritious meals with protein and fibre keep blood sugars from spiking and crashing, which also steadies out mood swings and the urge to binge.

Keep bone support front and centre. If you love gadgets, try a smart scale or bone density tracker; otherwise, mark down exercise sessions and calcium-rich meals on a wall planner or kitchen calendar. Seeing progress—however small—can be motivating on days when brain fog hits. And if you’re feeling wobbly, don’t be shy about asking your GP for a bone density scan, especially if you’re likely to be on steroids for more than a few weeks.

Your mental health deserves prep too. If you notice mood spikes or sleep tanking, set clear wind-down rituals: an audiobook instead of telly in bed, blackout curtains, no caffeine after lunch, and phone off at least 30 minutes before sleep. Keeping a ‘mood diary’ might sound like extra homework, but the routine alone can help you spot patterns. This makes it easier to get proper help if you need it—most GPs in the UK can refer you to a mental health nurse, and NHS online support groups are worth a look.

Another trick: rope in friends and family for a bit of gentle accountability. No one likes being nagged, but when my mood’s gone off the rails, Dillon is the first to notice, or Oscar (the dog) goes to sulk in the corner. Share what you’re going through; most people want to do something useful, even if that’s just giving you ten minutes’ break or cheering you up.

If you ever notice side effects spiraling—bone pain, new onset diabetes, deep blues that won’t shift—get in touch with your doctor promptly. There are more ways to ease steroids’ blow than you might hear about in the first appointment. And if things stay unmanageable, don’t be afraid to revisit whether prednisone is still your best option. There are a growing number of prednisone alternative options being studied and approved, so it’s not a dead end.

Managing prednisone’s side effects is a constant balance—but it’s completely doable with a bit of knowledge and support. From strengthening your bones and smoothing blood sugars, to keeping your mood steady enough for family game nights or a decent walk with your dog—it all matters, and every action adds up.