Anabolic resistance - prednisolone

Medical Q&A [Moderated]
1

Hi guys, I have recently caught up on old content on YouTube, and in one of the vlogs (vlog #33) Jordan talked about anabolic resistance, and mentioned glucocorticoids. The reason this is so interesting to me is because I have had a kidney transplant (chronic kidney disease, IgA Nephropathy, diagnosed as a child – led to complete kidney failure at 30, a few months on dialysis and then transplant in Nov 2012), and part of my medication regime is prednisolone, which is of course a glucocorticoid.

I was already aware that the pred is a problem to my training, as it inhibits mTOR, upregulates myostatin expression, etc, and so is just not something any right minded individual interested in strength training would take unless it was absolutely necessary…which unfortunately it is. I am now at 5mg daily, and that will be the dose I remain on for the life of the transplant (so hopefully a long time, but who knows).

So for a while now I’ve been trying to minimise the impact that this has on my training, by always aiming to time when I take it each day as far away from my training time as possible, and typically to also consume a good amount of protein/carbs alongside it, and thus try to reduce the interference with times when MPS should be at its highest, and also to provide some MPS stimulus when taking it.

I guess my questions on this are:

  1. Are my attempts to minimise the impact of the pred on my training likely to be having any effect, or is the fact that I’m taking it daily meaning that there’s plenty of it in my bloodstream and hence I can’t really do a great deal to offset the negative impacts to MPS, etc? I saw that the half-life for pred is 16-36 hours, sourced from Wikipedia, so must be true, right?
  2. How significant is a dose of 5mg likely to be?
2

Hi there,

I think you’re right that there is relatively little you can do to offset these effects, but I also think that the things you are doing are reasonable, since they probably aren’t a major inconvenience either. In other words, regardless of the pharmacokinetics at play, I would probably also take the dose further away from training vs. right before training. The main thing, though, is to ensure you’re training regularly and meeting the other physical activity guideline minimums - which will have a number of other beneficial effects beyond just muscle protein synthesis for someone in your situation.

3

Thanks, Austin. Agree 100% re the wider beneficial impact of meeting physical activity guidelines (to be fair, I’m doing a lot more than the minimum, so no worries there!).

Good to know, though, and yes it is ultimately no trouble trying to space out when I dose the pred versus when I train, and it won’t harm me by doing so, so I may as well give it a shot. Bottom line is I will certainly continue training consistently, following good nutrition, and I make gainzzz then great, if I just end up trying to cling on to what I have then so be it. It’s way better than being on dialysis or dead…