interaction question - Harmalas and corticosteroids (prednisone)

[Anodyne]

This one is so specific I am having trouble finding an answer, I was hoping someone could help me with this, and apologise if I've missed a thread which covers it.

I take an oral corticosteroid (prednisone,10mg) for a fairly serious autoimmune condition (actually a cluster: ankylosing spondylitis, psoriatic arthritis, IBS, and the like) and was wondering about potential interactions with a caapi-chacruna brew. I haven't found any direct interactions, but am wondering about secondary effects because prednisone increases adrenaline levels. Does anyone know whether this is likely to be a concern? Of course I will go off my meds if necessary, but the physical effects of my condition are pretty bad, and I'm concerned that I wouldn't tolerate the rigours of purging very well while unmedicated. The fatigue especially is crippling, I would often have trouble finishing a bowl of cereal let alone a nauseating brew.

I'm not asking for a definite answer, because I know there probably isn't one. I was just hoping that someone else might have had some personal experience with this combination, or be able to make an educated guess. I appreciate any advice.

 

[corpus callosum]

If you have been on prednisone for more than a couple of weeks you should NEVER stop the treatment abruptly; the dose should always be tapered down to allow your adrenal gland to 'wake up' and start producing glucocorticoids again.

Harmala alkaloids inhibit CYP3a4 which has a role in metabolising prednisone, so the combination can magnify the effects of the steroid including adverse effects on glucose tolerance and lipid profiles.

 

[Anodyne]

Oh dear, I wasn't even thinking about CYP inhibition. I certainly am now though! Do you know roughly how much of an increase in effects could be expected from the 3a4 inhibition?

Thankyou for the warning about the danger of stopping prednisone suddenly. I was aware of this, but a reminder is a very very good idea in a public thread.

 

[Warrior]

If you're feeling brave, make yourself some syrian rue tea. Make about 10g worth at a time ith some lemon juice, and keep it in the fridge. You could try--on your own accord--titrating very small amounts of the tea until you find some kind of non-lethal adverse effect.

I think the path you are on is a valid one, and a possible utopia of healing power. I have had a variety of health problems, including autoimmune, that dried up and vanished after some heavy experiences with Ayahuasca. I had joint problems (RA), ulcerative colitis, among other things. But I've also always been very active in spite of my physical limitations. I had a lot of health problems, sometimes all at once. I can empathize. Just be careful and go slow. They are as much in your head as they are real and affecting your body. It's weird when you see it for yourself. Stay smart and informed about it like you're doing.

Best wishes to you!

 

[Anodyne]

First trial yesterday. I'd done a sensitivity test with ~1g caapi earlier in the week, just to be sure I wasn't allergic or something (and to check how it tasted :d )
I halved my daily dose of prednisone, knowing from previous experience that I can tolerate this reduction without withdrawal effects (anyone else attempting a similar reduction please use caution, as CC says, this can be dangerous). I took 5mg in the early morning to allow full absorption, followed by 40g caapi around 1pm. No adverse effects.

Warrior, thankyou for your thoughts. I am thinking along similar lines I believe. I may not be able to change my illness, but I can certainly change how much I let it influence my life.

(p.s. Thankyou whoever changed the title, I'll try to name them better in the future!)