Prednisone speeds recovery from bad poison ivy

By Joe Graedon, M.S., and Teresa Graedon, Ph.D.

Q. There’s poison ivy, and there’s POISON IVY! My husband gets a barely noticeable, itchy rash that doesn’t impact his daily life in any measurable way. When I get poison ivy, I swell up like a balloon. The blisters are the size of half golf balls, and when they finally start draining, it takes days before the oozing stops.

Twice in my life I spent more than a week in bed prior to finally going to the doctor for help. I was only able to get up to use the bathroom, which was agony. For me, a typical course of poison ivy lasts more than two weeks. Prednisone is a lifesaver in my case.

A. For a severe allergic reaction like yours, corticosteroids like prednisone can be extremely helpful. A slow taper over a week or two is generally recommended. Dropping the dose too rapidly can lead to symptoms of adrenal dysfunction such as muscle weakness, fatigue, dizziness, fainting, headache, nausea, loss of appetite and low blood sugar.

Q. My insurance company won’t pay for Synthroid to treat hypothyroidism. As a result, I took the generic levothyroxine that my pharmacy dispensed for several months.

I thought I was going to jump out of my skin as I had such a horrible reaction. My heart rate went way up, and I had multiple bowel movements a day.

I learned that although generics have to use the main ingredient of brand names, they can use whatever fillers they want.

I have now been on Armour Thyroid for a few years. What a remarkable difference! I have so much more energy, and not the rapid heart rate and excess time in the bathroom that I had on the generic.

A. The Food and Drug Administration maintains that generic levothyroxine is the same as brand name Synthroid (JAMA Internal Medicine, Feb. 28, 2022). Your story is not unusual, however. We have heard from many readers that some generic thyroid pills do not behave the same as Synthroid.

Desiccated thyroid extract such as Armour, Westhroid, Nature-Throid or Erfa Thyroid contains both thyroid hormones, T4 (levothyroxine) and T3 (triiodothyronine). This makes a big difference for some people.

To learn more about treating hypothyroidism with levothyroxine or desiccated thyroid extract, you may wish to read our eGuide to Thyroid Hormones. This online resource is available under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. I read your article about swallowing big pills. I have tried most of the methods mentioned, but a different one works best for me: I make a nice, thick smoothie or milkshake when I have to swallow a big pill. Because the texture is thick, I barely notice the pill .

A. Your idea works great as long as the medicine does not interact with food or dairy .

Q. I used Primatene Mist for many years for asthma relief. It worked well for me, so I was disappointed when it disappeared.

My doctor switched me to prescription albuterol. Within a short time, the price skyrocketed, apparently due to a change in propellant from CFC to HFC. The drug company considered it a new or reformulated drug and jacked the price way up.

I am so glad that Primatene is available once again, as it is considerably cheaper than prescription albuterol.

A. Primatene Mist contains epinephrine, an old medication that opens airways. It was introduced in 1981 and removed in 2011 because of the propellant. This over-the-counter asthma inhaler was reintroduced with a different propellant in 2019.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”