Is it safe to treat a medical condition with tea, herbal supplements, and prednisone (a corticosteroid)?

Combining Herbal Supplements with Prednisone is Not Safe

Herbal supplements should not be combined with prednisone due to significant risks of drug interactions and potential for increased side effects. 1, 2

Risks of Combining Herbal Supplements with Prednisone

Drug Interactions and Safety Concerns

• The European League Against Rheumatism/American College of Rheumatology guidelines strongly recommend against using Chinese herbal preparations with conventional treatments like prednisone 1
• Prednisone is an immunosuppressant that increases infection risk, and herbal supplements may contain contaminants or adulterants that could cause infections in immunocompromised patients 2
• Herbal supplements lack standardization and quality control, making their interactions with prednisone unpredictable 1

Specific Concerns with Tea

• While some herbal teas like ginger, chamomile, and peppermint are commonly used for symptom management, they may interact with medications including prednisone 1
• Tea consumption, particularly medicinal teas, may cause increased nausea and diarrhea in patients on medications 1
• No clear evidence supports the safety of combining tea with prednisone 1

Prednisone Treatment Considerations

Proper Administration

• Prednisone should be taken as a single daily dose rather than divided doses 1
• Dosing should follow established guidelines based on the specific condition being treated:
  • For autoimmune conditions: 0.5-1 mg/kg/day initially with gradual tapering 1
  • For inflammatory conditions: 10-60 mg/day depending on severity 1

Side Effects and Monitoring

• Prednisone can cause significant side effects including:

  • Immunosuppression and increased infection risk 2
  • Metabolic effects (hyperglycemia, weight gain) 2
  • Bone density loss 2
  • Posterior subcapsular cataracts and glaucoma 2
  • Systemic absorption even from local injections 3

• Regular monitoring is required for:

  • Blood pressure
  • Blood glucose
  • Bone density (annual bone mineral densitometry) 1
  • Eye examinations for cataracts and glaucoma 1

High-Risk Populations

Particular caution is needed when considering prednisone in:

• Postmenopausal women (increased osteoporosis risk) 1
• People with diabetes (worsening glycemic control) 1
• Patients with latent infections (risk of reactivation) 2
• Those with emotional lability or psychiatric conditions 1
• Patients with hypertension 1

Alternative Approaches

For patients requiring corticosteroid therapy:

• Consider intramuscular methylprednisolone as an alternative to oral prednisone in appropriate cases 1
• For certain conditions, steroid-sparing agents like methotrexate may be appropriate to reduce prednisone exposure 1
• An individualized exercise program may help maintain muscle mass and reduce fall risk in patients on long-term corticosteroids 1

The combination of tea, herbal supplements, and prednisone poses significant risks with no proven benefits. Patients should always disclose all supplements to their healthcare providers before starting prednisone therapy.