Long-Term Follow-Up
Many transplant patients are left with a lot of questions about how to move forward and stay healthy after their transplant. We’ve curated a list of resources that address the most common questions we receive.
“It’s been 7 years now. This survey is a good yearly wake up for me. This is my second life (now one with a 3-year-old daughter), and I need to do better for her, my wife, and myself!”
— Allogeneic transplant patient, 2011
Newsletters
Results from the Financial/Time Toxicity and Revaccination After Transplant surveys that were completed by patients in 2022 and 2023.
Research Roundup and LTFU Profiles.
Honoring Dr. Mary Flowers, Fred Hutch and SCCA merger, Covid-19 survey
Covid-19 patient survey, Honoring Carina Moravec, ARNP, Dr. Paul Carpenter, Using MyChart to link and share your medical record
Clinical LTFU Leadership, Peer-to-Peer, Return to Work Survey
Patient Comments
For over 20 years, patients have been submitting LTFU questionnaires. Many patients have offered comments at the end of their questionnaire. Taken together, the comments show a patchwork of experiences. We selected comments that we thought were interesting and informative. Please note that while we’ve removed identifying information, we didn’t edit the quotes for content.
LTFU Research Papers
There have been many reserach papers published from responses to the many LTFU surveys patients have completed. Below are summaries from these papers.
COVID-19 Infection among Adult Long-Term Hematopoietic Cell Transplantation Survivors
Fatigue in Hematopoietic Cell Transplantation Survivors
Neurocognitive outcomes in adult survivors of hematopoietic cell transplant
Marital Distress among Hematopoietic Cell Transplantation Survivors
Sexual functioning in long-term survivors of hematopoietic cell transplantation
Neurocognition and Quality of Life for Pediatric patients
Autologous Transplantation - Late Effect and Quality of Life
PTSD in Patients and Caregivers
Heart disease risk after hematopoietic cell transplantation
Religious Spiritual Distress Screening
Religious and Spiritual Struggles
Depression and Fatigue among survivors of hematopoietic cell transplantation
Resilience, health, and quality of life among long-term survivors of hematopoietic cell transplant
Late cardiovascular complications after hematopoietic cell transplantation
Nonmalignant late effects and compromised functional status in hematopoietic cell transplantation
Preventive care practices among hematopoietic cell transplantation survivors
Resources
Below are a number of useful PDFs and documents that can answer questions about long-term follow-up care, dietary guidelines, nutritional needs, and more.
GVHD Assessment Tips (Allogeneic patients only)
Adult Allogeneic Transplant Manual
Adult Autologous Transplant Manual
Pediatric Allogeneic Transplant Manual
Pediatric Autologous Transplant Manual
Oral Photography Instructions - Video
Skin and Flexibility Photography
Dietary Guidelines
When you return home after your transplant, your immune system is still functioning below normal. You may also have increased nutrient needs due to medications or loss of muscle mass. Calories, protein, fluid, vitamins, and minerals are necessary for you to regain your immunity, maintain or achieve your weight goal, strengthen your muscles, and feel better!
Food Safety
- Allogeneic patients should continue the to follow diet guidelines for immunosuppressed patients until off all immunosuppressive therapy (such as prednisone, FK506, cyclosporine). Autologous patients should continue the diet during the first three months after transplant.
- When you discontinue the Diet Guidelines for Immunosuppressed Patients continue to use care when purchasing foods, preparing meals and dining out. Situations where you cannot control the cleanliness of the food put you at greater risk for acquiring a food-borne illness. Examples include salad bars, smorgasbords, delicatessens, bulk food bins, free food samples offered in stores. Review the Food Safety Guidelines in the Patient/Caregiver Manual.
- Continue to avoid herbal and other preparations, since they may contain harmful ingredients or infectious organisms. Herbs are not regulated for purity or for effect on health.
- If you rely on well water at home, have the water checked for purity at your local or county health department before using this water for drinking or food preparation. If you are unable to do this prior to moving home, you can boil the water at a full rolling boil for one minute prior to consumption or use in recipes. Boiled water may be stored up to three days in the refrigerator.
Calories and Body Weight
- Your goal is to maintain or achieve an appropriate weight for your body size.
- It is important to consume a nutritious diet including a variety of foods to promote recovery of your immune system.
- If you are underweight, weight gain may be slow after transplant. Set small goals (2-4 pounds or 1-2 kg per month). Don't skip meals or snacks. Drink beverages with calories and protein. Use supplements, such as Instant Breakfast®, Sustacal®, Ensure®, or Polycose®. Exercise to promote muscle gain.
- If you are overweight and medically stable (as determined by your physician and dietitian), you may choose to lose weight gradually - 1 pound/week. You must continue to eat a nutritious diet, following any special nutrition needs your dietitian has advised. Exercise is important prevent muscle loss.
- Calorie needs increase with fever, infection, and physical activity. Some people with Graft-versus-Host Disease (GVHD) may require more calories to maintain or gain weight.
Magnesium
- Cyclosporine and FK-506 increase magnesium loss from your body. Some people also lose magnesium due to other medications or after surgery, illness or autologous transplant. Supplementation (pill or intravenous infusion) is usually necessary. Your physician may need to adjust your magnesium dose based on your serum magnesium level.
- Magnesium-rich foods include nuts, bran cereals, brown rice and whole grain breads.
Fluid
- A high fluid intake helps flush your kidneys when you take medications that can impair kidney function, including Cyclosporine, FK-506, and some antibiotics.
- Serum (blood) Creatinine is a measure of kidney function. An above normal serum creatinine means that your kidneys are working below normal.
Blood Lipid Levels
Serum cholesterol and triglyceride levels can change after transplant due to medications including Cyclosporine and prednisone. If your cholesterol and triglyceride levels are elevated after transplant, have them remeasured two to three months after immunosuppressive drugs (Cyclosporine, prednisone, FK-506) are discontinued.
Vitamin and Mineral Supplements
Take a multiple vitamin/mineral supplement for one year following your transplant to ensure you get the vitamins and minerals you need while your body and immune system are recovering. A generic brand is fine. If you are considering taking any supplement (including antioxidants and herbal preparations) in addition to the vitamin/mineral supplement that has been recommended, discuss its' safety with your Fred Hutch dietitian.
When selecting a supplement, it should:
- Contain NO iron.
- Not be greater than 200% of the Recommended Dietary Allowance (RDA)
- Contain NO herbs or other plant materials.
Recommended Supplements For Adults
Mature Balance, One-a-Day 55 Plus
Protein
Your protein needs were higher than normal early after transplant to allow repair of cell damage caused by chemotherapy and radiation. Protein continues to be an important part of your diet to promote recovery of your immune system. Your protein requirement returns to normal two to three months after transplant, unless you have lost a large amount of muscle or are taking prednisone. Protein-rich foods are listed below. Your dietitian will tell you your daily requirement.
Protein Content of Selected Foods
Food Item | Serving Size | Grams Protein |
Beans: baked Refried | 1/2 cup 1/2 cup | 7 8 |
Cheese | 1 oz. or 1" cube | 7 |
Chicken: breast thigh or drumstick wing | 1/2 1 1 | 27 14 8 |
Chicken Noodle Soup, Campbell's Healthy Request Chunky | 1/2 cup 10 3/4 oz. | 3 12 |
Cocoa, instant - mixed with milk | 1 cup | 11 |
Cooked beef, fish, lamb, pork: size of a deck of cards | 3 oz. | 21 |
Cottage cheese | 1/4 cup | 7 |
Egg | 1 | 6 |
Hot dog | 1 (10/lb.) | 5-6 |
Ice cream or ice milk | 1 cup | 5 |
Luncheon meat: ham, turkey | 1 oz. | 5 |
Macaroni and cheese: Healthy Choice Stouffers Kraft Original | 9 oz. 6 oz. 1 cup | 15 11 11 |
Milk (nonfat, 2%, whole, buttermilk) | 1 cup | 8 |
McDonald's hamburger, single patty cheeseburger chicken nuggets shake | 1 1 6 nuggets 1 regular | 14 17 19 9 |
Peanut butter | 1 Tbs. | 4 |
Pizza: meat, vegetable, cheese | 1/8 of 12" | 13 |
Franco American Spaghettios with meatballs | 1 cup | 11 |
Pudding | 1/2 cup | 2 to 4 |
Taco Bellâ: taco | 1 | 10 |
Tofu | 1/2 cup | 10 |
Tuna | 1 oz. 1/6 can | 7 |
Yogurt: Yoplait fruit | 6 oz. | 5 |
Pediasure | 1 cup | 8 |
Instant Breakfast (made with milk) | 1 serving | 15 |
ScandiShake made with 8 oz. milk | 1 serving | 14 |
Sustacal, Boost, Sustacal Plus | 1 cup | 14-15 |
Calcium and Vitamin D
Calcium is essential for bone health, especially in:
- Adult females with hormonal changes
- Children and teens
- People taking prednisone
Vitamin D is needed for calcium absorption and transport to the bones. Food sources include fortified milk (100 IU/8 ounces); canned tuna and salmon (200-300 IU/3 ounces).
Calcium and Vitamin D Requirements after Transplant
Age | Calcium | Vitamin D | ||
Adequate Intake | During Prednisone | Adequate Intake | During Prednisone | |
Adult Males | 1000 mg | 1500 mg | 200 IU | 800 IU |
Adult females: with hormone therapy | 1000-1200 mg | 1500 mg | 200 IU | 800 IU |
Adult females: no hormone therapy | 1200-1500 mg | 1500 mg | 400-800 IU | 800 IU |
Choosing a calcium supplement
If you are not able to get the amount of calcium you require from foods, you should take a calcium supplement. Choose a supplement with vitamin D if your intake of vitamin D from food and your multiple vitamin supplement does not meet your requirement.
There are two main types of calcium supplements: calcium citrate and calcium carbonate. The following table shows the differences between these supplements and the best time to take them. Note: if you are taking a prescription to decrease stomach acid or use antacids on a daily basis, calcium citrate is recommended (instead of calcium carbonate).
Calcium Citrate | Calcium Carbonate |
Can be taken any time during the day. | Must to taken with meals or snacks for best absorption. |
Does not require stomach acid for absorption. | Requires stomach acid for absorption. Do not take with antacids. |
Gentle on stomach. | May cause gas, constipation, bloating |
Look for "USP" on label or box (confirms pill will dissolve in normal stomach acidity.) |
Calcium Content of Selected Foods
Food | Serving Size | mg Calcium |
Cheddar cheese | 1 oz. or 1" cube | 200 |
Swiss cheese | 1 oz. | 270 |
Cottage cheese | 1/4 cup | 35 |
Cream cheese | 1 Tbs. | 12 |
Kraft string cheese stick | 1 oz. | 150 |
Kraft processed American cheese slice | 3/4 oz. slice | 100 |
Kraft parmesan cheese | 1 Tbs. | 69 |
Beans: baked or refried | 1/2 cup | 65 |
Calcium-fortified orange juice | 1/2 cup | 150 |
Cocoa, instant - made with water made with milk | 1 cup 1 cup | 95 315 |
Cream soup (made with milk) | 1 cup | 180 |
Ice cream or ice milk | 1/2 cup | 85 |
Macaroni and cheese: Frozen: Healthy Choice Stouffers Made from box mix: Kraft Original | 9 oz. 6 oz. 1 cup | 300 240 100 |
Milk (nonfat, 2%, whole, buttermilk) | 1 cup | 300 |
Milk, calcium fortified | 1 cup | 400 |
McDonald's shake | 1 shake (10 oz.) | 325 |
Pizza: meat, vegetable, cheese | 1/8 of 12" pie | 100 |
Pudding: Del Monte or Snack Pack pudding cup Jello pudding snack Instant, made from mix | 3.5 oz. 4 oz. 1/2 cup | 50-60 94 150 |
Tofu | 1/2 cup | 130 |
Yogurt: Yoplait fruit flavor Dannon fruit flavor | 6 oz. 8 oz. | 200 350 |
Pediasure | 1 cup | 230 |
Instant Breakfast (made with 8 oz. milk) | 1 serving | 500 |
ScandiShake (made with 8 oz. milk) | 1 serving | 400 |
Sustacal, Boost, and Sustacal Plus | 1 cup | 200 |
Citracal | 1 | 200 |
Citracal + D (200 IU vitamin D per pill) | 1 | 315 |
Tums: Regular Strength E-X Ultra | 1 1 1 | 200 300 400 |
Nutrition Guidelines During Prednisone Treatment
- Protein: A protein-rich diet and exercise can help prevent muscle loss. Include a protein-rich food in every meal and consume 2 to 3 protein-rich beverages or snacks daily. Exercise can include walking, bicycling, low-impact aerobics.
- Calcium: Consume a calcium-rich diet and exercise daily to minimize bone loss. If your calcium intake is low, take a supplement of calcium carbonate (such as Tums) or calcium citrate (such as Citracal).
- Sugar (carbohydrate, glucose): If your blood glucose level is above normal, discuss with your dietitian or doctor whether dietary changes or insulin therapy are needed. You may be able to improve your blood glucose levels by avoiding sugar-containing beverages and fruit juices, and being careful to avoid eating more energy (calories) than your body needs.
- Potassium: You may need more potassium in your diet while taking prednisone. The following are good sources of potassium: bananas, oranges and orange juice, canteloupe, Instant Breakfast, beans (chili, kidney, refried, etc.), potatoes, Sustacal, Boost, tomatoes, tomato juice, V-8, winter squash, ScandiShake (Your dietitian can give you a more complete list.)
- Salt: A high salt intake can worsen fluid retention caused by prednisone. Avoid salt and salty foods such as canned, instant, and frozen soups and entrees, soy sauce, cured meats, and packaged sauces and seasonings. In general, processed foods contain too much salt.
Discuss With Your Doctor If:
- Your weight drops more than 2 pounds (1 kg) in 7 days
- You develop nausea, vomiting, diarrhea, stomach or intestinal cramps
- Your mouth becomes drier, sensitive, or develops sores
- You have swallowing difficulties
When you return home after your transplant, your immune system is still functioning below normal. You may also have increased nutrient needs due to medications or loss of muscle mass. Calories, protein, fluid, vitamins, and minerals are necessary for you to regain your immunity, maintain or achieve your weight goal, strengthen your muscles, and feel better!
Food Safety
- Allogeneic patients should continue the immunosuppressed patient diet until off all immunosuppressive therapy (such as prednisone, FK506, cyclosporine). Autologous patients should continue the diet during the first three months after transplant.
- When you discontinue the Immunosuppressed Patient Diet continue to use care when purchasing foods, preparing meals and dining out. Situations where you cannot control the cleanliness of the food put you at greater risk for acquiring a food-borne illness. Examples include salad bars, smorgasbords, delicatessens, bulk food bins, free food samples offered in stores. Review the Food Safety Guidelines in the Patient/Caregiver Manual.
- Continue to avoid herbal and other preparations, since they may contain harmful ingredients or infectious organisms. Herbs are not regulated for purity or for effect on health.
- If you rely on well water at home, have the water checked for purity at your local or county health department before using this water for drinking or food preparation. If you are unable to do this prior to moving home, you can boil the water at a full rolling boil for one minute prior to consumption or use in recipes. Boiled water may be stored up to three days in the refrigerator.
Calories and Body Weight
- Your goal is to maintain or achieve an appropriate weight for your body size.
- It is important to consume a nutritious diet including a variety of foods to promote recovery of your immune system.
- If you are underweight, weight gain may be slow after transplant. Set small goals (2-4 pounds or 1-2 kg per month). Don't skip meals or snacks. Drink beverages with calories and protein. Use supplements, such as Instant Breakfast®, Sustacal®, Ensure®, or Polycose®. Exercise to promote muscle gain.
- If you are overweight and medically stable (as determined by your physician and dietitian), you may choose to lose weight gradually - 1 pound/week. You must continue to eat a nutritious diet, following any special nutrition needs your dietitian has advised. Exercise is important prevent muscle loss.
- Calorie needs increase with fever, infection, and physical activity. Some people with Graft-versus-Host Disease (GVHD) may require more calories to maintain or gain weight.
Monitoring Height and Weight
Height and weight should be measured at your doctor's office: every month for pre-pubertal children or every three months following puberty. Record these values on the growth chart provided by your dietitian. When your child returns to Seattle for long-term evaluation, bring the growth chart with you.
Magnesium
- Cyclosporine and FK-506 increase magnesium loss from your body. Some people also lose magnesium due to other medications or after surgery, illness or autologous transplant. Supplementation (pill or intravenous infusion) is usually necessary. Your physician may need to adjust your magnesium dose based on your serum magnesium level.
- Magnesium-rich foods include nuts, bran cereals, brown rice and whole grain breads.
Fluid
- A high fluid intake helps flush your kidneys when you take medications that can impair kidney function, including Cyclosporine, FK-506, and some antibiotics.
- Serum (blood) Creatinine is a measure of kidney function. An above normal serum creatinine means that your kidneys are working below normal.
Blood Lipid Levels
Serum cholesterol and triglyceride levels can change after transplant due to medications including Cyclosporine and prednisone. If your cholesterol and triglyceride levels are elevated after transplant, have them remeasured two to three months after immunosuppressive drugs (Cyclosporine, prednisone, FK-506) are discontinued.
Normal Cholesterol and Triglyceride Ranges
Age: | Cholesterol (mg/dl) | Triglyceride (mg/dl) |
Below 1 year | 50-120 | 29-154 |
1-2 years | 70-190 | 29-154 |
2-16 years | <200 | 29-154 |
Adults | <200 | 30-150 |
Vitamin and Mineral Supplements
Take a multiple vitamin/mineral supplement for one year following your transplant to ensure you get the vitamins and minerals you need while your body and immune system are recovering. A generic brand is fine. If you are considering taking any supplement (including antioxidants and herbal preparations) in addition to the vitamin/mineral supplement that has been recommended, discuss its' safety with your Fred Hutch dietitian.
When selecting a supplement, it should:
- Contain NO iron.
- Not be greater than 200% of the Recommended Dietary Allowance (RDA)
- Contain NO herbs or other plant materials.
Recommended Supplements:
Children under 10 years: Fruity Chews, Sesame Street Vitamin Chewable Tablets (Follow the dose listed on the label for the age of your child.)
Children 10 years or older: Mature Balance, One-a-Day 55 Plus
Protein
Your protein needs were higher than normal early after transplant to allow repair of cell damage caused by chemotherapy and radiation. Protein continues to be an important part of your diet to promote recovery of your immune system. Your protein requirement returns to normal two to three months after transplant, unless you have lost a large amount of muscle or are taking prednisone. Protein-rich foods are listed below. Your dietitian will tell you your daily requirement.
Protein Content of Selected Foods
Food Item | Serving Size | Grams Protein |
Beans: baked Refried | 1/2 cup 1/2 cup | 7 8 |
Cheese | 1 oz. or 1" cube | 7 |
Chicken: breast thigh or drumstick wing | 1/2 1 1 | 27 14 8 |
Chicken Noodle Soup, Campbell's Healthy Request Chunky | 1/2 cup 10 3/4 oz. | 3 12 |
Cocoa, instant - mixed with milk | 1 cup | 11 |
Cooked beef, fish, lamb, pork: size of a deck of cards | 3 oz. | 21 |
Cottage cheese | 1/4 cup | 7 |
Egg | 1 | 6 |
Hot dog | 1 (10/lb.) | 5-6 |
Ice cream or ice milk | 1 cup | 5 |
Luncheon meat: ham, turkey | 1 oz. | 5 |
Macaroni and cheese: Healthy Choice Stouffers Kraft Original | 9 oz. 6 oz. 1 cup | 15 11 11 |
Milk (nonfat, 2%, whole, buttermilk) | 1 cup | 8 |
McDonald's hamburger, single patty cheeseburger chicken nuggets shake | 1 1 6 nuggets 1 regular | 14 17 19 9 |
Peanut butter | 1 Tbs. | 4 |
Pizza: meat, vegetable, cheese | 1/8 of 12" | 13 |
Franco American Spaghettios with meatballs | 1 cup | 11 |
Pudding | 1/2 cup | 2 to 4 |
Taco Bellâ: taco | 1 | 10 |
Tofu | 1/2 cup | 10 |
Tuna | 1 oz. 1/6 can | 7 |
Yogurt: Yoplait fruit | 6 oz. | 5 |
Pediasure | 1 cup | 8 |
Instant Breakfast (made with milk) | 1 serving | 15 |
ScandiShake made with 8 oz. milk | 1 serving | 14 |
Sustacal, Boost, Sustacal Plus | 1 cup | 14-15 |
Calcium and Vitamin D
Calcium is essential for bone health, especially in:
- Adult females with hormonal changes
- Children and teens
- People taking prednisone
Vitamin D is needed for calcium absorption and transport to the bones. Food sources include fortified milk (100 IU/8 ounces); canned tuna and salmon (200-300 IU/3 ounces), fortified cereals (40-80 IU/serving), Carnation breakfast bars (100 IU/bar).
Calcium and Vitamin D Requirements after Transplant
Age: | Calcium | Vitamin D | ||
Adequate | During Prednisone | Adequate | During Prednisone | |
0-6 months | 210 mg | 400 mg | 200 IU | 300 IU |
6-12 months | 270 mg | 600 mg | 200 IU | 400 IU |
1-3 years | 500 mg | 800 mg | 200 IU | 400 IU |
4-5 years | 800 mg | 800 mg | 200 IU | 400 IU |
6-8 years | 800 mg | 1200 mg | 200 IU | 400 IU |
9-18 years | 1300 mg | 1600 mg | 200 IU | 400-800 IU |
Choosing a calcium supplement
If you are not able to get the amount of calcium you require from foods, you should take a calcium supplement. Choose a supplement with vitamin D if your intake of vitamin D from food and your multiple vitamin supplement does not meet your requirement.
There are two main types of calcium supplements: calcium citrate and calcium carbonate. The following table shows the differences between these supplements and the best time to take them. Note: if you are taking a prescription to decrease stomach acid or use antacids on a daily basis, calcium citrate is recommended (instead of calcium carbonate).
Calcium Citrate | Calcium Carbonate |
Can be taken any time during the day. | Must to taken with meals or snacks for best absorption. |
Does not require stomach acid for absorption. | Requires stomach acid for absorption. Do not take with antacids. |
Gentle on stomach. | May cause gas, constipation, bloating |
Look for "USP" on label or box (confirms pill will dissolve in normal stomach acidity.) |
Calcium Content of Selected Foods
Food | Serving Size | mg Calcium |
Cheddar cheese | 1 oz. or 1" cube | 200 |
Swiss cheese | 1 oz. | 270 |
Cottage cheese | 1/4 cup | 35 |
Cream cheese | 1 Tbs. | 12 |
Kraft string cheese stick | 1 oz. | 150 |
Kraft processed American cheese slice | 3/4 oz. slice | 100 |
Kraft parmesan cheese | 1 Tbs. | 69 |
Beans: baked or refried | 1/2 cup | 65 |
Calcium-fortified orange juice | 1/2 cup | 150 |
Cocoa, instant - made with water made with milk | 1 cup 1 cup | 95 315 |
Cream soup (made with milk) | 1 cup | 180 |
Ice cream or ice milk | 1/2 cup | 85 |
Macaroni and cheese: Frozen: Healthy Choice Stouffers Made from box mix: Kraft Original | 9 oz. 6 oz. 1 cup | 300 240 100 |
Milk (nonfat, 2%, whole, buttermilk) | 1 cup | 300 |
Milk, calcium fortified | 1 cup | 400 |
McDonald's shake | 1 shake (10 oz.) | 325 |
Pizza: meat, vegetable, cheese | 1/8 of 12" pie | 100 |
Pudding: Del Monte or Snack Pack pudding cup Jello pudding snack Instant, made from mix | 3.5 oz. 4 oz. 1/2 cup | 50-60 94 150 |
Tofu | 1/2 cup | 130 |
Yogurt: Yoplait fruit flavor Dannon fruit flavor | 6 oz. 8 oz. | 200 350 |
Pediasure | 1 cup | 230 |
Instant Breakfast (made with 8 oz. milk) | 1 serving | 500 |
ScandiShake (made with 8 oz. milk) | 1 serving | 400 |
Sustacal, Boost, and Sustacal Plus | 1 cup | 200 |
Citracal | 1 | 200 |
Citracal + D (200 IU vitamin D per pill) | 1 | 315 |
Tums: Regular Strength E-X Ultra | 1 1 1 | 200 300 400 |
Nutrition Guidelines During Prednisone Treatment
- Protein: A protein-rich diet and exercise can help prevent muscle loss. Include a protein-rich food in every meal and consume 2 to 3 protein-rich beverages or snacks daily. Exercise can include walking, bicycling, low-impact aerobics.
- Calcium: Consume a calcium-rich diet and exercise daily to minimize bone loss. If your calcium intake is low, take a supplement of calcium carbonate (such as Tums) or calcium citrate (such as Citracal).
- Sugar (carbohydrate, glucose): If your blood glucose level is above normal, discuss with your dietitian or doctor whether dietary changes or insulin therapy are needed. You may be able to improve your blood glucose levels by avoiding sugar-containing beverages and fruit juices, and being careful to avoid eating more energy (calories) than your body needs.
- Potassium: You may need more potassium in your diet while taking prednisone. The following are good sources of potassium: bananas, oranges and orange juice, canteloupe, Instant Breakfast, beans (chili, kidney, refried, etc.), potatoes, Sustacal, Boost, tomatoes, tomato juice, V-8, winter squash, ScandiShake (Your dietitian can give you a more complete list.)
- Salt: A high salt intake can worsen fluid retention caused by prednisone. Avoid salt and salty foods such as canned, instant, and frozen soups and entrees, soy sauce, cured meats, and packaged sauces and seasonings. In general, processed foods contain too much salt.
Discuss With Your Doctor If:
- Your weight drops more than 2 pounds (1 kg) in 7 days
- You develop nausea, vomiting, diarrhea, stomach or intestinal cramps
- Your mouth becomes drier, sensitive, or develops sores
- You have swallowing difficulties