high inflammation markers but no pain.

[Cycleman]

I was on Prednisolone for about 6 years. For the last year I have been on zero with no recurrent symptoms of PMR.

I have recently had a number of blood tests as I had been to the doctor complaining about lethargy and tiredness. I remain active, going to the gym 3x a week although struggling somewhat.

The blood tests showed low folate, which could be a contributing factor, but of concer is that my inflammatory markers. Specifically ESR-58 and CRP-20 mg/l. These values are similar to those when I was first diagnosed with PMR, yet I don’t have any external aches or pain.

The GP is quite concerned and will keep monitoring with the possibility of referral.

I would be grateful for any comments on possible reasons

[PMRpro Ambassador]

It is usually the other way round - normal markers with symptoms rampant!! They are raised quite a bit but they are very non-specific and it could be anything really.

Studies have shown that low folate and B12 can be associated with raised inflammation levels because of their role in the metabolism of regenerating methionine from homocysteine so there may well be SOMETHING going on though what it might be is an interesting question!

[Cycleman in reply to PMRpro]

Thanks, Pretty sure it’s not PMR related or adrenal insufficiency. GP is monitoring as it is related to something probably internal. In the meantime I’m cutting out ultra processed food + chocolate, ice cream, biscuits & cakes, as I’m an ardent consumer

[DorsetLady PMRGCAuk volunteer]

As you know inflammation is a feature of many conditions, high levels do not AUTOMATICALLY mean you have a return of GCA/PMR, and further tests are needed to help rule out other conditions that cause inflammation. Your GP is spot on...

[piglette]

It can take up to a year or more to get your adrenals back to full working order.

[Cycleman in reply to piglette]

Thanks- pretty sure it’s not adrenal insufficiency, although I did raise with GP.

[piglette in reply to Cycleman]

As you say it is quite possible it is something totally different. We do tend to blame PMR for everything!!

[darkred in reply to piglette]

True! Right now, I'm carefully monitoring my shoulder pain. I ask myself: Is it PMR pain or osteoarthritis? Or a little of both? Extra strength Tylenol helped last night, indicating it is not PMR at the moment. Will have to see if Tylenol helps in the future. If it does not help, I will suspect PMR pain. In the meantime, I will avoid heavy lifting and overuse.

I would truly like to exercise more, but I know overuse should be avoided right now. I'm doing what my body tells me.

[Gimme]

I am glad that the GP is monitoring it.

[nuigini]

I've had the same issue of increasing CRP for almost a year without PMR related symptoms and currently undergoing a variety of tests to determine the cause.