I have just had some blood test results. There are several results which need looking at but someone has added "Normal for this patient". When I have asked before PMR or Pred have been blamed. I took your advice once over breathlessness for example and the GP did further tests.
Now the Red Blood Cell Count is 3.77 in a range of 3.80 to 5.80 and the GFR is 50 in a range of 90.00 to 9999. mL/min - ten less than a reading in March. Again they have put normal for patient. Other readings are out of range. I have bad circulation - cold hands, feet and calves but they were dismissed by the GP. I think it is a lack of oxygen in the blood because I also have had cramps.
Rather than just let things ride, I thought I should see why these readings are adrift and what I can do about it. Hence the question about Pred and PMR. If they are the cause then I need to know.
I am down to 7.5 mg of Pred but have more weeks to go on that level. I am not keen on too many supplements and Vit B12 and folate are in range and I take Vit D and K. Prefer to see what foods would be helpful.
Any thoughts or advice would be appreciated. Many thanks
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Motida
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There is a form of anaemia which is known as "the anaemia of chronic disease" and is very commonly found in autoimmune conditions. That is almost certainly why your red cell count is a bit low, not much though, What was your haemoglobin level like?
The GFR can be a bit of a variable feast - if you had a high protein meal the night before, were a bit dehydrated when the blood sample was taken for example - then the level may be a bit lower than a day when dinner was vegan and you'd been drinking lots of water all morning! It is based on some assumptions too - and they may not be accurate. GFR also falls as we age - that normal range is for young healthy subjects and is unlikely to be seen in an 80 year old however well they are. Organs wear out, just like shoes and clothes or cars and the older they are, the less perfect they are.
But a lower eGFR doesn't necessarily mean kidney disease - other parameters are required too, such as protein in the urine and a low eGFR 3 times in a row, 60 was fine last time.
Cramps may be due to low magnesium in the cells - that isn't uncommon when you are on pred since it makes you lose more through the kidneys. Lots of people on the forum take magnesium supplements or use magnesium footbaths/oils or sprays to help that.
Cold feet are more likely to be poor circulation - not low oxygen levels in the blood. If they were low, you would be breathless and probably coughing quite a bit. If you are worried about that, buy a pulse oximeter from the chemist. It measures the oxygen in the blood by shining a light into your finger tip - if it is over 93 it is fine. Often it will be as high as 98-100 but 93 is fine too,
Thank you so much for all your information. It certainly brought a lot of relief.
The Haemoglobin estimation was 120 in a range of 115 - 165 g/L. Further down Serum urea level 8.3 in a range of 2.90 - 8.20 and Serum creatinine 97 in the race 49 -92 mol/L were both flagged up by the lab but GP has put normal for this patient.
I will see the GP next Friday to discuss the kidney situation and blood pressure etc. as I am breathless and have a persistent cough triggered by change in air temperature and if I breath too deeply. He said it is due to the steroids. Not much I can say to that is there? After reading the link you included on kidney health, I got a better idea of the risks of neglecting dropping levels of GFR. The ESR was 39 so coming down from 48 in March. Again normal for this patient! The bottom line is that these blood test results would give a very wrong idea to another specialist.
The lab computer flags anything outside the set normal range - even it it is only a tiny amount that could be put down to variation with the estimation or the changes due to age or other conditions. But other things need to be taken into consideration before getting too worried about them. And no specialist should just look at the figures without the rest of the clinical picture.
The cough COULD be due to the pred - but it isn't that common really. I had a cough with PMR that improved with pred when I eventually got it but if yours has started since PMR/pred he has some justification.
Because of its close association with (much better understood) GCA, PMR is believed to be a form of vasculitis. If the inflammation spreads beyond the muscles, to the kidneys or other internal organs, symptoms can begin to appear there, also. The treatment is the same: enough steroids to suppress the autoimmunity, but not so much as to leave the body wide-open to infection and other side effects.
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