High CRP, low b12 and low heamoglobin

My husband has had awful problems with various DMARDS and came off Suphasalazine in September after bad side effects. Since then he has had problems with increasing CRP levels (now at 50), low iron and b12. He has also started itching all over his body - this is keeping him awake at night and he large sores where he has scratched. The rheumy nurse says itching nothing to do with RA but gave him an appointment for a review with specialist at end of January. He has been visiting his GP weekly, tried various creams and antihistamines all of which have had no impact. The GP has now said its systematic not topical and no cream will stop the itch. They've tested him for his liver and he's had an endoscopy as they thought the low iron could be a result of a bleed in his stomach - thank goodness all clear. The GP yesterday has now told him to stop Naproxen, up hi so cocodemol to max and wait for RA appointment at end of January. We get the feeling GP is out of his depth. Anyone else had similar issues?

12 Replies

  • Well I had low Haemoglobin for years until my disease (Psoriatic Arthritis) finally responded to treatment with Humira. Prior to getting ill I'd never been anaemic. There is something called 'anaemia of chronic disease' whereby the body squirrels away iron somewhere or other as a response to chronic disease and that's what I had. My Hb was never particularly low, just constantly a little less than it should be despite much spinach etc.! It wasn't a serious situation. Of course your husbands low levels might be something else entirely, but you can run that phrase 'anaemia of chronic disease?' past your GP and see what he thinks.

    As for CRP, well that's a measure of how much inflammation there is in the body and if you have untreated inflammatory arthritis that's to be expected. The itching sounds horrible. I know my GP would really only refer me to one specialist at a time, but it does sound as if, ideally, he should have an appointment with a dermatologist as well ..... perhaps the GP could arrange one and then cancel it if his rheumy comes up with an explanation. I think that's what I'd ask for anyway.

    I hope the upcoming rheumy appointment leads to answers and effective treatment.

  • Thank you for responding postie2 - this isn't the first time with the itching but it started 4 years ago when he had a bad reaction (skin blisters, mouth sores) to hydrachloquine. Methotrexate cleared it and despite a number of issues with methotrexate the itching stopped. However he had to come off the methotrexate in May due to issues with low white blood cells amongst other things. He then went onto sulphasalzine and after side affects again (he tried this drug 3 years ago) such as dizzy ness (he'd fall over as if drunk) he came off in September when the itching started. It seems the dmards are worse than the RA symptoms - needless to say his RA is still there and no better. The dmards never stopped the pain just added to his mix of issues!

  • Anaemia is also a symptom in coeliac/ gluten and wheat intolerance. And recently I have discovered that itching is also a symptom of thyroid problems. I have been itching for longer than I can remember and find that the antihistamine Telfast ( Fexofenadine) 180mg daily goes a long way in helping to alleviate this. I was diagnosed with underactive thyroid last year and have read that once it is properly medicated, itching may stop. Perhaps you can get a thyroid bloodtest done? Also read up on this ( thyroid group on Health unlocked) because just because bloodtests fall within so called "normal" ranges doesn't mean optimal. Good luck. Clemmie

  • Just one more thing, RA, under/overactive thyroid, coeliac, gluten/wheat intolerance are all auto immune problems and you tend to develop more than one so it is possible that your husband is adding to his collection! That's what has happened to me lol. Clemmie

  • Thanks Clemmie - we've also been doing some research and thought it may be Colieac. He mentioned this to GP yesterday along with thyroid and he is having blood test on Monday. Thank you as well for suggestion re the Telfast he will ask his GP on Monday - anything is worth trying we can really feel for you - no one knows unless you have suffered with it how bad itching can be and what a deterimental affect it can have on your life x

  • Itching can be caused by so many things. I have it, Dermatologist diagnosed Nodular Prurigo but would not give me systemic treatment, only creams - which did not work. Rheumy has said it's Rheumatoid Vasculitis, and I initially responded to treatment. High dose Prednisolone, 20mg Leflunomide, 20ml MTX injections. But as the Pred dose has been lowered, the itching has returned. So don't know what to think now!!

  • Thank you it's really difficult, at least your rheumy gave you some diagnosis and treatment. My husbands rheumy just says nothing to do with RA!!!. His GP gave him prednisone (more because of a bad flare) and it did help but it was a short term dose and soon as it was stopped itching plus pain returned. I really hope you can get some relief it's not good x

  • Low iron and low B12 is a good reason to test for malabsorption problems, in particular, coeliac disease. if he hasn't been tested, maybe he could ask his GP if it could possibly be a malabsorption problem like coeliac.

  • Thank you Earthwitch he is seeing his GP Friday and will ask x

  • Hi

    How did your husband get on?

    Sorry just reading your post now. Sounds like Coeliac Disease to me. Maybe they tested him when he had the endoscopy?

    KiKi x

  • Colieac ruled out as is thyroid, liver and diabetes. Crp still at 47, still itching and GP says at a loss as to cause. Now on 3 weeks of strong antibiotics and cream to cool skin down as it feels as if on fire from inside. Also got referral to dermatologist. He has also gone back on Naproxen as this also ruled out as cause. He's seeing rheumy at end of jan. So will update then x

  • I have something very similar, but the Drs are at a loss to what is causing it and are treating the symptoms rather than the cause. I have elevated CRP, very low b12, anemia, extreme pain etc etc. I get really bad itching, so much I bleed sometimes. I also have a chronic pain problem of unknown cause which is so bad I am in a wheelchair at the moment.

    Did you/your husband ever find out what was causing this? Wondering whether I have RA.

    H x

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