PMR and Vitamin D and/or D3 deficiency

[SIJennings]

I am new to this site. So glad to have found it.

I am interested to know if any sufferers of PMR have been diagnosed, or think they might have, a Vitamin D or more specifically, vitamin D3 deficiency.

I was diagnosed with PMR in 2012 and thought I had beaten it in 2014 but have been in a lot of pain recently. It was suggested to me that I might be vitamin D3 deficient. I have been to see a McTimoney chiropractor (very gentle) for the pain and asked her if she had heard of a connection between the two. She thought she had had a patient a long time ago who was deficient and had also suffered from PMR.

[Celtic PMRGCAuk volunteer]

It is true that a severe vitamin D deficiency can lead to a few 'nasties', not least pain similar to that of PMR.

You should ask your GP to arrange a Vit D blood test and if you are found to be deficient, a course of high dose Vit D3 Colecalciferol should return levels to normal. Normal is considered to be anywhere between 75 and 150/200 depending on which health authority you come under.

However, in case you are experiencing a relapse in PMR, if you are someone who had raised markers of inflammation at original diagnosis, your GP should carry out blood tests, including ESR and CRP, plus other tests to rule out other illnesses.

Meanwhile, be careful with the chiropractor - manual manipulation is contra-indicated in PMR, only gentle massage/heat treatment is advised.

[SIJennings in reply to Celtic]

Thanks for your reply, your comments are really interesting.

When I was first diagnosed with PMR via a blood test, my GP said that the results were 'inconclusive' but prescribed a very high dose of Preds which of course helped with the pain. I asked to be referred to a Rheumy after about 18 months of dealing with reducing the Preds without being monitored, I had reduced the preds to 1 mg and was pain free . After lots of questions he said he didn't think I had PMR, he didn't think I had never had it but he didn't think I had it now, he thought however that I had Bursitis. I was free from pain for about 12 months but then started to experience pain again which did however go when I was on holiday in Spain. After Christmas 2014 I started having severe pain again, mostly in my hands, fingers and forearms and went back to see my GP. I had blood tests again and X-rays on my hands which showed I had Osteo-arthritis. The blood test results showed no inflammation and so 'no action necessary'. I didn't know what to do next and this chiropracter was recommended to me. I have been to see her twice so far and I'm not sure she will see me again as I didn't feel any improvement after my first visit. I have to phone her next week to give her my results from my second visit. I guess it's back to my GP for me with fingers crossed.

[piglette in reply to SIJennings]

I went to have my ongoing ESR and CRP blood checks for PMR on Wednesday and mentioned vit D check to the nurse who said we may as well do that too now you are here. It took about two minutes for all of them.

[Hidden]

Hi SlJennings,

I don't have PMR but have another type of vasculitis. My Vit D when I first started getting symptoms was only 24, my Vit B12 was very low as well. Unfortunately replacing these didn't help my joint and muscle pain.

There was a poll over on the VUK site and over 50% of patients with vasculitis were Vit D deficient. It seems to go hand in hand with autoimmune disease for some people. It's well worth asking for it to be checked.

[jinasc]

Vitamin D deficiency is an exclusion test in the Guidelines for the Diagnosis and Treatment of PMR which are issued by the British Society of Rheumatologists which can be found of the NHS, BSR and PMR GCA North East Support websites.

Vit D deficiency causes aches and pains exacly like PMR, that is why it should be done and corrected before a diagnosis of PMR is made.

[teecee46]

An I right in thinking that if you had Vitamin D deficiency you would be unlikely to respond to Prednisolone treatment?

[PMRpro Ambassador in reply to teecee46]

I suspect that is the case yes, if it is vit D deficiency it isn't inflammation so I don't see how pred would help. It's the same with fibrolyalgia - can be very similar symptoms, different cause, pred doesn't help.

[sealine30]

Interestingly, i wasnt vit d deficient when my pains first started, but was the year before, a routine blood test showed up a low b12 first which was dealt with and the repeat teat was ok but vit d was low so was started on a primary care health pathway for this condition. The shoulder pain and stiffness didnt start until the following year, then all my blood tests were normal apart from the ESR and CRP which on my last test were all in range.

Now down to 15mg and consultants plan was to drop to 10mg this week (eek!), but i already hsve the heavy ache in both upper arm muscles which is often a sign that a really shouldnt pick the grandkids up!

[PMRpro Ambassador in reply to sealine30]

A 5mg drop in one go if you have PMR is just asking for trouble. But if you have aches - not a good idea to reduce.

Use the search box at the top right for "Dead slow and nearly stop reduction plan"