Pmr and lymes disease

[Robnc]

I was bitten by deere tick early June. Coincidentally had a physical scheduled with my internest June 12. Exam went great. Blood work excellent. Started feeling hip and shoulder stiffness some mornings midJuly. Noticed it was worse after a workout the previous day. September 2 went back to internest. Blood tests confirmed likely pmr . Lymes inconclusive. Doc has me dosing 30mg prednisone every other day. Not through a week of this but been a bit difficult. also taking doxycycline for lymes . Wondering about a possible tick connection and any experience with the every other day dose regiment? Thanks and good health to us all.

[Celtic PMRGCAuk volunteer]

Robin, firstly, there isn't a blood test that "confirms" PMR. The two blood tests used are the ESR (Erithrocyte Sedimentation Rate) and the CRP (C-reactive Protein). Either or both of these tests can show whether there is inflammation circulating in the body, but about 1 in 5 patients with PMR and/or GCA never have raised markers. Such patients can be given a trial dose of Prednisolone and if their symptoms improve by around 70% within a week or so (sometimes within a day or two), that is generally taken as a diagnosis of PMR.

Lymes Disease can cause arthritic-type pain in similar areas to those of PMR, and I was in touch with someone years ago on another PMR forum who was looking for answers for his wife's undiagnosed pain, which was not helped by Pred. Having, by coincidence, just read an article on Lymes, I asked if she had been in any areas known to be at risk of Lymes. She had, but her Dr had refused the relevant blood tests. She returned to her Dr, demanded the test, and it came back positive for Lymes, was treated with antibiotics and recovered.

Hopefully, if you do have Lymes, the Doxycyline will resolve your pain. If you have 'just' PMR, then you should experience at least a 70% improvement in your pain within a week or so. Personally, I have never tried alternate-day dosing, but I know that PMRpro has done so and I'm sure she will be along with her experience with that regime.

[Robnc in reply to Celtic]

I'm pretty sure the doxycycline didn't help. Unfortunately I depend on my body sometimes in a very physical way to make a living. I understand now the relationship between activity and subsequent inflammation. Crazy, but I haven't taken the time to see what my ESR/sed rate and CRP were, but will. Thank you so much Celtic.

[PMRpro Ambassador]

I think it is a bit silly mixing the medications - he won't know which it was but I suppose at least he is covering all options.

Dosing alternate day is common in other illnesses but isn't generally recommended in PMR and absolutely not in GCA. I used everyday dosing at first to get the inflammation under control and then changed to alternate dosing to see how I got on but only once I was down to 10mg/day - and that is the dose at which it is suggested, not before. You are on 15mg/day equivalent so the alternate day regimen shouldn't really have been considered.

Since Lyme disease causes inflammation, that could also be the cause of the raised blood markers (ESR/sed rate and CRP). Obviously you never noticed the herald rash but how long was the tick attached to you? It is said that if it was attached for less than 36-48 hours then Lyme is far less likely.

[Robnc in reply to PMRpro]

I've taken myself off the every other day dosing and let my doc know. For two days been dosing 15mg. around 130am. Had a very physical day working yesterday but feel 50% right this minute which is wonderful . I'm not sure about the tick attachment time. Finished the doxycycline two days ago. I think he was covering bases. I can't tell you how valuable your comments have been, and not just this one. Thank you. Thank you.