Is anemia part of the diagnosis of PMR?

[nymima01]

Hello All - I was recently diagnosed with PMR by a rheumatologist and was put on 20 mgs. daily of prednisone. I am feeling much better and most of my awful fatigue is diminished thanks to the medication. I was also recently diagnosed with anemia by my PCP. My latest numbers for iron is 9.4. Six months ago I was at >12. I seem to be dropping .2 pts. every 2-3 weeks or so. I don't have any internal bleeding that I can see, and I go for a colonoscopy every 3 yrs. I am due for one the end of next year. I have already received my protocol for weaning down on the prednisone and this should take me to the end of Oct. 2017. I thought I had read about others who mentioned anemia on this site too. My PCP doesn't seem too concerned about it for now, and in fact I will do blood work for him again on Jan 9th 2017. But my main complaint before I was diagnosed with PMR was extreme fatigue, and although the prednisone has taken care of that pretty much, I am getting more fatigued due to the drop in my iron. Any thoughts??

[TooSore]

I do not have any issues with my iron, but fatigue is an issue that shifts and changes over time. What are you to do about the anemia. Diet changes?

[nymima01 in reply to TooSore]

Never had a problem with anemia. I am concerned because I take iron as prescribed by my doctor, I eat iron-enriched foods and nothing seems to be helping. I feel it happened when the symptoms of PMR started. Like the same time - and I can play medical detective and notice the drop when my PMR symptoms started to become overwhelming. My PCP felt that the fatigue I had at that time was not equal to the amount of anemia I had going on - which was 10 at the time my extreme fatigue started. So he sent me to a neuro and a rheumy for tests. Kind of puzzling. Never took iron in my life before this.

[Hidden in reply to nymima01]

I developed anemia after I had been diagnosed with Polymyalgia. My GP noticed it initially when I had a blood test, but he didn't do anything about it until I was admitted to hospital with cellulitis. The doctors there were not happy about it and gave me a couple of blood transfusions. When I came out of hospital my GP put me on iron tablets and sent me for a colonoscopy and a Gastroscopy, he was worried about the cause of my anemia. The tests didn't reveal anything nasty. Gradually I felt much better, no longer really tired. I have now stopped taking iron tablets, I probably took them for about six months and my blood count is ok now.

I looked into causes etc for anemia and apparently it can be associated with illnesses such as Polymyalgia although it doesn't seem to be that common.

[PMRpro Ambassador]

Mild anaemia is a common symptom of autoimmune illness and is found fairly often in PMR. But severe and continuing anaemia isn't usual - and could suggest you don't have "just" the PMR we are usually talking about. It's the usual confounder: PMR is not the illness itself, it is the name given to an underlying illness. In our case it is generally an autoimmune vasculitis (inflamed blood vessels) but there are a lot of things that can cause PMR symptoms - and there is nothing to stop you having two different things going on at the same time. I would be wanting my PCP to look a bit wider...

[SusanEleven]

I was anemic when first diagnosed with PMR and continued to be for about the first 6 months of blood tests. I didn't take iron pills but developed an intense craving for meat and baked beans! The craving lasted for a few weeks and I indulged. I was no longer anemic at last round of blood work.

It had been mentioned to me that there is an "anemia of chronic disease and inflammation."

[Sallyaches]

I have been chronically anemic since having PMR, my haemoglobin has hovered around 10.00. I take iron 3 times a day without significant improvement. I was told it was the anaemia of chronic ill health, which cheered me up no end. I am just hoping when my PMR improves so will the anaemia.

[SusanEleven in reply to Sallyaches]

I think I read somewhere that when it's the anemia from chronic ill health the pills don't help.

[nymima01]

I just did blood work this week for the anemia to see where I stand. My PCP does not seem overly concerned about it - it actually dropped another .2% a little over 2 weeks ago when I had b/w done for another doctor. I called him about my concerns. But I suppose he will address this with his b/w test results when I see him next week. I am feeling more tired, as I am in the weaning down process with my prednisone protocol. So I am concerned and don't want to go back to that awful fatigue I had before my diagnosis of PMR. I have the most awful leg cramps going on too! They get me every morning!