Jeanmh

[Jeanmh]

Just put a post on about my blood test been on the border line i meant to say what does this mean this gca is all new to me just had steroids put to six tablets a day from 8 tablets is this the reason hope i have explained it right

[DorsetLady PMRGCAuk volunteer]

Hi,

Looking at your previous posts you seem to having recurring problems, and I would say it's because your doctor is trying to reduce you too quickly. 60mg to 30mg and then back up to 40mg and now down to 30mg again. No wonder you are getting problems and less than perfect readings.

The 40mg to 30mg drop may well have caused the raised ESR, but other things can affect it too, like a cold, doing too much or stress. That's why you need another test, to see if it was just a blip, or an upward trend. Are you getting a return of symptoms as well?

Who has changed your dose, GP or Rheumy? Unfortunately many GPs don't under how GCA or Pred really works.

You are given a recognised dose at the beginning - usually but not always around 60mg for GCA, 15mg for PMR. That is to get a grip of the inflammation in your body that is causing you pain, then you have to reduce SLOWLY enough until you get to the level that controls YOUR pain. Not the same as anyone else, nor necessarily the text book, but yours! Do it do quickly, either in time or dose, and you may go past that level. Result, you get a flare! For some reason, a lot of doctors don't get that.

These illnesses are different to most, they don't have a specific life span, they arrive unannounced, and seem to hang around for anything between 2 yrs (if you're lucky) and 6 yrs, in many cases a lot longer. However long they last, you need to be on the correct dose at any one specific time. Hopefully as you go along, the reduction of Pred correlates to the reduction of inflammation in your body, but sometimes it doesn't! Which is why, on occasions people have to increase their Pred, very often after addition stress etc.

It's not an exact science, and I think that's why it's very often difficult to deal with, especially at the beginning.

To return to your question, if your second blood test is high again, you may have to increase the Pred, unfortunately. But whatever the outcome you need to agree with your doctor that a. You need to stay at each level long enough to know it's working, and b. Smaller reductions.

Mine were, from 60mg down to 25mg a month at each dose, then AFTER blood test okay and no symptoms, reduce by 5mg a time.

A recognised mantra is 'don't reduce more than 10% of the dose you're on'. At 60mg that's 6mg (say 5mg) NOT 10mg.

Take care,