Advice please

[Shazney64]

My mum has had PMR for about 18 months she has been progressing well on medication and has been reducing medication gradually all of sudden the last two blood tests have shown raised levels so her tablets have been increased again is this normal .

[PMRpro Ambassador]

All the pred does is manage the inflammation that is created daily. You start on a dose that is higher than it is likely you will need and then taper that dose very slowly to find the lowest dose that manages the symptoms - which is the dose that is just enough to wipe out the inflammation each morning. Once there is left-over inflammation it starts to mount up and in most people the blood markers start to rise again. That is what is happening with your mum - and it will happen to pretty much everyone when they overshoot that line. It helps to reduce in very small steps and to stay on each new lower dose for at least a month once you get below 10mg - to be sure this dose is still enough. Rush down and you overshoot and have no idea where it stopped being enough.

You can also have a flare while on a steady dose that has worked for months if suddenly the underlying cause of the inflammation becomes more active. It produces more inflammation and needs more pred.