Low tapering of Prednisone

[Orchid47]

Hi

I have been tapering 0.5mg Prednisone, DSNS, per month for the past 6 months.

Before lowering Prednisone again from 3.5mg to 3mg, I went for blood tests again.

Results:

ESR has gone up to 35

CRP from 0.5mg to 1.1mg

(2 months ago it was OK 0.5mg)

I increase Prednisone now to 5mg per day, but no difference.

I still have pain on left upper arm (Deltoid area) in the morning, when I get up, but this vanishes after a short time.

My right knee above the Patello bone hurts me and I have on the same leg also varicose veins.

I live in a very hot and humid climate.

My question is if these complains are related to PMR?

Could this be the reason for higher blood results?

I have had PMR since June 2014, I am on Prednisone since November 2014.

I would very much appreciate, if any of the experts of this forum,

like Dorset Lady and PMRPro could give me some advice.

Thank you very much in advance

Orchid47

[DorsetLady PMRGCAuk volunteer]

Hi Orchid47,

Would say that if your pains are not both arms and/or legs unlikely to be PMR (not impossible, but unlikely). The ESR and CRP are quite likely to have risen with those pains - so again not necessarily PMR. Plus if 5mg has made no difference, again may not be PMR, but it might be wise to stay at that level for a couple of week and see if it makes any difference, and then maybe have another blood test.

Not sure what effect the varicose veins would have on bloods unless they are painful as well - you don't say.

Unless you have done something specific to either your left arm and/or your right knee, then I'm afraid it may just be the aches and pains of life! I found at low levels of Pred, all sorts of nasties came back - or maybe you have reached YOUR level of Pred and they may be warning signs something's not quite right.

Sorry I haven't answered your question, but to be honest I don't know, just surmising!

[Orchid47 in reply to DorsetLady]

Hi Dorset Lady,

Thank you for your answer.

I also thought that ERS and CRP have risen due to my knee and arm pain and it could be Rheumatism of old age

. I shall stay on 5mg for 2 weeks and then decide if to reduce Predisone again.

ORCHID47

[PMRpro Ambassador]

Some experts would suggest using 5mg above the dose at which the suspected flare happened - so you could try a few days of 8 or 9mg and see if that makes a significant difference. If it doesn't you can drop straight back to 5mg.

It may be that 4mg was only just enough - and having gone lower you have had tiny amounts of left-over inflammation building up over time. Now you maybe need a little spring clean!

But weather can have a BIG effect on PMR for some people.

[Orchid47]

Thank you PMR Pro.