Blood test results - help please!

[Dobermanlover]

Dear Friends, I had a blood test last week to check that I had not become diabetic (very tired all the time) and to check my inflamation levels (sorry is it CPR, CSR or what? -Senior moment!)

Just phoned up for the results, blood sugars fine, so that's really good news. My other reading was 27 though, which the person I spoke to said was normal! Now I don't think it is, because when I was first diagnosed with PMR the levels were in the 90's and after taking the dreaded Pred came down to 8. At that time, no pain and no stiffness.

I went to my Doctor a couple of weeks ago and she wasn't pleased that I was on a dose of 11mg (down from 30mg at the start 2 years ago as 15 not enough). I said that I was reluctant to decrease at the moment, as my shoulders were very stiff and quite painful in the mornings and felt that I should stay on this dose for a little while.

She really is a lovely doctor and is very understanding and didn't push me any further. What are your feelings on a reading of 27? Would be very grateful for your advice. Hope everyone is having a 'good day!'

[DorsetLady PMRGCAuk volunteer]

Hi DML,

If it's ESR then it's slightly high, if CRP very high. Would imagine it's ESR so just outside the "normal" range, which would correlate with your shoulder pain/stiffness. If your inflammation is well controlled then I would expect it to be lower - maybe not as low as 8, but certainly low teens. Mine went very low at beginning of Pred (as you would expect) but most of the time was between 9-16ish!

Stick at 11mg, hopefully the shoulders should improve, but if they don't then maybe another blood test in a week or so to see if that changes. However if the pains don't seem to be getting any better maybe a extra 1mg might do the trick.

No point in being on too low a dose!

[Dobermanlover in reply to DorsetLady]

Dear Dorset Lady - it is CRP level, at least that is what they said. I do however have other issues, such as arthritic knees and I broke my shoulder a while ago, which is still painful at times. Thanks for your quick reply.

[DorsetLady PMRGCAuk volunteer in reply to Dobermanlover]

Hi,

Yes both of those will increase inflammation rates, but do keep an eye on it. Personally I wouldn't have said it was normal for CRP, going on mine, but different labs seem to have different procedures/readings.

Take care.

[PMRpro Ambassador]

If you have achieved lower levels - that is your "normal" and if it is ESR and you have got to 8 in the past and are now mid-20s I'd say you were flaring. And so do the fatigue and stiff shoulders! And if it is CRP your are quoting that is DEFINITELY raised.

You can have a flare because you take your dose too low. Or you can stay on the same dose but the activity of the underlying autoimmune disorder may increase to a level that that dose is not enough to manage. Either way - I'd say try 12mg and see if it is better.

If you needed 30mg originally it suggests you don't absorb a lot of your pred (can be anything between 50% and 90%, not the 70% they quote, that's the mean) so needing over 10mg isn't the end of the world, especially after only 2 years.

[Dobermanlover]

Just checked with my surgery PMRpro and it was definitely CRP levels they quoted me. Had a lot of family upsets recently, probably why things aren't going so well. I know stress plays a big part in how we handle things (we being PMR sufferers). I think I'll wait and see what my doctor says next Tuesday and then decide. She is quite good at listening to me, giving me credit for being reasonably intelligent and knowing how my body feels. I don't like the thought of going up, but if needs be............!

Thank you so much for your sound advice - I'm sure I'll take it, but don't want to put my doctor 'off-side' when she has been so much better than my last doctor.

And thank you once again Dorset Lady

[PMRpro Ambassador in reply to Dobermanlover]

Don't stick your head in the sand - if you deny the possibility too long you could end up having a full-blown flare and needing a much higher dose of pred. And no-one wants that.

[Rugger in reply to Dobermanlover]

Have a look at my post, showing how my ESR went up from 8 to 23, then 54!

My PMR flared as bursitis, but I didn't recognise it as a flare, so carried on tapering!

Don't do as I did - do as PMRpro and DL say and nip this in the bud now.

My GP wasn't too worried at 23, as it was only just above the normal limit, but I could see it was rising. Hindsight is a wonderful thing.

After 2 months on the higher dose, the bursitis is resolving and I'm just about to start tapering again - slowly!

healthunlocked.com/pmrgcauk...

[Dobermanlover in reply to Rugger]

Thank you Rugger will take you good peoples' advice - useless asking for it otherwise. It would also seem like a good idea to ask for another blood test. Sorry, talking to myself again, can I blame a little insanity on the Pred? Most things get blamed on it!

[Megams in reply to Rugger]

~Rugger - is this correct that bursitis can flare our PMR? I was never aware of this and have noted that the bursitis in my hip had settled with physio last 6 months or so but appears to be niggling me at night once more.

In light of my Rheumy telling me today I can try (again) to reduce 0.5mg, I will stay put - these wonderful wee snippets of info here always warmly received, thank you ~

[Rugger in reply to Megams]

Megams, as far as I know, it's the other way about - Bursitis is one of the ways PMR manifests itself - if that makes sense. (PMRpro has had bursitis, so we're in good company!) So my PMR flared up and the way it did so was as bursitis, rather than muscular pains. When I increased my pred from 4mg to 10 mg, my hips improved in a few days and steadily got almost 100% better. My shoulders are taking longer, but I feel they're 95% better. If I had realised it was a sign of the PMR flaring, I wouldn't have suffered the bursitis for 2 months and I expect it would have taken less time to resolve. We live and learn! Did you look at my graphs in the link above? I did the graphs after the event - should have done them sooner and realised what was going on!

Take care.

[Dobermanlover]

Ok you've convinced me! I'll take it up tomorrow and see if it makes a difference. Do you think 12.5 would be too high?

[DorsetLady PMRGCAuk volunteer in reply to Dobermanlover]

Sorry for jumping in PMRpro.

Maybe....but if no significant improvement within a few days..then bit higher. A few days at 15mg wouldn't do any harm, and so long as it nips things in the bud quickly, you can come back down again relatively easily.

[PMRpro Ambassador in reply to DorsetLady]

Exactly what I was going to say...

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

😊👍

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The unfortunate thing about GP's is they know a little about lots of diseases. When is comes to specialised diseases then the experts take over (even some of those aren't that good) So it's no good in me asking my GP for advise regarding upping or lowering my Pred. My inflammation markers have risen, ESR is now 10 mm/h up from 2 and CRP risen from 13 to now 15 mg/L ( normal rate without inflammation for women is: (0.29) ESR and CRP should be less than 3 mg/L and always less than 10. I'm not sure what to do myself now......I'm so reluctant to increase when I feel fine in myself.

[Cats64]

I understand your anxiety