Hello everyone. I was diagnosed with PMR three years ago after waking up one morning hardly able to get out of bed because of stiffness and pain all over. Doctor said he thought it was a virus but did blood tests anyway. Phoned me a week later to go to the surgery as he had a diagnosis. PMR he said, ESR was 80, started me on 30mgs of Prednisolone for 2 weeks. After taking the first dose, the next morning all my symptoms had miraculously disappeared! Two years or less you will be over this, he said.... Three years later, numerous flares (mostly I now realise stress related) and again I'm having to increase from 7 mgs to 10 mgs for 2 weeks then back to 7 mgs for 8 weeks. This flare has happened after trying to reduce to 6 every other day for about 5 days. My last blood tests show that my iron levels have dropped significantly due to the prednisolone, was prescribed ferrous fulminate for 3 months, gave me terrible stomach cramps, now on liquid iron, Sytron. Has anyone had this problem whilst taking steroids?
PMR and iron levels: Hello everyone. I was... - PMRGCAuk
PMR and iron levels
Sorry - I really cannot accept at face value "iron levels have dropped significantly due to the prednisolone". Have you been on PPIs for your stomach? Used long term they ALSO can lead to severe iron deficiency. Just as they can cause osteoporosis. But we never hear our doctors saying that and handing out alendronic acid for needing a PPI for reflux do we? Perhaps the pred did play a role - but there are other equally significant factors and "little drops of water, little grains of sand" and all that soon mount up.
The inflammation of autoimmune disease can cause anaemia - and the pred reduces that risk even though in some patients pred CAN lead to anaemia. But there are other causes in autoimmune disorders and rather than simply blaming the pred, it requires proper investigation, preferably by a haematologist.
Your GP should have been doing full blood counts on a regular basis all the time and watching for such things - and, if he has been, and there haven't been signs over time then for it to have happened relatively suddenly suggests there is something else at the root. Have you had any tests for blood loss from the gut for example?
You may find this helpful:
patient.info/forums/discuss...
Thank you PMRPro for your reply and the link with some very interesting info. No, my doctor doesn't do regular blood tests, I have them every four months when I see the Rheumatologist at the hospital. I will ask my doctor if he can do interim tests between hospital visits. I did one of those stool tests they send through the post which was all clear, so no blood loss there. Only yesterday I received a copy of a letter to my doctor from the hospital following my last visit at the beginning of February...... I know the postal service is sometimes slow but my letter must have been delivered by a pigeon who's lost his way!
Every 4 months isn't too bad - but for it suddenly to have become acute in that space of time needs an explanation.
I am lucky - I leave the appointment with my copy of the consultant's letter in my hand, the GP is able to access it online. But this isn't the UK...
How can that be? Sounds like a great service. I have blood tests at the hospital following my appointment, then wait a month or so for the results to reach my GP although to be fair the consultant's secretary did ring me once when my ESR went sky high to tell me to increase the steroids.
The GP and hospital have access to the database - although the hospital doctors can't see everything the GP has written for confidentiality reasons. Theoretically it is what the NHS thing was to do - but it only works when you don't use monkeys to do the programming...
I can pick up my own copy of blood test results as soon as the lab posts them, some same day, or I can let the GP look at it and tell me. I can also get any scan results within a few days and we are encouraged to keep our own record of results. I have no desire to move - especially back to the UK! I see a GP same day I decide I want to (turn up and wait) and while for a routine consultant appointment I might have to wait a few months, urgent or emergency mean that. I can also choose to go anywhere in the region if there is an earlier appoitment. Or I may be offered one today/tomorrow if they have a cancellation. First appointments are 45 mins and follow-up still 30 mins though that may change. If I have a rheumy problem I can call the unit and the nurses will ask His Nibs - who will then see me urgently if deemed necessary.
I totally agree with you. I know the details of tests and consultations are posted electronically on our records, but several times it has been down to me to see the doctor to discuss results and only then he'll look at the letter and prescribe what is necessary/up my doses etc. Where do you live? I would be more than happy with your medical services. Also, trying to get an appointment with my own doctor......well, that's another story...
In northern Italy - the German speaking area South Tirol, an autonomous region. I moved here 8 years ago because i could - and with a bit of luck, here I shall stay 
How lovely, lucky you. I'm going to the Amalfi coast in May and soooo looking forward to it.
Once they are computerised theoretically the gp can see your results. Even my dental xrays from the hospital were accessible within a week to my knowledge so probably immediately they were attached to.my record.
Wondering whether the doctors check ALL letters/results as they come in or maybe a member of the admin team put them on the computer????
Hmm, I wouldn’t buy Pred being the cause end of investigation, either. Too many other causes.
Thanks for your reply Snazzy D, will try and get an earlier appointment with the doc or Rheumatologist who not due to see for another two months as feeling very low and weak at the moment.
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