ESR up but feeling ok! Increase pred or not ?

[Jo1947]

Started 15mg pred in Oct 2017, down to 5-1/2 mg without too many problems, thank goodness. Had blood tests last week and ESR was 20mm I dont feel bad other than DF and havnt spoken to doc about it, should I stay at 5-1/2 or be increasing ? Please help you wonderful people.

[DorsetLady PMRGCAuk volunteer]

Hi

Best not to take a knee jerk reaction to one blood test - get it done again. ESR in particular can be affected by many things as well as your PMR. If the next test is similar or higher then discuss with doctor. In the meanwhile stay at the level you are on.

Just keep your eye on your symptoms - they really are the key!

Good luck.

[Jo1947 in reply to DorsetLady]

Thank you Dorset lady, that’s what I’ll do.

[PMRpro Ambassador]

What was it before? How often do they check?

DL is right - stay where you are until you see what your ESR does in a couple of weeks. Raised ESR without symptoms means wait and see - not a kneejerk increase in dose. The other way round can be different - symptoms are always taken over lab tests.

[Jo1947 in reply to PMRpro]

Just checked las results 15/6/2018 they were ESR 15 so have gone up a bit. How often should we have bloods done, thank you PMRpro

[PMRpro Ambassador in reply to Jo1947]

Depends - every 3 months is probably OK if your ESR/CRP mean anything (mine don't really), are stable and you have no symptoms. If they are rising, you are tapering and/or you have symptoms maybe a bit more often. If it were me I'd stay where I was dose-wise and get the ESR checked in a month to see if it is still rising. It could be up a bit for all sorts of reasons, not just PMR, especially if you have no symptoms.

[Jo1947 in reply to PMRpro]

Thank you for your advice, I’ll follow it

[Janstr in reply to Jo1947]

I have a blood test every couple of weeks before I start a new 1/2 mg taper, & if the CRP is raised I don't taper.

[Jo1947 in reply to Janstr]

Is your doctor on board with the 2 weekly blood test, I can’t imagine mine would be, thanks for your reply

[Janstr in reply to Jo1947]

The Rheumotologist started it, & GP has just renewed it.

[Jo1947 in reply to Janstr]

That’s good, gives you a good idea how things are going and enabling you to manage it better yourself. Will see how my doc responds to a similar request, thanks