Blood Tests

[HJC321]

Hi again, I have a blood test booked for Monday now my GP has received Consultants letter suggesting I may have Polymyalgia Rheumatica. So I have 2. Questions please.....

1). We all know that there is no specific blood test for PMR - it is diagnosed by symptoms and elevated inflammation levels as well as eliminating other things like Lupus that can mimick the PMR - is that right? Therefore should the blood test form be asking for just CRP and ESR levels? I don’t know what’s on it till I collect it at time of blood test - but I am anxious to make sure everything needed is included as we do hear that not all GP’s have a lot of knowledge with PMR.

2). It’s just occurred to me (duh!) 🙄 that as I was in pain - my GP prescribed me a strong anti-inflammatory (Etoricoxib 60mg) a few weeks ago - do I stop taking this I wonder before blood tests???

Thank you for any advice! 😊

[PMRpro Ambassador]

If I were you I'd be trying to get off the etorcoxib now you are on high dose pred - if it is PMR/GCA etorcoxib won't make a lot of difference, nothing but pred does.

No, most good doctors would include other tests besides CRP and ESR for all sorts of reasons but they are important in the context of PMR and GCA.

[HJC321 in reply to PMRpro]

Not on Pred yet until ? PMR confirmed. Just don’t know whether taking Etoricoxib will make a difference to blood results?

[PMRpro Ambassador in reply to HJC321]

It could - but it isn't making any difference to your pain.

Sorry, thought your GP had started pred. He should have.

[DorsetLady PMRGCAuk volunteer in reply to HJC321]

Don’t think so if it’s PMR - my understanding that only Pred addresses the inflammation caused by PMR and/or GCA.

However, as you know inflammation can be caused by many other things - where Etoricoxib, as a NSAID, may help - but it won’t touch PMR.

You could stop it for a day or two before tests if you think it might muddy the waters.

[HJC321 in reply to DorsetLady]

Thank you, those were my thoughts but I wanted opinions of those “in the know” 👍

[PMRpro Ambassador in reply to HJC321]

I have found an article that says some COX-2 inhibitors can RAISE the CRP - however they are all different and I can't find details for etoricoxib.

[HJC321 in reply to PMRpro]

Thank you for looking. Am going to leave Etoricoxib off now - don’t think it’s made any difference anyway.

[PMRpro Ambassador in reply to HJC321]

It is quite useful for rheumatoid arthritis and ankylosing spondylitis and possibly gout, but not PMR or GCA.

[HeronNS in reply to HJC321]

I found this just now. I think this is why it's off the market in some countries.

ncbi.nlm.nih.gov/pubmed/180...

Surprised, actually, that it's still available anywhere. Oh, wait. Big Pharma. Nothing should surprise me....

[PMRpro Ambassador in reply to HeronNS]

And probably a lot of doctors who panicked about their favourite painkiller being censured! They've had a paddy about paracetamol too.

[jinasc]

You could ask your GP to do a Full Spectrum blood test and to include magnesium &

Vit d. Then you will have a base line for your records.

[HJC321 in reply to jinasc]

Thank you!

[piglette]

If the Etoricoxib isn’t working I would definitely not bother with it. The fact it does not work is a pointer to PMR in that pred is about the only thing that does help. When I was first diagnosed with PMR I had a couple of pages of blood tests, including thyroid, rheumatoid arthritis, cholesterol, glucose, full blood test, folates, liver, u&e, ESR, CRP and probably more that I have forgotten.

[HJC321]

I’m going to leave it off now anyway because of blood test - will also give me a chance to see if pain is worse or no different. Thanks! 😊

[PMRpro Ambassador in reply to HJC321]

Good idea - because it it makes no difference it is a bit of support for a PMR diagnosis

[meandpmr]

Good morning. I’ve followed this post with great interest - as my rhumy prescribed extoricoxib for me alongside Pred during one particularly ‘bad patch’ and it really helped. Now - a number of years later (and 9 years this coming November since diagnosis) I’m on 1mg Pred plus 30mg Entoricoxib daily. Is this a really unusual combo? Anybother thoughts? Thank you very much.

[HJC321 in reply to meandpmr]

I’m not sure - but know lots of other ladies will help - great that you only take 1mg Pred now though! 😊

[PMRpro Ambassador in reply to meandpmr]

It is unusual for pure PMR, yes. It suggests to me there might well be something else going on - it would work well in ankylosing spondylits for example which can present in an identical manner to PMR in the early stages. It has some nasty long term effects and if it were me and a few mg pred worked as well I'd choose pred over entoricoxib.

[HeronNS in reply to PMRpro]

This drug is not approved for use in Canada. I was puzzled when I saw it mentioned because I thought the only one in the family available here was celecoxib, so looked it up. Etoricoxib not approved for use in the US either.

[HJC321 in reply to HeronNS]

😲 that’s a bit daunting

[HeronNS in reply to HJC321]

Exactly. I knew about this because when I was undiagnosed with PMR the doctor I had at the time prescribed Celebrex but when I read up about it I wouldn't fill the prescription. It was apparently the best of a bad lot, the others had been withdrawn from the market, but even so I thought it a dangerous drug. As it happens it wouldn't have worked for me anyway as I had PMR. At the time I thought I was suffering from a major development of long pre-existing osteoarthritis.

Later I remembered my former doctor, now retired, had given me a bunch of sample size packets of Celebrex to try for OA but even back then I was leery and never took any.

Given my attitude towards medication you can imagine how hard it was for me to accept the inevitability of prednisone!

[skb4skb in reply to HeronNS]

I truly understand the 'attitude' about Rx or any medication! Age 70 and hadn't had a prescription for over 20years.... then GCA, then added Sjogren's syndrome Holy Moly! Tapering from predisone now. Thinking positive thoughts for Fergus123 for accurate diagnosis and treatment.

[HJC321 in reply to skb4skb]

I know you’re replying to HeronNS - but Thank you for those positive thoughts wishes! So sorry GCA and Sjögren’s syndrome hit you like that! 🥴 but glad the Pred is helping . Were you like me, I’m not having blood tests till Monday but already I’m worrying and unable to think of anything else. What a godsend this site is 🙏🏻.