My crp levels are above normal but i can tolerate

[crochetlover]

My doctor increases my pred when my crp levels are high and then drops the dosage when they get back to normal range. Then when she drops them my crp levels climb above normal again. It's a vicious cycle. The question is I feel ok when my crp levels are elevated (about 15 mg/L). Could I just stay on the lower dose and live with the elevated levels or is it important to get the levels within normal range? Will the PMR eventually go away?

[DorsetLady PMRGCAuk volunteer]

Hi,

Really any adjustment in steroids should be related to your symptoms, not just your blood markers - they can be raised for a variety of reasons - and some patients never have raised markers. Symptoms are the key - always! Plus if your doctor gets you into a yo-yoing situation it’s just going to make things more difficult for you.

The aim is to find the lowest dose that controls your symptoms. What dose are you on now, and are your symptoms under control?

PMR normally goes into remission, but it can take anything from 2-6 years depending on the individual - so you should be thinking long term.

[crochetlover in reply to DorsetLady]

Thank you for the reply! I'm on 8 mg of methylprednisolone. A little more potent than prednisone.

[Gary1310 in reply to DorsetLady]

...when PMR goes into remission, will I feel normal?.....have energy? No pain?

[DorsetLady PMRGCAuk volunteer in reply to Gary1310]

Once the illness is in remission then you should have no pain.

It can take some time for you to return to normal - anything up to a year in some cases - particularly for your Adrenal glands to get working at full speed - so you may still feel a little fatigued for a while.

[Gary1310 in reply to DorsetLady]

Thank you. Good to keep moving forward with that goal.

[PMRpro Ambassador in reply to Gary1310]

No real answer to that - I still have PMR, I have no PMR pain. And when it does go away, you will be x years older - and things happen in x years.

[Dream21]

I would feel uncomfortable to live with high inflammatory markers. It means my disease is not in control and harming my body. I would rather take the medicine prescribed for it.

[PMRpro Ambassador]

One-off raised CRP without accompanying symptoms should never result in a kneejerk increase in pred dose - that just creates problems in the long run.

What SHOULD be done is to wait a week or two and repeat the CRP check and establish a trend. If it is rising then there is more justification for increasing the dose. But even when it is better than ESR, CRP is still a very non-specific test, a cold with a chest infection can send it up a long way. And so can bruising and trauma of any sort.

To me though it sounds as if you shouldn't be reducing quite as far - that you are absolutely on the border of the dose you need, the lowest dose you get to is just slightly too low and then allows the inflammation to increase but not enough to get to causing symptoms before the doc puts it back up. In how big (or small) steps are you reducing?