Shingles and Prednisone : Looking for advise all... - PMRGCAuk


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Shingles and Prednisone


Looking for advise all your previous information has been so helpful.

Background concerning me

58 male overall pretty healthy. I was diagnosed with PMR in December 2018 by outpatient center. I was seen by Rheumatologist in February 2019 and confirmed I had PMR. I was put on 30 mg of prednisone. Since then I was tapering down with the recommendation from the doctor. I had one flare up when I was down to 8 mg. I was then put back to 15 mg. Moving forward with me I am now taking 4 mg of prednisone for a month then I will taper down to 3 mg.

My question is do people that take prednisone have a higher risk of getting shingles. If so is there anything I should do to prevent shingles and not have PMR.

Another thing what are your thoughts on CBL and helping with PMR.



22 Replies

If anyone knew how to not have PMR......

The virus which causes shingles is in your body if you've had chicken pox. My understanding is that there has been an increase in the incidence of shingles in the general population so I doubt that PMR itself has a significant influence on whether you'll have an attack or not. I believe the recommendation is if you suspect you're coming down with it you should receive an anti-viral medication within 72 hours of the onset of symptoms. There is no point in using this medication prophylactically. As a PMR patient the "live" shingles vaccine, Zostavax, is not recommended. The new vaccine, Shingrix, made with killed virus should be safe, but not usually covered by public health plans yet, plus apparently there is a supply problem as there is heavy demand for it, despite the cost.

You can get chicken pox from contact with shingles blisters or from any fluids either spread by body contact , or in the air in coughs or sneezes that may include droplets which have infected matter in them ( trying to think of a polite way to put that!). This can happen at any age , you can also carry the live virus even if you are immune to it.

Shingles does not have the same level of pre rash infectiousness as Chicken Pox does , but often the rash itself can be mild at first and it is confused for other things , and exposure by touching that rash or being exposed to cells from it can bring on an defence response in the immune system , later a case of Shingles can develop if the Dormant Virus is triggered by this defence , especially in people whose immunity or general health is low because of having a Chronic Health Condition or taking medication , like Steroids. Shingles can be reactivated from many causes , over exposure to any Pathogen ( live bacteria, virus or fungi ) or Allergens ( anything you are physically intolerant to) , infection or injury , Stress , Sun Exposure basically anything that causes more weakness to an immune system .

You can make the choice to have the Non Live Shingles vaccination to protect yourself from developing the Virus . If you choose not to do this , or it isn't available , it is more important to be vigilant and Disease Aware , just as you should try to be with other things like Flu , Bacterial infections or Viruses of all kinds when your immune system is more compromised. Catching another infection further weakening your Health and Immunity can be a trigger for a bout of Shingles.

If you have friends or family that plan to visit , or you plan to visit them , it's always good to check if they are suffering from an infection of any sort , or feel like they are coming down with something , if so , it's better to reschedule than take the chance. Don't just go in for the hugs and kisses with people until you know how they are . The amount of us that end up catching all sorts of things , that can last for us much longer , from having body contact with people first then being told later that they have a cold , or just getting over a funny tummy , or even Shingles , is very big. It may feel a bit awkward to get into the habit of checking first , but if you explain people understand and it pays dividends.

Be aware in public places , especially Hospitals and Doctors Surgeries , keep yourself covered up and wash hands well before eating or drinking anything or touching your body , especially the face area. Keeping an antibacterial hand wash in your bag or pocket can help . Don't touch left over tissues or rubbish , get someone else to clear a space if you see these things left about at home or are finding a spot in a cafe or at a table on a train.

If you feel like you are coming down with something , follow the same protocol you want your friends and family to do with you . Stay at home , away from people or places that you could pass on your infection , but also to prevent you catching something else if you are already run down. Give yourself rest , fluids , vitamins and minerals , and TLC and keep an eye out for symptoms and what they are . These efforts won't stop the Infection but will reduce the severity of its impact on your system if it develops .

If you feel tingling in the skin , nerve pain and get a rash in patches , especially coupled with headache , temperature and flu like symptoms, make an appointment with your GP and explain to the Receptionist that you have PMR and suspect you may have Shingles . They should get you in straight away to try and treat the infection before it becomes too severe with Antiviral Medication.

At the Surgery , keep yourself covered and away from others as best you can and only arrive for the appointment just before your Time , as you could be contagious yourself and don't want the possibility of passing anything on to other immuno compromised people . Spending less time out in the cold or in uncomfortable places at the beginning of an infection is also less tiring for you.

HeronNS in reply to Blearyeyed

I thought you could NOT catch shingles. A person can catch chicken pox from someone with shingles if they have contact with the bodily fluids containing the virus.

Blearyeyed in reply to HeronNS

It is possible to develop shingles or catch chicken pox from someone if you have never had chicken pox or have had chicken pox that recurred. The live virus is in the blister fluids or can be in fluids or skin that has been in contact with fluids / cells from blistered areas. You aren't technically catching Shingles from other people by contact with them , the Disease Aware Protocols are to cover the possibilities of causing immunity issues that can trigger shingles , and the post doesn't specify if the person has ever had chicken pox ( or the rare but possible incidence of more than one incidence of chicken pox in their medical history).

HeronNS in reply to Blearyeyed

But surely you can't have shingles if you haven't already had chicken pox? That's all I'm trying to clarify.

Hidden in reply to HeronNS

HeronNS in reply to Hidden

Yes, that article says what I've been trying to say.

Blearyeyed in reply to HeronNS

In a paper I read , I can't remember whether it was NIH , or something else from Canada Board of Health, before Christmas it did mention that shingles or chicken pox could occur , I cannot remember the reason why , or if that was just the whole statement.

I did wonder at the time , but I decided it was worth remembering.

I suppose , the bigger issue , was that it was the compromised immune system that could cause a higher probability of the Dormant Shingles Virus becoming live or Chicken Pox variants occurring in a Patients system from various factors so it was better to take greater precautions around anyone with Active Shingles or Chicken Pox. In the same way as they should around anyone with any Active and Infectious Bacteria or Virus .

I'll see if I can find it again when I can and let you know .

HeronNS in reply to Blearyeyed

If in your travels you come across an answer to this question, I'd be grateful: if you receive a chicken pox vaccination does that make it possible for you to develop shingles later?

Blearyeyed in reply to HeronNS

Did you have one ?

I know it's an option early on in Canada

You can get Shingles if you have had the chicken pox vaccination but it is less likely than if you had the chicken pox virus , sorry just adding this in as I replied halfway through xx

HeronNS in reply to Blearyeyed

I've not had chicken pox so far as I know, and I have never had a vaccination for it or shingles. I wouldn't let my husband get Zostavax vaccine as I thought it might put me at risk but he has since had Shingrix. I keep meaning to ask my doctor to have me tested for chicken pox. She was very keen for me to have the Shingrix vaccine. I do seem immune as two of my children had chicken pox at different times, but the third child didn't show any symptoms either. So who knows.... ;)

nickm001 in reply to HeronNS

I cannot imagine that you were taking care of your kids with chicken pox and did not get infected unless you HAD chicken pox already. Even your 3rd kid might have had it, but the reaction/symptoms are not always obvious.

HeronNS in reply to nickm001

I know. So one day I will remember to ask my doctor to have me tested, I hardly ever see her and so far I've forgotten every time. She should have had the test done after I refused the Shingrix shot, a couple of years ago now.

HeronNS in reply to nickm001

When my older son had chicken pox, a very mild case, he and his younger brother were still young enough they were bathing together. At that time their older sister, still young enough to share a room with them, didn't get any CP symptoms either. She, however, had chicken pox years later at the age of fifteen.

PMRproAmbassador in reply to HeronNS

HeronNS in reply to PMRpro

Not that this information helps someone who isn't a child any more. :D

PMRproAmbassador in reply to Blearyeyed

You cannot catch shingles - shingles is the reactivation of a dormant virus in nerve endings which is left there after an earlier infection with the chicken pox virus.


Ths nhs statements on this are as follows:

Shingles cannot be passed from one person to another. The virus that causes shingles, varicella zoster virus (VZV) can spread from a person with active shingles and cause chickenpox in someone who had never had chickenpox or received chickenpox vaccine.

Shingles is caused by the reactivation of the varicella-zoster virus, which is the virus that causes chickenpox. After you have had chickenpox, the varicella-zoster virus lies dormant (inactive) inside your body. It can become reactivated at a later stage and cause shingles.

I blame my Giant Cell Arteritis on my second Shingles vaccination. I have never had shingles but was advised by my dr's. to get vaccinated.

You should definitely get the Shingles vaccine. There are two and you need them both.

PMRproAmbassador in reply to lcove

If you mean the Shingrix comes in two parts, yes. But it is not available in some countries yet except privately and at quite high cost. You do not need both the Shingrix and the Zostavax vaccines.

There is a much higher risk of Shingles while on Prednisone...

I’m a PMR patient down to 4mg too and I have a small patch of Shingles...I even had the first Shingles Vaccine, however, there is a newer, better vaccine now..You can not get either vaccine while you have an active infection...

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