Melatonin & PMR

[Whitner]

I am having trouble sleeping for the first time since going on prednisone 8 months ago. I know part (maybe most) of the problem is since reducing to 7 mg I have pain in my shoulders so wake up frequently to turn over. Wondering if melatonin at night would help. Information online seems to indicate it could be beneficial with PMR in helping relieve inflammation as well as a sleep aid. I took an Advil PM one night and had a wonderful nights sleep but don’t want to do that often. Appreciate the knowledge of the group.

[alvertta]

I have GCA and started on 60 mg prednisone. I took melatonin 1 mg for a number of months. Helped me sleep.

[Whitner in reply to alvertta]

Thanks for the information. Happy it helped you and hopefully it will help me too.

[piglette]

Do you think you are on too low a dose of pred and you should increase a bit?

[Whitner in reply to piglette]

I’m wondering if that’s not the case. Figure I’ll give it a little time.

[piglette in reply to Whitner]

You could up your dose by say even 5mg for a week or so and then reduce back again without tapering if you feel OK and then reduce to say 1mg above what you are now and see if that is OK.

[Whitner in reply to piglette]

Good suggestion. When I reduced to 7.5 mg I started having these pains in my shoulders so I would probably need to go back to 8 for that to improve.

[piglette in reply to Whitner]

Maybe go a little higher for a week to really get it under control and then drop back to 8mg where you felt OK.

[Whitner in reply to piglette]

I’ve been on 8 mg for 3 days and the first day I played 18 holes of golf with no problem until the next two days when the shoulder pain, tight thighs and right hand stiffness came back. I think I’ll give 8 mg a few more days and if no improvement, up to 9. Thanks piglette!

[SheffieldJane]

I m in the throes of early GCA insomnia and you made me wonder about Melatonin with your post. I know my children were either taking it or looking into it as they did post school gap years and traveled through time zones. It seems from my early looking that we can’t access it via the NHS, or supplement shops, unlike many other countries. Readjusting my sleep patterns seems to be what I need. My body thinks that I am in Australia. I will keep looking.I’d like to try it.

[Mary63 in reply to SheffieldJane]

I bought melatonin when I was in the US. Do you know anyone who could post it to you?

[Whitner in reply to Mary63]

I'm in the US and we can get it at the grocery store. Most likely not as effective as that available by prescription. If you'd like me to mail some to you SheffieldJane, just send me a PM. I'd be happy to.

[PMRpro Ambassador in reply to SheffieldJane]

If I remember rightly, in the UK melatonin is only approved for short term use for insomnia in over 55s. It is a POM (prescription only medication).

[PMRpro Ambassador]

If the pain is since a reduction - it probably means that reduction was a step too far! You aren't heading relentlessly for zero, you are looking for the lowest dose that manages the symptoms as well as the starting dose did. It is unusual for normal pain-killers to improve PMR pain - so that suggests this may not be entirely directly PMR. It could be myofascial pain syndrome: one of the pairs of trigger points in MPS is in the shoulder muscles forming an area of hardened muscle fibres that can be felt as a knot and can also be mobilised manually. That knot irritates the rest of the muscle and can cause it to spasm or affects any nerves running nearby and leads to pain referring into the neck and/or arms.

[Whitner in reply to PMRpro]

Interesting. I’ll keep that in mind. Before I got on prednisone I was taking one Advil in the morning and one after dinner and that allowed me to get through the day pretty well until it stopped working. Thank you PMRpro!

[PMRpro Ambassador]

When I read this post earlier there was something niggling at the back of my mind about melatonin and steroids. I've found it:

mountsinai.org/health-libra....

Scroll down to Possible Interactions where it says:

"Steroids and immunosuppressant medications. Melatonin may cause these medication to lose their effectiveness. DO NOT take melatonin with corticosteroids or other medications used to suppress the immune system."

It may not make much difference in PMR, at worst you would have a flare of pain and stiffness. It might be a problem in cases of GCA.

[SheffieldJane in reply to PMRpro]

Ahh! That’s out for me due to Atenolol as well. Thanks for the info.

[Whitner in reply to PMRpro]

I saw a warning on the bottle to check with a doctor if there was an issue with an autoimmune disease. I saw that after I took 5 mg of melatonin. It did help with my shoulder pain so I guess it did reduce the inflammation? That's what I'm thinking.

[Mstiles in reply to PMRpro]

I’ve been taking time-release melatonin for several years since I started taking pred for PMR/GCA and never heard about interactions with prednisone. Melatonin has been s godsend for my sleep. Should I be concerned about this?

[PMRpro Ambassador in reply to Mstiles]

I don't know - if the pred has worked OK probably not. Though the question does arise as to whether you would get to a lower dose without the melatonin.