What do any of you know about the connection between inflammation and depression? my inflammation CPR has been normal for months now. But depression worsening over same period. The Depo-medrone reduces the depression significantly. And why having lost 7.5 kilos in 15 months and becoming too thin, sugar and carb consumption now so low I struggle to know what to eat, the blood sugar remains hyperglycaemic? so confusing!
Inflammation and depression; Near normal blood re... - PMRGCAuk
Inflammation and depression; Near normal blood results for CPR, with ESR stubborn at 43 and blood sugar at 43
Written by
Bennijax
To view profiles and participate in discussions please or .
30 Replies
•
PMRproAmbassador
The hyperglycaemia is related to the fact that pred triggers the liver to release random spikes of glucose from the body stores of glycogen in the liver. When are you measuring high levels? And what is your Hba1c level?
I have to say, omitting carbs and sugars from my diet still leaves me a wide selection of no or low carb options so I'm a bit confused by your struggle!
I need to be gluten free as well. Even if I eat good real sourdough bread, or spelt bread, I get unpleasant digestive problems the next day. If I eat gluten free breads or crackers, no bad reaction but the tastes and textures are unpleasant, so I do eat but without pleasure. Many of these have high sugar content. Doctor told to further cut out carbs, red meat, anything with sugar in it. What to eat? eggs, smoked salmon on nothing, oatmeal with plain sheep yoghurt, green vegetables, carrots, broccoli, blue berries, small pieces of banana, and poached fish or baked chicken. I am not starving, PMRpro. I get really painful hunger pains and with so little choice of what to eat (no sauces, etc) I have getting no joy from eating.
I have a wheat allergy and when it was first identified the only option was to use gluten-free foods. I decided changing how I looked at food was a better way. I abandoned bread - haven't found a commercial one that was worth it - and I really don't miss it. I eat oatcakes which I do love, especially coarse ones, but they aren't available here so I am rarely tempted, they are a treat for when visitors come from the UK.
It is perfectly possible to make low carb sauces - I make cauli cheese by beating an egg in a small tub of plain yog (I use 2/3 tub of Total greek yog), sprinkle cheeses on the par cooked cauli in a small oven dish (blue, Brie, parmesan) and pour the "custard" over it, top with a slice of a cheese that melts well. 180C for 25 min usually does.
Cream makes superb sauces for meats of all hues. What is the objection to "red" meat? Brown the meat in a heavy frying pan and cook through - I use turkey schnitzel as well as veal, beef and pork - I love mushrooms, bit more butter and brown them and tip in cream and bubble it to reduce - takes up all the juices from the pain. Or lemon sauce - coat the meat in a dusting of flour if you like, I don't always, pan fry in butter or olive oil and tip in lemon juice or white wine at the end and allow to reduce. Using flour makes it thicker but I like thin sauces.
You can make peppercorn sauce with 2 low salt beef stock cubes mixed with a little bit boiling water. Add to small saucepan and cook out a bit to thicken and grind in your choice of peppercorns. Take off heat and add a tub of quark. Stir to mix. Might need to put back over very low heat to warm through. Need to be a bit careful as it can split. (that's from my daughter)
Layer of sliced veggies - anything, everything - dot with butter and a bit of olive oil and grind herbs over to choice. Lay fish fillets on top with skin side up, also herbs if you like on the flesh. Half an hour at 180C - flesh should be done through and comes away from the skin easily. Works with pretty much any sort of fish.
Roasting your veggies in the oven gives them far more flavour - and it is flavour that creates joy in eating, not just textures.
Google low carb sauces - bound to be loads of recipes available. I think your mistake is to be thinking low carb - and continuing with low fat. If you cut the carbs you need some fat and protein to fill you up.
Here you are:
ditchthecarbs.com/carbs-in-...
All sounds so delicious. I've had GERD since 2011, was ill for three months that summer with bloating and acid reflux which is still there in the background, so I avoid cow dairy, sheep and goat soft cheeses cause no problem at all. Gluten free pasta and pasta sauces cause indigestion and acid reflux. Too much to go on about. I am so sorry you can't get hold of oat cakes - are you in the USA? Maybe I can send you a care package! There is one with ginger and turmeric that I like the most. some have sugar content too.
I do keep a cucumber in the fridge and eat it when hungry - I love fresh cucumbers.
Dear PMRpro, I forgot to mention that I had high blood sugar in the readings from my GP surgery before I started preds. The number, from before I was a diagnosed with PMR remains constant between 42 and 44, nothing seems to shift it. But the nurse is getting more bolshie and insistent about me cutting back and back.
She clearly has no more tools in her toolbox.
I read a wonderful article that made strong links between depression and inflammation, ages ago, on here I think. This is useless because I can’t remember the source, I just know that it made perfect sense to me and my history. It also explained the prolonged high following my early doses of Prednisalone and the lifting of a long term, low level depression.
I’ve been researching and making copies for my own use of academic research papers. As of a paper published last year the link between inflammation and depression is also linked to cardiovascular issues. No scientist can say what comes first, depression, inflammation or vascular problems but what is becoming clearer is that inflammation is involved in the part of brain that regulates mood, and it is also clearly implicated in reducing serotonin uptake.
So although I’ve had the ‘black dog’ since teens the current horrendous level of suffering from it seems absolutely linked to flare ups of inflammation. I don’t use preds, my treatment pathway is via steroid injections of depo-medrone. I thought at first that the depo- medrone was giving me a high, but now it looks much more likely that it is dampening down the inflammation - why pain and fatigue levels go right down - and this lessening of inflammation also relieves the mental suffering. I’m monitoring and charting mood along with dates I receive the injection and then, physical relief from pain and fatigue.
What a good idea!
I wonder if this is a factor in individuals finding it hard to taper off Pred. as well?
Ooo, I don’t know but if I happen upon something pertinent I’ll share it.
Please do! Depression definitely gives rise to aches and pains.
And constant aches and pain lead to depression ....
I read a book called The Inflamed Mind by Edward Bullmore which covered this.
If that figure is your Hba1c - your nurse needs some education about the effect of pred on BS levels and acceptable levels:
"HbA1c is your average blood glucose (sugar) levels for the last two to three months. If you have diabetes, an ideal HbA1c level is 48mmol/mol (6.5%) or below. If you're at risk of developing type 2 diabetes, your target HbA1c level should be below 42mmol/mol (6%)."
Under the circumstances 42-44 is pretty good going. The only thing that will make a significant difference would be stopping pred - and that ain't going to happen!
Thank you PMRpro. I have been concerned that the Preds will push me higher and tip me into diabetes type two. My Pred intake is stepping up now.
Between September and May I only had 320mg of depo-medrone from four injections, 120mg, then 80mg, then 40mg, then another 80mg.
Since then I’ve had 160 over 10 weeks, and will be having 80mg every five weeks. When the nurse told me I must cut out sugar and carbs, I began to wonder should I laugh or cry, I’ve already cut out so much!
Sounds like your trying hard to ditch your carbs! Pity you can't ditch the nurse !.Not very sympathetic to someone with depression ! Make an app with your Dr to talk about it .Lots of things to help you.Good luck .Viv x
My HbA1c is 41-42 and I'm told that is normal as it's below 42? So you are not far off normal. I don't have much fruit, only blueberries occasionally. Very rarely have any alcohol. Never have bread or rice or pasta or potatoes. So I don't see how I could get my reading any lower. Are you taking Pred or steroid injections or both? I read the list of side efects for Pred recently are there are lots of psychological things listed including depression. I even noticed recently I get depressed for a few days just after an injection, but then again that could just be the current situation with Covid etc.
Hi T, 48 is considered to be Diabetes type 2. I had been about 42 way before the PMR struck, then it climbed to 44 when it did, but dropped back to 42-43 over this past year. I think the practice nurse is being too cautious. But because the depo-medrone injections are now going to come every five weeks, I’m told I must be very careful to eliminate sugar and carbs.
I’m learnIng - I think I’m learning! That inflammation also affects the brain, the part that deals with mood, and it disrupts serotonin uptake. In my case, unlike yours, the depression has been very much more severe as I go into a flare. About 5-7 days after the injection my mood lifts and I feel ‘myself’ again. I reckon the D-M dampens down the inflammation including in the brain and the symptoms of depression clear away for awhile.
In th3 days after your injection you say you feel more depressed. Does it then lift again? How long does it feel better?
I'm glad you got the D-M injections sorted out but why every 5 weeks not 4 as in the Dasgupta paper? When I had the last injection the nurse went through the side effects as usual and mentioned it can cause depression. I brushed it all off and said it's fine, I don't have an side effects, I've had them lots of times. But then the next 2 days felt really low and tearful for some inexplicable reason, it only lasted a couple of days. I don't recall it happening before but I might just not have noticed. I am convinced that the fatigue and brain fog I used to get when I was on oral Pred was because I wasn't on enough steroids, because these days I rarely get it until the injection is wearing off at the end of the month, it's one of my cues that the next one is due. On the whole the injections have been brilliant, this time last year I was absolutely euphoric as I was yomping round Austria and had so much energy. I'm lucky I don't suffer from anxiety or depression really it must be very debilitating.
It does seem that each of us reacts to PMR and press/steroids uniquely to a degree, there is no one thing that fits everyone, I know you are very aware of that. But it must be very hard for the rheumatologists and our GPs. With the five weeks - it is a bit step up to previously where the rheumy did not want me to have more than one each 6 month period!
Out of interest - what dose of injection will you be given? It should be 120mg - and simple arithmetic tells you that over a month that averages out at 4mg/day. If that works you are on a VERY low dose of pred that no doctor should be concerned about. Even an injection every 2 weeks would be 8mg which is a physiological dose.
I started on 120 last September, but the reaction was such that I asked for 80mg in January, and that works well. So far. During the first six months I had only 240mg total (120+80+40) as at the start of lockdown the rheumatologist advised me have an injection of only 40 mg which did virtually nothing at all. Since May I’ve had 240 mg, about 80 every five weeks x 3 so far. . Rheum is trying to stabilize symptoms so not yo-yoing up and down. I’m small and now weigh less than 48kilos.
We are so different, but this forum is such a blessing, I have learned almost everything practical from you and everyone posting.
I’m now trying to deal with bouts of horrid depression, and keep blood sugar from increasing.
80mg once a month is barely 2.5mg per day - a negligible dose that no doctor should be worrying about.
I'm glad you got the injections sorted and hope you continue to find them helpful and that you reach remission soon. I hope your doctor can also help with the depression. Re the discussion above, I don't think you need to worry about the blood sugars as you are not pre-diabetic or anything and they seem well controlled.
Not what you're looking for?
You may also like...
ESR and CPR results
Good morning all
I am currently on 12.5mg pred, I have just had some blood tests done at my...
Flare with normal blood inflammation levels ?
Hello everyone,
Just after some advice please.
I began my PMR journey last February albeit...
Dilemma at 5mg with symptoms and ESR on the up
Hi, I posted a couple of weeks ago about tapering, slowly, from 5.5mg to 5mg and feeling that...
I've signed up for Tim Spector's ZOE study looking at blood sugars and gut health
I've long had an interest in how the foods we eat affect inflammation and weight and generally...
ESR and CRP normal - is damage still being done to my blood vessels?
Hi Gang!
I'm still waiting for a diagnosis so am not on any medication as yet but seem to be...
Related Posts
Plant sterols for cholesterol and continuous glucose monitor for blood sugar - good results
Tired and stiff with a normal ESR
Can you have Polymyalgia with normal CRP and ESR?
Aches and pains with ESR and CPR lower than usual....is this strange?
Advice when bloods stay normal for ESR and CRP but shoulder stiffness and pain are increasing little by little
Moderation team
Fran_BensonPartner
SophieMBPartner
