Markers up

[Uglow]

Hi all Go just called me to say inflammatory markers are up so I did right upping steroids. Why do they go up does anyone understand this polymyalgia. I knew they had because my back was killing me. Thank you everyone

[PMRpro Ambassador]

PMR is the name given to the symptoms that are caused by an underlying autoimmune disorder that creates inflammation. It causes swelling in the tissues and that causes pain. The pred combats that inflammation and that relieves the pain. The inflammation is caused because the immune system suddenly becomes unable to recognise the body as self and thinks it is an invader to attack and defeat.

Every morning, about 4-4.30am, the body sheds the inflammatory substances in the body. They travel to various parts of the body and start to attack the tissues - causing inflammation. You start with a dose of pred that is high enough to clear out any existing built up inflammation and then you reduce that dose slowly to find the lowest dose that works as well as the starting dose did. If you go too far, there is more inflammation being created than the pred is able to deal with and the inflammation starts to build up again. When that happens you need to go back to enough pred to do the job.

When there is inflammation in the body the liver is triggered to produce proteins - and they are measured as the ESR/sed rate and the CRP (c-reactive protein). It can happen in response to an infection or an injury as well.

Does that explain?

[Uglow in reply to PMRpro]

Thank you so much I’m getting scared. My markers were 80 in beginning then down to 19 but up to 30 now. I will take my pred and hope it takes it down. Again thank you.

[PMRpro Ambassador in reply to Uglow]

No need to be scared - you have just gone a little bit too low on the dose and a bit more should sort it out.

It's like a tap dripping into a bucket - if you scoop out the same amount of water as is dripping into it from the tap, it won't overflow. But if you only take out a coffee cup full when a mug full is going in, the bucket will fill up and overflow. You need enough pred as long as the illness is active. At the start it usually needs more than it will later - but it usually settles down eventually and you get to a quite low dose. But it isn't worth trying to manage with too low a dose, it just builds up over time.

[Snnib in reply to PMRpro]

You explain things so clearly and easy to read. Thanks.

[Susan1705 in reply to PMRpro]

Thank you very helpful, I am waking up at the moment at 4 with pain around ribs and this helps explain why!

[DorsetLady PMRGCAuk volunteer]

The reason they increase is because the inflammation - which is all part and parcel of your underlying illness- has been allowed to build up.

That’s usually happens because you are either on too low a dose to control the daily shedding of substances which cause the inflammation, or you have done too much and caused stress on your body.

Not sure if you’ve read this, but it does explain a bit more about illness/treatment -

healthunlocked.com/pmrgcauk...

[Hidden]

It's really strange how some people's marker remain the same...don't go up due to inflammation. So I imagine hard to diagnose Polymyalgia. Maybe that's why some doctors may miss it and can only go on symptoms. Mine at diagnosis was 515. Just waiting to see what my blood tests results show that were taken the other day, hopefully, nice and low.

[PMRpro Ambassador in reply to Hidden]

The markers are very general though - they rise with all sorts of things. They just show something is going on. But then, so do symptoms.

[Hidden in reply to PMRpro]

I read many ladies posts on the forum that have said that their markers on diagnosis weren't elevated. My brother in-law who lives in Spain was diagnosed approx 6 months ago, his were normal, so doc said it wasn't Poly. However, due to his pain and where the pain is the doc conceded that it was in fact Poly. He was originally started on 70 mg was reduced far too quickly, doc told him to stop taking them as still didn't think it was Poly....pain returned, now thinks it is Poly again, and back on a high dose to try and whack the inflammation on the head.

[PMRpro Ambassador in reply to Hidden]

A high dose doesn't help - in fact it often makes the rest harder. PMR responds to a moderate dose, 15-25mg should be plenty, so using 70mg is really excessive and just adds to the difficulty of pred. The inflammation is due to a chronic conditon and the pred is needed as log as the autoimmune bit is active. So it was good they reduced quickly - or it would have been had they stopped at about 15mg and then gone really slowly. It is strange - Spain has some really good PMR research groups but the doctors who see the patients are really hopeless!!