Advice on latest blood test results

[Jo1947]

good morning everyone, after not having a blood test for PMR for 9 months, the latest figures show ESR at 22. I had upped my pred 3 weeks ago to 10mg for 5 days, 8mg for 2 days and 6mg for 1 day, then back to my 5mg. I had been experiencing hip and leg pain for approx 1 month before going from 5mg to the higher doses to clear the flare. Now at 5mg am getting some of the pain back. Do I need a much higher dose to get the 22 ESR down to the normal band of 15 tops. Confused and disheartened. I have been on pred for 3years 7months. Have been down as low as 2-1/2 but keep getting flares. Thank you

[PMRpro Ambassador]

At what point did you start getting the flares - is it always at a similar dose? What is the lowest ESR you personally have achieved on pred? In most of the world, 20 would be accepted as OK _ but only if you don't have symptoms.

5mg is obviously too low for YOU - you are not heading relentlessly to zero, you are looking for the lowest dose that manages the symptoms as well as the starting dose did. This may vary over time but there is usually a small range that is right for you. Go even a bit below it and over time the left-over inflammation that isn't cleared out each day will mount up - like a dripping tap will eventually fill the bucket under it, sooner if the drip is big, later if it is smaller, but it will fill up. And you will get symptoms again. The trick is to find where you can keep the level steady. Once you know your personal lowest ESR you should aim to maintain that so having it checked ever few months is useful - if it starts to creep up, even within normal range, it is a sign you are too low with the dose. Even 1/2mg ca make a BIG difference over time.

[Jo1947 in reply to PMRpro]

Thanks PMR, I will have a look at my ESR past numbers and try and find a pattern. I have a telephone call with my doctor on Friday, hospital was supposed to check crp numbers as well but they don’t seem to have done that. I now wish I’d kept a chart of my readings but didn’t. I think pain along with ESR of 22 is showing I have inflammation and need to accept I have to go a bit higher dosage.

[PMRpro Ambassador in reply to Jo1947]

"I think pain along with ESR of 22 is showing I have inflammation and need to accept I have to go a bit higher dosage."I think that is very likely - symptoms ALWAYS trump blood markers anyway.

[piglette]

On the printout I get it says 3-35. I have tried to attach an example of mine.

ESR

[Mota1]

My printout gives 30 as the upper level. Does this mean that the acceptable range varies with hospital/lab ?

[PMRpro Ambassador in reply to Mota1]

Yes - and the figure in brackets after your result is the most relevant to you. Mind you, if YOUR personal normal ESR is 5, if it gets to 25 it is not "normal" for you, even if it is still "in normal range". Normal range is the range of results found in a large population of apparently healthy people - not one single person.