Flare of PMR or hormonal imbalance?

[PollyBrown]

Flare of PMR?

I was diagnosed with pmr in November 2018. Had treatment with pred 15 mg. Good response. After a few mild flares where I increased pred., I have now been off pred for 15 months. During this time I have had various issues:

Some aching

Urticaria and angiodema

Oesophageal spasms and gastric problems

Sciatica and hip pain

Swollen painful bilateral knee joints

I contacted GP a few weeks ago as I felt I was having a flare. Bloods taken. All normal apart from CRP which was slightly raised at 7.8.

GP listened to everything I had been experiencing and decided it might be a hormone imbalance. She contacted the gynaecologist and they gave permission to trial me on HRT.

I’m not convinced that is my problem and feel reluctant to go down that path. Any ideas on how to move forward? I’m feeling it may be too much histamine.

Grateful for advice

[PMRpro Ambassador]

What's the matter with a flare of the PMR? More likely than hormonal - and the markers often lag way behind the symptoms. And the CRP is already up a bit. Do you know what your CRP was before? Mine is vanishingly low - if mine got to your level it would be pretty high for me.

However - if she is offering, I would try the HRT, I had similar symptoms in my late 30s and started HRT, it helped a lot and I stayed on it for 13 years until there was one scare story too many. Needless to say it was one that was discounted a few years later! Anyway - my PMR started within about 18 months of stopping HRT. If I were offered HRT again I would accept - just to see if it helped. You can always stop if it doesn't suit you - more easily than stopping pred after the first couple of months.

[PollyBrown in reply to PMRpro]

Thank you so much for your response. Good to hear your views. My crp this time last year was 7.4 so not much different. On PMR diagnosis it was 46 and after coming down has hovered around the 7,8 10 mark. I will chat to the GP on Monday a bit more. I’m 69 so feels weird to start hrt but it may well help!

[PMRpro Ambassador in reply to PollyBrown]

I have a friend who is still on HRT at 84! We both credit HRT for the good state of our bones despite pred.