Rheumy's opinion of my blood results

[Broseley]

I posted a couple of weeks ago about my blood results. My CRP was up to 21 but no ESR result as there wasnt enough blood. I went for a repeat blood test. CRP now 19, ESR 32. Rheumy phoned me with the results, asked me how I'm feeling - fine bar very slight stiffness in my hips - so he said no worries, he treats the person not their blood results, so I've been told to carry on tapering by 1mg every 6 weeks. I'm now on 7mg, tapering to 6 next week. What do people think?

I also had my covid booster last week (after the blood test), with no ill effects whatsoever, not even a sore arm!

[PMRpro Ambassador]

Is that ESR high for you? For many of us that would be raised but it is difficult to tell in isolation.

The CRP going down even slightly suggests that something had been going on but is improving - they are very general markers so only guides.

I suppose you have to see how you do with a lower dose. Just be very watchful.

[Broseley in reply to PMRpro]

Thanks, just checked my previous bloods. On diagnosis (PMR &GCA) last October ESR 78, CRP 58. In January ESR 8, CRP less than 5.

[PMRpro Ambassador in reply to Broseley]

They are high then - I'd want to see them heading lower before reducing and like DL I'd want to have it checked sooner than 3 months.

[DorsetLady PMRGCAuk volunteer]

As PMRpro says both are quite specific to the individual-but would say from my experience -the low readings are to be expected early days when you are higher doses of Pred..after that they do fluctuate a bit.

Problem is nowadays regular testing seems to have gone out the window so it’s difficult to see a trend.

To me the CRP is a bit on the high side, but reducing so that’s a positive -ESR okay ish.

Might be worth asking for re-test in a month to see what’s happening then -if you can.

However do watch the hip stiffness-and maybe reduce by 0.5mg from now on …with a slower tapering plan.

It’s very often a “suck it and see” journey…

[Broseley in reply to DorsetLady]

thanks. I am being retested in 3 months by which time I'll be down to 5mg. But he did say i could ring the helpline any time.

[DorsetLady PMRGCAuk volunteer in reply to Broseley]

Okay fine -but they can’t test bloods over the phone 😊..hopefully you won’t need contact -but as I’ve said on many an occasion took me as long to get from 10mg to zero as did to get from 80mg to 10mg ..so don’t rush on regardless…

[MamaBeagle]

Hiya, it took me 12 months to get from a starting dose of 30mg, high I know but it worked brilliantly, to 7mg. Then it took another 3½ years to get to zero. And to be honest I ditched, very diplomatically of course, the doctors advice and followed the wise and experienced on here. I'm still holding on zero, nearly 6 months now.

[Broseley in reply to MamaBeagle]

did you try following the doctor's advice to start with?

[MamaBeagle in reply to Broseley]

I did. He told me take the tabs and you'll be better in a year🤣. I believed him of course. That was in France October 2017. I found this forum about May 2018 and soon realised his prediction was a bit of a fallacy🤷🏼‍♀️. Moved back here. New GP very amenable to me taking control. He just prescribed and called me every couple of months to see how I was doing. Moved house and continued in same vein. It actually removed a lot of stress because I was armed with info and support here and not having to educate/fight with whichever GP I came across.

[Broseley in reply to MamaBeagle]

That's good. My GP hasn't been in touch since I started pred (they initially prescribed it) as I was handed over to rheumatology.

[Pr0jection]

My ESR and CRP have been very low since I started on 15mg prednisolone in August 2020 and reduced to 7.5mg in October 2020. Two months ago I started to taper 7.5mg/6.25mg on alternate days and felt fine but my CRP has gone up from .02 to .80. I can only assume that it's due to the tapering schedule. However I will also admit to a return of the bursitis in both buttocks......

[PMRpro Ambassador in reply to Pr0jection]

It is due to the tapering schedule taking you below the dose of pred you need to manage all the inflammation being created. If the markers are rising - be wary and watch out. You are very likely hatching a flare as a result. Your lowest CRP/ESR reading are what you should be aiming to maintain for drug-induced remission.

[Pr0jection in reply to PMRpro]

Hi PMRpro, have just gone back up to 7.5mg every day as we're going away for a short break soon and the car journey will take approximately 2 hours so would prefer not to have sit bone pain. I'll continue on 7.5mg until my next blood tests in November. As someone has said in the past (maybe you?) - it's not a race. Enjoy your weekend...

[PMRpro Ambassador in reply to Pr0jection]

It is the race the tortoise won ...

[Pr0jection in reply to PMRpro]

Ah yes, I remember it now...

[PMRpro Ambassador in reply to Pr0jection]

[Flivoless]

Like you I'm currently at 7mg but personally I won't drop more than .5 at a time at this level.

[Exflex]

You could try 1mg but maybe using a taper plan, eg DL’s. Thereafter you may be advised to reduce at 0.5mg, again using the slow taper I mentioned.