should I take prednisone before my blood tests?

[sewingdays]

Hi. I was diagnosed with PMR in February 2021 & this is my third attempt to get below 8 mg so this time I am going to 7.5 mg rather than 7 mg & hopefully down to 7 mg in 6 weeks. In May my rheumatologist said he didn’t think I had PMR any more as my bloods have been normal for while showing no inflammation . My question is should I be taking my steroids before my blood test ? I always have but don’t know if it makes a difference to the readings. Many thanks

[PMRpro Ambassador]

For goodness sake - what is it they don't "get" about normal ESR.CRP when a patient is on pred? Of COURSE you markers at at normal levels, that is because you are on an adequate dose of pred which is managing the inflammation - and THAT means there is not enough inflammation present for long enough to trigger the liver to produce the proteins that make the CRP and ESR markers rise. That DOESN'T mean that the PMR has gone, just that it is well managed.

The markers do take time to rise but taking your daily dose shouldn't affect them. Do you have any symptoms early in the morning?

However slowly you reduce, you won't get below the lowest effective dose. I really don't understand why they have such difficulty understanding that!

[jinasc in reply to PMRpro]

Me neither -

Too many brains and not enough commonsense❓

[Charlie1boy in reply to jinasc]

Hmm!, . I can think of one or two others to whom that comment applies.

Paddy

[Suffererc in reply to jinasc]

box tickets and no brains!!

[sewingdays in reply to PMRpro]

thanks PMRpro. I don’t feel any worse in the morning to later in the day but I tend to have either a good day or a bad day. I’m feeling better this time reducing from 8 to 7.5 than I did the previous times going straight to 7. I am going to take my time reducing & find my level to keep it managed & listen to my body rather than keep reducing as the rheumatologist said.

[PMRpro Ambassador in reply to sewingdays]

Do the bad days follow a good day where you have done too much as a result?

[sewingdays in reply to PMRpro]

yes that is the pattern unfortunately. I should know when to stop but when I feel good I forget the downside. I am trying to pace things better now I have reduced my work days from 4 days to 2 days a week so less stress

[PMRpro Ambassador in reply to sewingdays]

Have you seen these posts?

healthunlocked.com/pmrgcauk......

[sewingdays in reply to PMRpro]

thanks. I remember reading the spoons one ages ago and thinking it made a lot of sense but forgot about it. I will read them all & will definitely have to pace myself and stop before I over do things. Thank you.

[piglette]

I despair. What on earth does your rheumatologist think he gave you steroids for? To reduce the inflammation so your blood readings will be normal!!! One does not need to be a qualified doctor even to understand that.

[sewingdays in reply to piglette]

Thanks piglette. I will ask more questions when I see my rheumatologist next month. I feel more informed since reading this site.

[Suffererc in reply to piglette]

🤣😂🤣😂🤣😂

[sewingdays]

Thanks Dad2cue. Good idea. I have been keeping a kind of diary of how I have been feeling most days. I will make some notes of dates & feelings & doses to speak to my rheumatologist when I see him next month.

[Jackoh]

I despair! A new GP has asked that I have blood test before reducing again. I have a feeling he would have said the same to me- results normal therefore PMRGCA gone! I did preempt it by saying I was one of 25% where my ESR and CRP are never up!! 💐

[sewingdays in reply to Jackoh]

Hi Jackoh, that's interesting about the 25%, my ESR and CPR have been normal for over a year now. I will speak to my rheumatologist about that when I see him next month. Many thanks

[PMRpro Ambassador in reply to sewingdays]

Up to about 20% (it depends on the study) have normal range ESR and CRP even before diagnosis, But EVERYONE should have normal range markers once they are on the right dose of pred or above as that should bring them back to normal range. The markers are raised because of the presence of inflammation somewhere (they don't say what type or where though) and enough pred stops the inflammation so the markers are not created.

Any doctor who tells you the PMR has gone away because the markers are in normal range when you are on pred simply doesn't understand the mechanics of PMR and pred relating to the markers.

[Artnmusiclover in reply to PMRpro]

Sorry to jump in..this is interesting. My markers are up every time (most recent my ESR was 45, CRP 30). I have stuck at 6mg for 3 months as symptoms, as always, reappeared at 6mg. Does this indicate something else (I do have diverticulitis and diabetes) not sure if these would contribute to high markers...thanks

[PMRpro Ambassador in reply to Artnmusiclover]

Both diabetes and diverticulitis can contribute to raised CRP and ESR - they are very non-specific. For you I think you have to say they run high because of background disorders even though you don't have infection associated with either. I suppose it would be interesting to see if they are consistently at those levels except when you have a flare of PMR - but generally your symptoms are going to be a more reliable monitor.

[Artnmusiclover in reply to PMRpro]

Thanks for this...its very helpful information as I'm always concerned that they're high whatever I feel like or whatever dose I'm on

[PMRpro Ambassador in reply to Artnmusiclover]

Then like me probably not of much use unless you follow them regularly and a diary of how they correlate with your symptoms. Mine are the opposite though - always low, even in a flare!

[Artnmusiclover in reply to PMRpro]

Ill think about them differently now and yes that's a good idea ...I'll log comparisons between markers and how I'm feeling/what I've been doing ...thanks

[Suffererc in reply to Jackoh]

did he believe you or even know about that .

My GP just pfft when i told her 5.9 years not 2,

[Jackoh]

PMRpro explained what I was about to, that I have never had high numbers on my CRP or ESR. Even when first diagnosed and at my worst they were not high.

I don’t know if he believed me, I don’t really care to be honest, I think we know a lot more about the condition then they do and also what we’ve learnt here. They are GPs and it is very difficult for them to know everything about every condition in detail. So I tend to be very pleasant but immoveable on what I say. I also have a rheumatologist who I refer to and state what he says( he is one of the good guys) In fact he, the Rheumatologist, said to me that he believed that he was my “ insurance” to use against bad advice given by the GP and yes he is! 💐

[AshPen9 in reply to Jackoh]

Exactly! I also use my rheumy as insurance but had never thought about it like that. It does tend to work though.