Do adrenals starting up equate to a small rise in ESR and CPR?

[Dochaz]

Now on 7 mg/day for GCA/LVV (started on 40 mg), my latest 2 blood tests show a small but gradually increasing rise in ESR (23) and CRP (6). Is this adrenals stuttering or a flare in the offing? I'm supposed to taper this weekend, but I'm planning to stay on 7 mg for the moment. No big increase in symptoms in comparison with other tapers, but jelly legs in the evenings and some fatigue, but not every day.

[PMRpro Ambassador]

No good reason for that that I can think of. That sounds far more like the inflammation starting to escape the current dose since you are seeing a trend. What dose were you on when the ESR started to go up and what was it at its lowest? I definitely wouldn't reduce yet - stick where you are and have another blood test. I'm always suspicious when someone says "no big increase in symptoms" - it means to me there are some!

[Dochaz in reply to PMRpro]

Thanks for the advice! My ESR and CRP were at their lowest when I was on 10 mg/day. I got down to ESR 8 and CRP 2. I'll be talking by phone to my dr tomorrow to get my new prescription. He's not averse to prolonging a taper when necessary. When I say "no big increase in symptoms" there are good days (like today) when I can walk for 2 hours and do some cooking and others when I just sit around reading with no energy. But generally, I feel ok and would like to avoid upping the Pred unless it's unavoidable.

[SnazzyD]

This dose level I found quite challenging because it was low enough that I ran out of steam very easily and still a bit too high for the adrenal glands to think they needed to increase their effort. Jelly legs and no oomph is one sign that you don’t have enough cortisol. I had to adjust my lifestyle to cope with it; a two hour walk was out of the question for me. You may descend gracefully down the dose staircase or you may find you ‘trip on your skirts’ more before it gets better. I always went for doing less rather than upping my dose to get through the day unless it was especially important. Challenging your body to make more is by not having enough but it’s a fine line between overdoing it and not. An increase in inflammation markers could be something brewing that you aren’t aware of yet, though I had an inexplicable rise about now too. Another blood test would help see if it is a trend or a blip.

[Dochaz in reply to SnazzyD]

Thanks for the info. It's always useful to see how others experience things. I tend to agree with you, I would prefer to do less and work my way slowly down rather than go back to a previous dose. More blood tests in 2 weeks. I'm hoping it's a blip!

[piglette]

My inflammation markers did not seem affected although I was!

[Joseph14612]

I pray you rebound from this...🙏