How to respond to my doctor

[SRIXON]

Hi diagnosed with PMR in 2017. Up and down levels of pred keen to reduce as I am a type 2 diabetic.

Down to 2mg pred in Jan this year but pain in shoulders, neck and base of back along with nasal and head congestion some mornings.

I saw my doctor in Feb he agreed I could put pred up to 5mg which has seen some improvement also had some bloods taken which a week later indicated my inflammation markers to be good.

My question how can this be so with markers the doctor is referring me again to a rhemy but that's what they will say my inflammation does not show PMR.

THANKS COL.

[DorsetLady PMRGCAuk volunteer]

GP is obviously concerned that you seem to be struggling with your PMR because you needed to go up again, so probably wants the Rheumy’s input.

Are you still on 5mg? Or have you reduced again?

And no raised markers don’t show you DON’T have PMR , only that’s it’s being controlled by the steroids at the time the bloods were taken.

[SRIXON in reply to DorsetLady]

Thanks for input. I'm still on 5 mg probably need to increase but prefer to manage discomfort. Being a diabetic it's a balancing act.

[DorsetLady PMRGCAuk volunteer in reply to SRIXON]

That’s probably why you are being referred -GP may think you need a steroid sparer. I think that only a Rheumy can prescribe that not GP.

[SRIXON in reply to DorsetLady]

Steroid sparer!

[DorsetLady PMRGCAuk volunteer in reply to SRIXON]

Methotrexate is currently recommended by both international and local guidelines as the first-line steroid-sparing drug to consider in polymyalgia rheumatica.

[PMRpro Ambassador]

How did your markers parallel symptoms in the past? Do you know? Some people find their markers don't rise with a flare when they are on any pred or the rise is very delayed.

It COULD have been your adrenal function lagging behind the reduction in dose. And the sinus problems COULD have been allergies that were controlled at higher doses and not at 2mg. Both would have improved with the increase