anaemia

[Gardendaffodil]

I’ve recently finished taking pred after a four year struggle. I am now diagnosed with anaemia ! I’ve had two blood tests so far, a urine check, a bowel kit done and am now waiting for a colonoscopy. This is to eliminate anything like internal bleeding. I do not have Celiac disease either. In the mean time I am so weak and my arms and shoulders are aching like mad and I have now energy. Has anyone gone through this after pred? I’m hoping it’s the anaemia and not the polymyalgia coming back 😤😤

[SheffieldJane]

Your doctors are being reassuringly thorough. It is not something that I personally have heard much about however, chronic illness can be a causal factor. Good luck with your results. Let us know what they say.

[PMRpro Ambassador in reply to SheffieldJane]

Why prone to B12 deficiency? Never come across that before.

[SheffieldJane in reply to PMRpro]

Sorry, I am not doing very well today. Something prompted me to take it many moons ago and I thought it was that. Maybe it’s because I don’t eat meat. ( B12).

[PMRpro Ambassador in reply to SheffieldJane]

That certainly is a risk factor - need more Marmite ...

[Gardendaffodil in reply to SheffieldJane]

I’m going to increase my greens and maybe a steak once a week as we mostly eat chicken and fish. Plus I bought an iron rich drink called Spatone to see if it will help while waiting for the doctor to sort me out. It only contains 5mg iron can’t hurt surely 🤞

[Stella3 in reply to SheffieldJane]

I had anemia after my initial 60 mg dose of prednisone for GCA. I felt terrible too. I had a colonoscopy and a bleed was discovered in my intestine. I recovered but it took a while. Good luck.

[PMRpro Ambassador]

I have to confess my first thought, even before reading your report of aching arms, was that maybe the PMR isn't entirely gone. It really isn't unusual for symptoms to reappear within 6 months of stopping pred because the disease activity is very low and it takes time for the drip drip drip of inflammation to build up enough to cause symptoms. I really wouldn't rule it out. If you move fast, you may well get away with 1mg of pred. And mild anaemia can be a result of chronic illnesses like PMR.

[Gardendaffodil in reply to PMRpro]

Do you think I should request an ESR/CRP blood test while waiting just incase ?

[PMRpro Ambassador in reply to Gardendaffodil]

Will do no harm though the bloods can lag a long way behind symptoms

[PMRpro Ambassador]

Increasing your iron levels isn't really masking test results

[SnazzyD]

is your vitamin D ok? Low levels can cause aches. Keep an open mind regards the PMR, it might not be done enough to have no Pred at all.

This might help with tips on how to increase iron intake eg vitamin C and good sources plus foods that reduce the amount of iron you absorb.

healthline.com/nutrition/in...

[Gardendaffodil in reply to SnazzyD]

Thanks SnazzyD I’m going to ring doctors after 2pm and have a chat with her to see what she suggest.

[Gardendaffodil in reply to Gardendaffodil]

Plus I’ve been on SunvitD3 for a few years now. Waiting for my second Dexa-scan anytime soon.

[DorsetLady PMRGCAuk volunteer]

Arm & shoulder pains as well as lack of energy could also be low adrenals-have cortisol levels been checked?

[Gardendaffodil in reply to DorsetLady]

No they’ve never been checked

[DorsetLady PMRGCAuk volunteer in reply to Gardendaffodil]

Might be worth it then ….

[Gardendaffodil in reply to DorsetLady]

I’ll ask this afternoon - thank you.

[DorsetLady PMRGCAuk volunteer in reply to Gardendaffodil]

GP surgery can do the basal test -early morning . Gives a clue -then another can be find if necessary.

Have a look at link for your info -and see if anything resonates-

healthunlocked.com/pmrgcauk...

[Lonsdalelass in reply to DorsetLady]

If someone has low adrenals, is it a case of sitting it out or is there medication to help? Just wondering, as now you've mentioned arm and shoulder aches that's what I've been having since coming off the pred (I took my last steroid in May last year). Don't think it's re-emergence of PMR as it doesn't feel quite the same, and recent inflammatory markers are within normal range. So maybe it's low adrenals? Basal cortisol test for me? If it is low adrenals what can be done?

[DorsetLady PMRGCAuk volunteer in reply to Lonsdalelass]

If it’s adrenals being sluggish, the only thing really is time [it can take up to 12 months for them to be fully functional after coming off Pred] but do request a basal cortisol test to check their levels….. if there is cause for concern then you may be referred for further investigation and Endo Dept…usual treatment is hydrocortisone ….

But are you 100% sure it’s not PMR grumbling?…and it can take some time for inflammation markers to rise again….

[PMRpro Ambassador in reply to Lonsdalelass]

If it is adrenal insufficiency after all this time then it depends on what your cortisol levels are. After nearly a year with no pred they should have recovered as much as they are going to but if they haven;t recovered enough for safety, the only option is replacement therapy with pred or hydrocortisone. There is nothing that will persuade the adrenals to recover any more than lack of pred dose. If you see what I mean.

[Lonsdalelass in reply to PMRpro]

Thanks both to PMRpro and DL for your helpful replies. X

[Blearyeyed]

Have they tested your B12 and Folates with blood tests as well as the other thorough tests? Have they done a test for Pernicious Anaemia?I discovered recently that my recurring anaemia was because I have Vitamin B 12 deficiency Anaemia .

Since beginning the injections my anaemia has been improving , as the lack of B12 can prevent you from metabolising iron and other nutrients properly.

Long term steroid use and use of other medications like PPIs can have an effect and cause low B12 or Folates and each of these deficiency issues if not treated causes many symptoms including Severe Fatigue ,,Muscle weakness , dizziness , palpitations, digestive issues , poor skin , insulin resistance, numbness or pain in the limbs on activity , and muscle loss in arms and legs to name just a few.

If you have had these tests and they said they were normal get a copy of the results , if they are borderline low it would still mean you would benefit from increasing B12 and Folates with oral supplements. It will also help you to metabolise any iron tablets you may have been given.

If your initial Vitamin B 12 test was done and is in normal range , ask for an Active B12 test. The usual test is for total B12 , sometimes it is only the active B12 which is deficient while the total is normal. This Deficiency type shows an issue with long term processing of B12 and means you need long term B12 injections to prevent the symptoms.

Not everyone can tolerate or process ferrous iron tablets , I can't. I take active iron instead which is easier to process and lasts longer in the system , for some reason they don't offer it as an option on the NHS except in hospital. I use Solgar Gentle Iron which is also easier on the stomach and doesn't cause constipation.

[PMRpro Ambassador in reply to Blearyeyed]

It is because you can have an allergic reaction to it and it is administered with monitoring.

[Blearyeyed in reply to PMRpro]

I assume you are talking about the iron?Yes I have friends whom get an allergic reaction , I'm in the group whom doesn't but the B12 issue means I don't metabolise the ferrous iron efficiently but can process the active iron.

I read about it , it's the iron which is automatically used in the Netherlands for pregnant women and older people as standard because it doesn't cause the issues of constipation and stomach pain as well as remaining in the system longer as well as people being more willing to take it if they don't have problems on it.