does poor adrenal function until they work again increase CRP results?

[sdowney717]

As in your dropping the prednisone under 10 and down lower and lower?

I just dropped today from 7.5 to 5, and don't yet feel any different.

[PMRpro Ambassador]

Not entirely clear what you mean. It is inflammation that increases the CRP - and that will build up if you go to too low a dose to manage the daily new dose of inflammatory substances, Adrenal function has little to do with that.

[sdowney717 in reply to PMRpro]

I thought even normal people produce inflammatory substances, just less of it and the adrenal cortisol production deals with that. If a person's immune system gets challenged by an agent in the environment, that creates an inflammatory response. Such as getting an infection, or allergies or an injury.

[PMRpro Ambassador in reply to sdowney717]

It is very complicated and yes, normal people produce cytokines, But it isn't quite as simple as you want it to be and it isn't just cortisol that modulates it. The inflammatory response in PMR isn't a normal one either - it is the immune system gone wrong and unable to recognise your body as self so it turns on body tissues and attacks them.

[Gimme]

My ESR and CRP have never been raised at any stage of the game.

[Flivoless]

2.5mg is too much at your level. Personally I wouldn't go more than 0.5mg at a time.

[Zebedee44]

Hi, looking back at your posts you seem to be one of the lucky ones who make this journey through the PMR experience quite quickly. But a drop from 7.5mg to 5mg could well bring your rapid taper to a sudden end if the inflammation accumulates. Like PMRPro says it is like a leaky tap dripping into a bucket, which will eventually overflow.

I do wish you the very best with your taper but I would caution a more considered reduction over a longer period. Your reduced adrenal response to the lower pred dose might also make you feel quite unwell so please look after yourself. best wishes, Chrissie

[sdowney717 in reply to Zebedee44]

I am at 5 for days now and doing ok. The mornings though are tougher at 5 than they were at 7.5. Actually, look forward to taking that 5mg pill every AM. I t takes several hours to feel better. Took my second dose of MTX, I take once a week on Thursdays. It seems to have no ill effects, but not been on it very long. Hydroxychloroquine seems to have no ill effects either.

I was also reading that Metformin may cause arthralgia, and I also had that increased from 1500 mg to 2000 mg right before my PMR got bad, and it makes me wonder if there could be a link. I am going to stop taking Metformin for a week and see what happpens. I am used to taking more insulin due to the prednisone I have had, so I can compensate.

[PMRnewbie2017]

When we talk of inflammation in PMR or GCA it is caused by a type of cytokine called Interleukin-6 that is being produced in excessive quantities. Inflammation can be caused by many other types of cytokine or other substances: histamine, chemokines, interferons, lymphokines, or tumour necrosing factor. Often these substances have a protective role but it is when they are produced in excessive amounts that the problems start. As PMRpro has said the whole system is very complicated but for simplicity, the immune response to an infection is not the same as an auto immune inflammatory illness.