Does higher elevations enhance PMR symptoms?

[SMH4CRNA]

Every time I visit my son in Colorado at a 5-6k feet elevation I seem to have difficulty after a couple days. On prednisone (5mg) I feel 5/10 lower extremity discomfort. Without predinisone I would rated it around 8/10. Always in the lower extremities.

[fmkkm]

There is less oxygen in the air so your muscles are getting less oxygen delivered.

[SnazzyD]

5-6k feet isn’t insignificant and if you have an issue with poor oxygen supply such as due to the PMR you might feel it when someone who has no issues may not notice.

From having a read around, the usual level at which it is considered a risk for altitude sickness is about 8k feet (2500m). However, people with health problems that are sensitive to low oxygen may feel it at 5-7k feet (1500-2100m). I remember getting out of a cable car up some mountain in Switzerland in my 20’s and we made off towards the cafe. After about 50m we were struggling; I was amazed.

[PMRpro Ambassador]

I don't know - I haven't spent several days at 1800m for a long time, but I was at 1900m for a week for a meeting some years ago and I don't remember the PMR getting worse. But if you have any problem with blood supply to the lower legs, the low O2 at altitude won't help

[winfong in reply to PMRpro]

Sounds like you're pretty well acclimatized at this point. I doubt the extra 100 meters made much of a difference.

[PMRpro Ambassador in reply to winfong]

No - I live at 830m, like the top of Snowdon, that's another 1000m I was talking about. Bit different!

[winfong in reply to PMRpro]

What's a 0 between friends?

[Gimme]

I don't know, but I will be at 12.5k (i.e. 12,500 ft) in Bolivia in October, so I will be able to report back. We are taking a slow drive up from the lowlands, so I will be able to experience the changes with increasing altitude. I was in Ladakh in 2019 with undiagnosed PMR and we went up to 14.5k. From memory, my aches and pains were no worse than lowland Britain, but then I did have pneumonia and so my attention was probably focussed on other basics, such as breathing. I did ask the consultant rheumatologist if the Bolivia trip would be safe and he said that he had no concerns clinically, but he did wonder how comfortable I would be feeling. Interpret that how you will. I expect that there is enormous variation in individuals are affected by altitude, much the same as there are variations in how well we acclimatise and variations in how we experience PMR. I have spent a lot of time at high altitude (10k plus) and I am asthmatic, but I don't usually suffer too much with my respiration until I get above about 12.5k, so long as I am acclimatised. Acclimatisation is everything at altitude.

[SMH4CRNA]

Thank you for all the feedback, I truly appreciate it. I personally do not believe altitude has an effect on my "PMR". Just an observation I made when I went to higher altitudes

[PMRnewbie2017]

I doubt it would affect the Interleukin-6 element which creates the symptoms we call PMR but decreased oxygen in the blood and therefore in the muscles could create muscle fatigue which might be interpreted as PMR. Because PMR is a vasculitis I should have thought any reduction in oxygen supply plus reduced clearance of lactic acid etc could make you feel like your legs are made of lead. It's been 40 years since I skied in Colorado but I still remember preferring to use the lift (elevator) rather than taking the stairs because my thigh and calf muscles would burn.