Anaemia anyone?

[gillsky8]

So the latest is diagnosed with anaemia.

Add iron supplements to the steroid list !!

Whatever next…. 🤪

Doc seems happy with everything else

[PMRpro Ambassador]

It is a common finding in chronic illness. How long have you had your PMR diagnosis?

[gillsky8 in reply to PMRpro]

Since early August

I’m also on esomeprazole

[PMRpro Ambassador in reply to gillsky8]

Then I'm surprised they didn't identify then - or maybe they didn't look, I doubt it is the PPI yet.

[gillsky8 in reply to PMRpro]

104g/l was haemoglobin do you mean you doubt it’s the steroids yet?or omeprazole ?

[gillsky8 in reply to gillsky8]

Am pretty sure I’ve had PMR for quite a few months before being diagnosed

[PMRpro Ambassador in reply to gillsky8]

The PPI, the omeprazole. Steroids rarely lead to anaemia - but when it is the anaemia of chronic illness, as often found in autoimmune disease, correcting the inflammation using steroids frequently also corrects the anaemia after a few months.

[gillsky8 in reply to PMRpro]

So PPI THE LIKELY CULPRIT!!

is 104/l worrying ?

[PMRpro Ambassador in reply to gillsky8]

No - it is more likely that it is due to the PMR, It is really too soon for anaemia due to the PPI reducing the amount of iron you are absorbing. Anaemia rarely happends in a few weeks, unless you are bleeding and that amount of bleeding would be noticed,

104 isn't too bad really, 120 is the bottom end of the normal range for women and down to 100 is classed as mild anaemia. There are various reasons - it can be you have fewer red blood cells than you should, or each red cell has less haemoglobin than usual. But the first place to start is usually iron and see if that improves things.

[Gimme]

It is reportedly very common in patients with PMR. Anaemia may be due to absorption of iron from the gut, but it can also be metabolic, due to your body not being able to add the iron to your red blood cells. I wouldn't be surprised if the chronic inflammation has a role in the second of those two. You could add a B complex to your supplements, especially B12 and folate, which have a role in making red blood cells, or make sure that you get plenty of dark green leafy veg. I assume that you have already been told to take Vit D.

Luckily for me, my iron count has always been good, and recent blood results have confirmed that it still is, despite 7 months of pred and goodness knows how many years of undiagnosed PMR. At least one part of my knackered out body still works.

[springeramber]

Hi gillsky8

I developed severe anaemia after 15 months on steroids - march 2020 put on iron and folic acid- had all the investigations- eventually after a hospital admission I was diagnosed with LVV and put on an iron infusion and haemoglobin has been fine ever since that was in march 2021

[Richmond162]

Hi. Just been diagnosed steroid induced diabetes, so like you, another thing added to the list!! Waiting to see dermatologist as have very itch rash over body, wondered if it was blood pressure tablets or stomach protector tablet but doc says no. Will have to wait for diagnosis, but it is driving me crazy ugh!! Regards.

[PMRpro Ambassador in reply to Richmond162]

Have you tried antihistamines? More to the point - what BP tablets are you on? I was given an ACE inhibitor and after a short time developed anitchy rach which started at my neck and spread outwards. The ward doctors weren't interested - but at the weekend it was a different consultant, I told him and I was off the tablets pdq and it is now all over my notes: ACE inhibitor allergy.

[Richmond162 in reply to PMRpro]

Hi. Amlodopine bp tablets, steroids, omeprazole. I have tried all antihistamines, plus e45 itch cream £31 x 3 plus other creams. Doc said I will have to wait for dermatology report. She thinks it may be an allergy. But is is all over body. It can really affect moods can’t it? Thanks for reply. Julie

[PMRpro Ambassador in reply to Richmond162]

Any problems breathing? Amlodipine can cause a itchy rash. If she thinks it is an allergy, why isn't she considering that?

[Richmond162 in reply to PMRpro]

I did mention this to her. Her reply was if you look at side effects on all tablets, it said they can cause itch/rash! I did ask for another blood pressure tablet but she said wait until after my dermatology appt on 27th. I am wondering if to leave blood pressure tablet off for a few days. It is 2.05am now and the itch has won again,I am longing for a good nights sleep!!Regards.

[PMRpro Ambassador in reply to Richmond162]

Er - b*££*"$s ... Some are just itch, some are allergic reactions and when they are potentially allergic reactions you do something. Can you see another GP in the meantime?

[Richmond162 in reply to PMRpro]

Hello. Unfortunately my surgery has no permanent GP, so different GPs. I rang this morning to ask for appt. Same old same old, no appts. Ring Monday or go A&E!! So I am deffo going to ask change BP tablet, I think I know my own body, and am willing to rule things out one by one. Thank you for replying. I will keep you updated on any progress.

[PMRpro Ambassador in reply to Richmond162]

They MUST have emergency appointments and the ED is not their cover for an emergency appointment - that is why the EDs are overwhelmed. If that rash gets worse - go to the ED.

[DorsetLady PMRGCAuk volunteer in reply to Richmond162]

Does surgery have eConsult facility ? Look here if not sure.

econsult.net/nhs-patients

Much easier than hanging on phone - and there is a trail

[Richmond162 in reply to DorsetLady]

Hello. I have just contacted the above and filled out questionnaire. Hopefully I will have reply on Monday. Thank you so much for that info. Regards Julie

[Colin-s]

I also recently tested as having mild Anemia. I was was diagnosed with PMR 28 months ago and am on Steroids and PPI. The GP was concerned about the anemia and consequently have had a camera put up and down both ends to look for any bleeding but all was normal so I think they are putting it down to my chronic inflammation. I am on a very low steroid dose to am not entirely symptom free of PMR.

[gillsky8 in reply to Colin-s]

When you say mild what was your reading ? mine was 104 g/L and it looks like normal is 110

[PMRpro Ambassador in reply to gillsky8]

No, normal range for women is about 120 to 150, men is 138 to 172.

[Colin-s in reply to gillsky8]

I can’t remember the numbers but GP said it was ‘borderline’

[Gaycreasey]

I too have been diagnosed as anaemic after seven years of pmr. The usual tests were done, ct scan, faecal test, the latter revealing blood in the faeces. A gastroscopy and a colonoscopy were done within two weeks. Unfortunately during the colonoscopy the pain was so bad I had to ask them to stop. Another appointment was made for the 20th September and in the meantime I asked my GP to prescribe some iron tablets. Never straightforward, the prescription was for tablets containing lactose, which I am unable to take. ( I had foolishly thought that this information would by now be written all over my notes in big letters, as I had asked for). I asked for the prescription to be changed and had got the information from the pharmacist as to which iron tablet did not contain lactose. After three days of no response from my GP and desperate to start the tablets, because of the short window before the next procedure and having to stop taking the tablets a week before, I decided to buy my own tablets. They were very reasonable and I am now taking two a day. The weakness and dire weariness has lessened considerably, however I have just been informed that my appointment has been cancelled due to the doctors’ strike and the ‘list’ and has been rescheduled for November 1st. Presumably the two week schedule has been jettisoned!

[phebamom in reply to Gaycreasey]

If iron supplements help then you have iron deficiency anemia, not Anemia of Chronic Disease. Glad you found something that works for you. For me the issues is citric acid and anything made with barley.

[phebamom]

Do not take iron supplements without a doctor's supervision. It is quite possible that you have something called: Anemia of Chronic Disease. The condition can be a part of PMR/GCA. This type of anemia is not caused by a lack iron. The cells can not bind the iron and use it . I have the condition as part of my illness. I was given iron infusions in the past and they did not help. Too much iron can be dangerous. There is not a lot that can be done to treat this type of anemia as a specific illness. The best treatment is to successfully treat the chronic disease causing it.

[Gaycreasey in reply to phebamom]

The iron tablets were prescribed by the gp. Unfortunately she did not understand that I cannot take tablets containing lactose. My decision to buy my own was because the gp took so long to change the prescription to the lactose free type.

[Avadip12]

yes me to, B12 and D3 added to my list