Happy Christmas to all of you out there and hope you are all celebrating with your loved ones.
I have a little problem for any of you who might know more between PMR and liver function. Had quite a flare a month or two back and settled at 8mg for now. 4.5 years into PMR.
But .. not been well for about three weeks, very tired but just about coping. No PMR aches. But itchy scalp and head which then slowly spread around the body. Vague stomach discomfort which slowly worsened an hour or two after meals and then a few days ago feeling pretty wretched with full on stomachy pains with a vomiting episode and bodily itching. No appetite. Thirsty. Went to my local urgent care centre and surprised to find out that normal CRP but very high liver enzymes results. Was referred to nearby hospital (Lancaster) that confirmed these and admitted for further obs. No obvious ‘cause’ of a possible hepatitis diagnosis. No alcohol, no trips away etc.. they appear to want to discharge me as it’s Christmas and be treated as an outpatient. Yet still feeling rough. A scan has been booked but no news whether today or not.
Does anyone know of any autoimmune link between PMR and abnormal liver enzyme function ? A long shot I know….
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Bachfugue
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I don't know about PMR and liver function, but I do know that methotrexate can cause sclerosis of the liver. I am taking that drug and my Doc tests my liver enzymes every 3 months. Are you taking it? May need to see if it is a side effect of any meds you take.
Thanks for your reply. No not taking methotrexate though the rheumy is always plugging it. And no other ‘new’ medications. Rather baffling. Waiting for a liver scan and results of blood tests taken some hours ago. But fear they will send me home with no diagnosis.
Probably a good thing you are not on methotrexate. It seems like it is always something new with this PMR and the meds. It is in these times and circumstances, when we cannot stand on our own strength and understanding, that we need to fall on the grace of God and trust him. Hang in there.
If you have one autoimmune disorder, you are at a greater risk of developing another so it is possible it is an autoimmune hepatitis. But it is also not uncommon for PMR to present with raised enzymes though they are not usually extremely high.
Thanks PMRPro, only Pred, magnesium and Vit D/K2 combo and small doses of oestrogen gel that Ive been taking long term. But did take some multivitamins (taken before) and a few Bach Remedy drops recently which the doc appears to have blamed for this rapid rise, whilst ignoring my discussion on possible links with autoimmune diseases including PMR that may affect the liver. Have to wait until Tuesday for a scan and results of more blood tests, so Christmas effectively cancelled. Though have to admit I’m sort of enjoying the rest.
Yep! I get it, though the beauty of the Italian alps has a certain charm. A tad more than an English NHS hospital ward. But at the same time it’s quite an enlightening experience being here.
Your body issues sound scary. Hope you get a solid diagnosis and treatment in just a few days. I get tested for liver and kidney function every time I get a blood draw. Thought it was because of taking steroids.
I had high LFT last year and no cause was found, no idea what it was but at the time I was quite poorly with chest infection and bowel obstruction so that may of been the cause, I used to like a baileys but don’t drink anything now, anyway all liver test are normal, so maybe you are going through an unknown cause
VERY good to know. I don’t even drink … at the time PMR was showing itself I couldn’t tolerate alcohol - even the smell of wine was horrid. Rheumy had no answer as to why. And so it has remained.
I have had a raised AST since recovering from an allergic reaction to an antibiotic. It is raised all by itself. ALT and others are normal. Rheumy said it was to do with muscles. When asked when does a liver enzyme become a muscle enzyme he replied ‘when in conjunction with other enzymes’. Complicated! However I am waiting a BT to rule out Autoimmune Hepatitis which if positive will be treated believe it or not, with steroids! I was in A&E last month or to be precise SDEC with a prolonged bout of Afib and Trachycardia which I blame on steroids!
What I keep saying to myself is - given a chance the liver does regenerate. Doesn’t it? 🫤 It will be an alcohol free Christmas! Mind you I have been alcohol free apart from the odd sip for a long time. Feeling tired/shit after eating rings a bell.
"I was in A&E last month or to be precise SDEC with a prolonged bout of Afib and Trachycardia which I blame on steroids"
Mt afib is due to PMR - started about the same time and they are confident it was the autoimmune part damaging the sinus node. Steroids actually improve it!
I know! 🥴 But I never as far as I was aware had heart issues for the four months I went undiagnosed and for two months when I first started steroids. After 2months steroids my heart got bumpy and I was diagnosed with ectopics. Then Afib episodes started a year later and usually after an increase in dose. So I do understand what they say but I can’t help but think in my case…….!
I asked Prof Mackie if it was more common in PMR patients and she said they didn't know but it was the same age group which complicated things. I didn't see why - was there MORE in PMR patients than a matched group? And a recent study finds there IS! So I was right - it felt like that from the forums.
I have delayed my booster as just not feeling right. After my first AZ had a flare with some double vision which eventually settled down but second AZ was fine. Moderna a year ago okish but a fair bit of irregular heart beats for weeks that my GP rather ignored. So I’m rather apprehensive of another particularly as only option is Pfizer.
I worry if I do I worry if I don’t. It is difficult. I haven’t had the last two. Until I breathed in lime dust I had the longest run of feeling good without flares. I tested for antibodies and they were high. Cross fingers
Thank you Ridge for your experiences. I don’t know the exact readings but it was mentioned that one test which should have been in single figures was 500+. I’m having blood tests daily but NO medic conversation for two days. No AF but had an ECG earlier. Still no scan - poss closed for C’mas so the nurse mentioned I may have a CT scan if it’s quicker. Itchiness still there ++ But I actually ate a little today after having zilch appetite for days. Face turning yellowish. Happy Christmas!
It sounds as if you are in the best place. Tough for you though. I remember being told that my AST at 400 ish was not concerning it would be if near a 1,000!! It should be 30.
It is difficult in hospital when you are feeling bad. Do you have someone who can help a little? I’m sorry I should have read your profile and now if I try it says I should save changed!! I probably should but what changes….? This text? Just want to say I’m routing for you and keep us posted.
If you leave the page you are on - you lose what you have written. You can post it and go back and edit or you can open another window to do what you wanted to do ...
My last two ALP I think they call it, have been high…but could be liver or bone issues! Don’t know yet, but I’m teetotal due to painkillers for years now, so I’m not pickling my liver! Hope you’re better soon, S x
I developed very high LFTs about 3 months before I was diagnosed with PMR 3 years ago. I was referred to the hospital but they never found a cause. After about 3-4 months they slowly returned to normal. I get them checked on an annual basis and they have been fine since. I still drink alcohol but not much. The liver is very good at repairing itself.
Thanks Symph, your post is so encouraging and adds to the research on links between LFT and emerging PMR. I hope you continue to improve. Happy Christmas Day!
Raised liver enzymes really are quite common with PMR but they will check you. Bear in mind you can get raised liver enzymes with paracetamol but they don't usually look for them.
not meaning to be specious, anyway the itchiness is intermittent with me but mainly upper trunk and underarms, derm MD said probably some sort of exema or psoriasis or atopic dermatitis and was not familiar with PMR as I have found most MDs here in US are unfamiliar with PMR since it is not as visibly debilitating as RA nodules and deformed fingers. Have used hydrocort 5% cream for itching, but cant use as much as I would like due to overabsorption side effects. currently on 5mg pred again but rheumy wants down to 1mg very very soon.
From bpac.org.nz/2023/pmr.aspx Liver function tests (approximately one-third to half of people with PMR have mildly elevated liver enzymes, particularly alkaline phosphatase). I thought this was so, as I think I was checked for liver function prior to prednisolone prescription?
So sorry to hear this. Where are you based? Good news is that I’m fine though took all manner of testing to eliminate all types of hepatitis, plus ultrasound and gastroscopy that showed bile staining on the stomach wall with gastritis. I was discharged from hospital with no treatment and liver function slowly returned to normal, itchiness stopped, urine colour ok, jaundiced skin receded and stomach discomfort stopped. A doc at the hospital suggested a possible chemical poisoning by a tumeric compound in vitamin pills but no new pills so I’d rather poo pood this at the time.
However, a week or so later I took two magnesium pills (had stopped taking them when in hospital) and within hours had an itchy scalp and feeling rough. I’d started this particular brand (Boots) in November that also contained vitamins. So out of curiosity looked at the many ingredients and noticed that the food colouring (yellow tabs) contained a tumeric compound…. Felt fine the next day and chucked the rest out.
So maybe there is something in this. Found a medical paper on this relationship, rare but it happens. Apparently there are tabs that contain some form of bark that can have a similar effect.
GP has an open verdict. I have had a difficult few months with the loss of a younger brother, and a stressful work year (now retiring as an academic), I think I’d lost all my bodily reserves yet just carried on. So no doubt mega depleted.
Lessons learned …. What effect this has on my PMR I can’t imagine. Been at 8mg since the liver episode.
so good that everything works well for you . I had only ultrasound done and all of the blood tests . My liver enzymes higher day by day and they can’t find the reason for it. Did they did mri for you? I’m based in England. Come to hospital with pneumonia and find out i have high liver enzymes. I’m so worried. Thank you for your reply much appreciated
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