Short dose increase?

[tonyevans48]

On 25mg mild symptums. Weekend activity coming up. Thinking of 5mg uplift for couple of days to get through. Any prroblem?

[Charlie1boy]

Not sure that everyone would agree, but 25mg is quite a high dose for pmr( I actually started at 30mg to clear up the accumulated inflammation), and you have only recently started, it seems.

Yes, pmr does require us all to consider our activities, and really to change our lifestyle, so I’m tempted to ask what the activities are that you’ve planned, and whether these could be reduced. I carried on as normal to begin with before I realised that this was not really an option!

Personally, I would not be increasing by 5mg at such an early stage, and for sure, I wouldn’t seek to do so without your GP being consulted. I think you need to give the prednisolone a chance to do its work at 25mg, and see how you get on.

Others will be along to give their advice in due course.

Good luck.

[PMRpro Ambassador]

Your posts suggest your diagnosis is PMR and you started on 15 but obviously your doctor has increased that to 25 mg? Is that correct? It is very difficult to comment any further without some context - perhaps you could add more details either to your profile or in your post.

Yoyoing your dose really isn't recommended to accommodate extra activity like that. If you start doing it, you tend to do it more and more - and the idea is to be tapering the dose of pred not increasing it because when you start upping it and then dropping down again it sometimes makes it less effective, you feel you need more all the time and your dose starts creeping up.

25mg is a highish starting dose for PMR anyway and the first thing you need to do is get your symptoms well under control - if that doesn't work, your doctor might need to think whether this is "just" PMR. If you go up, that obscures the view. Are you modifying your lifestyle to accommodate the PMR? Being on pred isn't a free pass to go back to your previous activity level - you have to do your bit too. Pred does nothing to the actual underlying disease process - it just manages the inflammation it causes - and it is chugging along in the background, attacking your muscles and making them delicate. Too much pred over time doesn't help that so keeping the dose lower is quite important for that reason as well as all the other potential adverse effects.

[DorsetLady PMRGCAuk volunteer]

If you have PMR - and there seems to be some doubt according to your very scant bio - then 25mg should be adequate. so no I wouldn't recommend adding in 5mg without medical advice... and as stated steroids aren't to be popped as and when.

If 25mg is not cutting the mustard then either it isn't PMR as we know it, and a proper diagnosis is required - or you haven't grasped the fact you need to moderate your activity level to manage your underlying illness.

If you haven't read this please do, and note the link on pacing yourself -

healthunlocked.com/pmrgcauk...

[tonyevans48 in reply to DorsetLady]

Brief history. Started 15mg for nearly 4 weeks - no symptum relief. Taken off Pred 15 to zero in 10 days - ouch! Further blood tests - conlusion PMR (and pre diabetes!). Different GP puts me on 20mg - still symptums so agree after 1 week to up to 25mg. Symptums milder but still sore stiff shoulders and weak arms (particularly mornings). See GP in 10 days but interested to know if temporary 5mg uplift for couple of days is sensible or reckless.

[DorsetLady PMRGCAuk volunteer in reply to tonyevans48]

I know we do suggest an increase to cope with a flare, but that’s in regard to established patients - and a definite diagnosis of PMR.

The issue some of us would have with you increasing your dose is , although ‘concluded’ due to blood tests [which actually doesn’t prove you have PMR only that you have raised inflammation markers, but not the cause] so it could be PMR but it might not.

A definitive diagnosis is based on blood markers and your reaction to Pred -and that seems to be ‘so-so’ at the moment.. so to be able for the GP to make a more accurate diagnosis you really shouldn’t be adjusting your dose yourself [albeit for only a few days] it could lead GP up the garden path….

So although it’s not reckless, it may not be helpful in the long run..

Hope that makes sense.

[tonyevans48 in reply to DorsetLady]

FYI blood test results - ESR normal, CRP 154. PMR?

[DorsetLady PMRGCAuk volunteer in reply to tonyevans48]

As I said and any check online will say same thing - high reading arevnot specific to PMR or GCA -m

A high reading shows that there is inflammation somewhere in your body. Other tests might be necessary to find out where or which specific illness or infection is causing the inflammation.

[piglette]

Are they sure you have PMR? Perhaps they should relook at your symptoms and results.