GCA/pmr flare?

[Cfmad298601]

I’ve been trucking along pretty well since 2022. Currently at 4mg pred and 15 mg MTX, both CRP & ESR have been fairly consistent within range.

I’ve been at 4mg pred for 3-4 months as my Rheumy wanted me to stay on the same until my synacthen test (had first one cancelled) beg of Sept - which came back quite good apparently.

The past 2-3 weeks have been a bit stressful, holidays and busy at work.

Still on 4mg, not yet tapering lower……as thought better to wait until things were quieter.

A couple of weeks ago I noticed a bit of hip and foot ache intermittently, but had been walking on hols so wasn’t sure if that was it…..this went away over a week or so.

But last couple days I’ve had slight recurrence of intermittent temple ache, no visual disturbances…..but just as when I first started all this shenanigans.

I had a scheduled blood test last week and it said that both CRP & ESR are raised, both in the mid 20s, about double the my average of last year or so.

should I increase pred for a while, it’s obviously not due to tapering, as I haven’t recently…….

What do you knowledgeable people think I should do ?

[DorsetLady PMRGCAuk volunteer]

Might be sensible to try the flare protocol - contained in this link -

healthunlocked.com/pmrgcauk...

.. probably due to your comments--The past 2-3 weeks have been a bit stressful, holidays and busy at work.

[PMRpro Ambassador]

Have you spoken to your doctor? Have they registered that your markers are noticeably higher? Though the stress won't have helped!

[Cfmad298601 in reply to PMRpro]

They haven’t mentioned those at all. But I do have an appt with my Rheumy at end oct.

Do you think I ought to make contact before, or just follow a flare regime, and up pred for a bit and see how things go……

The aches and such are quite sporadic, some days….not others.

[PMRpro Ambassador in reply to Cfmad298601]

I think it is possibly better to give it a few days and see if it improves - there are other causes and if you do the flare protocol and it goes away the rheumy might be more sceptical. If they worsen at all and become daily, then do it.