Intra-muscular depo-madrone injection

[sp22]

I have had an intramuscular 120mg depo-medrol injection to treat newly diagnosed rheumatoid arthritis affecting my hands and wrists as a “test” before starting DMARDS. Can anyone shed any light on what as a “test” means, how long it takes to work and how long any relief may last?

[Barrister]

It varies on how long it can take to work - for me it usually works within a couple of days, but it usually brings great relief. How long it will last for, again , varies. I can only say for myself and it’s usually around the 6 week mark. Some find it lasts a lot less, others for longer. We are all so different. The test is whether it actually makes a difference to the pain. If it does then it’s taken to mean that your pain is of an inflammatory nature as the steroid helps to reduce inflammation and so DMARDs would hopefully make a difference to your disease progression. Good luck, I hope you quickly get some relief, it’s no fun.

Clemmie

[sp22 in reply to Barrister]

Thanks Barrister. I had mine 6 days ago. Some relief in last couple of days in that I have a greater range of motion in my wrists and pain levels are less but still very painful. No relief at all to the trigger finger I developed a few weeks ago.

[SlowDragon Administrator in reply to sp22]

Do you have hypothyroidism/Hashimoto’s...are thyroid levels correct?

nhs.uk/conditions/trigger-f...

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If/when also on T3, make sure to take last third or half of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

[sp22 in reply to SlowDragon]

Hi SlowDragon

I am having my thyroid function tested next week at my GP’s surgery. I have had it tested previously a few years ago and was ok.

The only meds I’m on at the moment are naproxen and Omeprazole plus I had the intramuscular depo-medrole injection last week.

[SlowDragon Administrator in reply to sp22]

GP likely to only test TSH

Politely request that thyroid antibodies and all four vitamins are tested too

How long have you been on omeprazole?

Long term use of PPI can lead to low vitamin levels

pulsetoday.co.uk/clinical/m...

gov.uk/drug-safety-update/p...

Many hypothyroid people have acid reflux...due to low stomach acid

healthunlocked.com/search/p...

PPI like omeprazole is to treat high acid

[sp22 in reply to SlowDragon]

I’ve only been on Omeprazole for a week. The naproxen about 2 months. I hadn’t had any acid or stomach problems from the naproxen but doctor prescribed it as a precaution. I had my vitamin levels done in November when my first symptoms of tingling and numbness in my hands started which preceded the joint stiffness and pain in my hands and wrists.

[SlowDragon Administrator in reply to sp22]

So what were your B12, folate, ferritin and vitamin D results and ranges?

[sp22]

I don’t remember them specifically but remember the consultant telling me they were in normal range. He never gave me a written record of them though

[penny]

I recall reading that RA and vitamin D (low/resistance) are linked. Dr Coimbra treats RA with vitamin D.

[magsyh]

I have read that before steroid drugs pregnenolone was the number one cure for RA. It was stopped because no profit in it. If I were in your shoes I'd look into it.

[sp22]

Hi SlowDragon

I had my thyroid test results and they’re considered normal.

TSH of 1.55 and T4 Of 18.

I eventually experienced some considerable relief from the intramuscular depo-medrol injection after 2 weeks but not complete relief. Not sure what that means?