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Circulating cortisol levels -- Does it have an effect on PMR?
Polymyalgia Rheumatica (PMR) | Last Active: Jul 10 3:22pm | Replies (4)Comment receiving replies
"Some studies have suggested that the bodies inability to produce enough cortisol in a PMR trigger also caused the original PMR."
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I'm not entirely clear with this part. My understanding is cortisol levels are "normal" at the beginning of PMR. The triggers of PMR are stressful events and cumulative stress over time or maybe infections. There really isn't a "normal cortisol level" which is why cortisol levels aren't tested very often --- they are too variable. Cortisol levels are notoriously hard to interpret.
I think cytokine levels like IL-6 in particular can increase for some reason that isn't entirely clear to me. The pro inflammatory effects of IL-6 may overwhelm the ability of the adrenals to produce enough cortisol to regulate the excess inflammation. In a way ... there isn't enough cortisol but cortisol levels aren't abnormally low. I think it is more a case of too much IL-6 that throws everything out of whack.
That is just my opinion ... I don't really know. What seems very clear to me is how prednisone suppresses adrenal function over time. Sometimes I think it was a miracle that I was able to taper off prednisone.
I needed something that suppressed my IL-6 levels rather than the production of cortisol from my adrenals.
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You are a miracle child. You need to donate to science. Ok. I agree. I had a lengthy discussion on another site concerning how this all got started and how the body uses both natural cortisol and prednisone cortisol once you reach the 3mg range. I like you dont know the answer any better today. But lets take another example . My wife who has GBM. She was on 4mg dexamethasone. They told me to taper off so she could start immunotherapy. I could get her to 2mg and her inflammation would increase and she would get hydrocephalus and go into almost a coma like state. No pain with it. just go into a coma. Not at all the same symptoms as PMR. But Cortisol still had its role in her reaction to the taper. My education in corticosteroids is from a failed attempt to help my wife. Cortisol and PMR symptoms as you described are intertwined. Their relationship is dependent on each other. Where I get frustrated is the term PMR flare. Seems to be over used. Although it definitely describes the condition you are in.