Comprehensive Overview Of PMR

Interesting that Baby Boomers is in caps in the gout manuscript that @pattiobrien111 attached. The authors are at Alabama - where Sattui did residency.

"Few evaluations of the risk of other chronic diseases in patients with gout have been performed [4]; none focused on adults ≥65 years of age, which is a rapidly growing population owing to the Baby Boomers that will increase in the USA from 34.4 million in 2000 to >70 million in 2030 [5]. "

Common onset of gout is 40-60 years (mostly male population) but not exclusively. It is believed Covid virus and the vaccine has played a role in the increase, including younger folks. There is a correlation of increased uric acid levels.The articles are many if you are interested in researching. Peer reviewed.
Best Wishes.

Some good information in that vid. I'm never comfortable when drug companies are named as sponsors though.

Interesting that 20mg of prednisone/prednisolone (in Australia 15mg) is given to start treatment for PMR and is supposed to be effective at that dose. At 21:07, he says "The need for higher doses of steroids [more than 20mg] goes against the diagnosis for PMR." Yet quite a few people here say they started at higher doses. Are those doctors over-prescribing or is the PMR diagnosis wrong?

The proposal in the vid that people should be fast-tracked to a specialist to confirm diagnosis before starting prednisone is a nice idea, but in Australia at least, we have a shortage of rheumatologists and long wait lists to see one, sometimes a couple of years. I was referred to a rheumatologist in September and got a letter saying they received the referral and they'll write again when I'm on their waiting list. Four months later, no word. Imagine if everyone had to wait in pain for that long, and imagine the inflammation damage which would likely be caused by such a long delay in starting effective treatment.

I don't know when my onset of gout was. I passed a uric acid kidney stone about 4 years ago. There was some excitement about my elevated uric acid levels then. I doubt my kidney stones formed overnight. In any case, my kidney stones were treated successfully by a urologist until they recurred after treatment was stopped.

My rheumatologist addressed my uric acid blood level with allopurinol initially. The comment at the time was "maybe" my uric acid level was contributing to my symptoms --- meaning my symptoms of the past. I didn't have any symptoms when the comment was made.

A year later, I still didn't have symptoms and didn't feel any different being treated with allopurinol. It was determined that I was "asymptomatic" so my uric acid level didn't need to be treated. Two years after stopping allopurinol... a random uric acid level was rechecked by my GP. I still wasn't symptomatic but my uric acid level was high again. My GP deferred to my rheumatologist to determine if it should be treated or not.

At my recent rheumatology visit, I was asked if I was sure I didn't have gout. I asked "How would I know but I didn't think so." My rheumatolgist said they could do a quick check by doing an ultrasound of my big toe. The ultrasound took a minute to do. It was conclusive for my rheumatologist to say, "definitely gout and very surprising that I never had a gout flare."

I did some Google research into "IL-6 levels and gout" and found the following:
https://pubmed.ncbi.nlm.nih.gov/27219123/
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Maybe the Actemra I take is preventing gout flares.

Trust me if you have a gout attack you will know it, the pain can be very intense

I’ve been to numerous doctors and can’t get any answers for what is happening in my body. I’m in severe pain in my joints and muscles. My blood work comes back normal which is good but also bad because I’m not getting any answers and I’m getting worse. I can barely get out of bed and walk in the morning and to get in and out of the car is extremely difficult. The blood work that came back high was the MCV AB 63 high. My primary care doctor doesn’t know what that means and referred me to a neurologist but can’t get in to see her for 6 months. What else can I do to find out what is going on ?

I’ve been to numerous doctors and can’t get any answers for what is happening in my body. I’m in severe pain in my joints and muscles. My blood work comes back normal which is good but also bad because I’m not getting any answers and I’m getting worse. I can barely get out of bed and walk in the morning and to get in and out of the car is extremely difficult. The blood work that came back high was the MCV AB 63 high. My primary care doctor doesn’t know what that means and referred me to a neurologist but can’t get in to see her for 6 months. What else can I do to find out what is going on ?