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PMR Diet: Foods to eat and avoid
Polymyalgia Rheumatica (PMR) | Last Active: Aug 17, 2025 | Replies (133)Comment receiving replies
I have no opinion about melatonin but sometimes the right answer is that it depends on the circumstances. I used Benadryl (diphenhydramine) for sleep but not so much anymore since I came off Prednisone. I'm given Benadryl and acetaminophen before my Actemra infusion but I don't think I need those medications for my infusion. The combination of Benadryl and acetaminophen helps me sleep.
"Despite these multiple anti-inflammatory mechanisms of melatonin, its role is more complex than simply one as an anti-inflammatory mediator. Prior studies have shown that melatonin’s role differs depending on the stage of inflammation. It appears to have a pro-inflammatory role in early inflammation and an anti-inflammatory role in late inflammation"
https://pmc.ncbi.nlm.nih.gov/articles/PMC7979486/
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I agree with the part about cortisol but it depends on the cytokine. Cortisol normally downregulates pro-inflammatory cytokines and upregulates anti-inflammatory cytokines. Cortisol "regulates" inflammation but that is complicated too.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3186928/
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The part immediately following what you quoted about melatonin is of interest for PMR which involves chronic inflammation:
"In the early phase of inflammation, which is necessary for healing to occur in response to an acute insult, melatonin activates proinflammatory mediators including phospholipase A2 and arachidonate 5-lipoxygenase. This activation is a transient phenomenon and extinguishes within 2–3 hours. In the late inflammation phase, which refers to chronic inflammation responsible for many disease processes, melatonin exerts anti-inflammatory effects by downregulating the aforementioned inflammatory mediators and pro-inflammatory cytokines and also by reducing oxidative stress (Radogna et al., 2010)."