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Cause of PMR
https://med.stanford.edu/news/all-news/2024/02/women-autoimmune.html
This article isn't light reading but goes into why women are more likely to have autoimmune diseases than men. Bottom line - it's thanks to our 2 X chromosomes. If you skip down to the bottom of the article, they say the discovery could lead to better screening for autoimmune disorders that are associated with the Xist gene that they explain in the article.
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@caroljeand
I think flares of PMR are "stress related" too. It can't be a coincidence that prednisone replaces cortisol which is the hormone the adrenals produce naturally that "regulates inflammation." Maybe it is only a coincidence that cortisol happens to be called the "stress hormone."
https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037
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People often say that stress is what triggers their PMR flares. PMR is certainly a form of chronic stress and stress causes inflammation.
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1 Reaction@dadcue
Totally agree about stress/cortisol causes. I had seen an endocrinologist in 2021 (4years before PMR diagnosis). I suspected I could have high cortisol. He determined I was borderline low. Wondering now if that was an indication of my being a candidate for PMR, with also having a genetic link through my mother.
Seeing this doctor again next week for his input for my blood sugar issues and prednisone tapering.
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1 ReactionFor Me it was statins. I had been taking a low dose of Crestor ( 5 mg 3x week) for years with relatively no problems. A Cardiologist increased my dosage to 10mg/ day and within two weeks I couldn’t move or walk. I told her I would rather die of a heart attack than continue life in this pain. I stopped all statins and had no relief. I kept thinking that as the statin half life dissipated I would get comfortable. My PCP said I think you have PMR. I’m going to give you 15 mg of prednisone daily and you should feel better within 3 days.
He was right, and now I have tapered down to 1.5 mg / day along with carefully adding back the statin only 3/ week. It’s been 9 months since the diagnosis. Hopefully I can wean off the prednisone entirely in the next 2-3 months?
@jfannarbor Great information, thanks! This especially caught my eye:
"Several lines of evidence suggest that environmental factors can trigger PMR in predisposed individuals, including seasonal clustering of new cases and associations with infections.”
PMR hit me a few weeks after Covid. I was sure, and still believe, that Covid triggered it.
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2 ReactionsMy PMR symptoms began this past June, 3&1/2 months into a very stressful time for me. The most stressful I can remember in decades. I have this unconfirmed idea that some of us with a genetic predisposition for autoimmune/ rheumatic diseases may have PMR "laying low" in our bodies and the stress gives it what it needs to present itself. Now medical information to reference, just my idea!
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3 Reactions@jfannarbor the problem with AI summarizing this type of medical issue is that it pulls together all the information which is available, and some that will be old less accurate than we'd like. For example, it is known that in a significant percentage of sufferers CRP and ESR may not be elevated. Also that more people under 50 have PMR, and that flu vaccine as trigger is well supported in the medical research. This whole area is likely one where underlying causes and triggers are two different factors in the development of the illness. There seem to be many triggers all of which may be related to overloading the immune system.
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1 ReactionI@Inelsbeth
In Dec. 2024 I received Covid and Flu shots at the same time at the recommendation of the pharmacist. 2 weeks later I was diagnosed in the emergency room with PMR.
@kayept, I agree with you.
PMR and GCA afflict Europeans, especially Northern Europeans, and Caucasians at a higher rate than people of other races. I read that Minnesota has the highest incidence of PMR/GCA in the US.
GCA was identified as far back as the 10th Century by a physician in Baghdad who observed swollen arteries concurrent with vision loss.
My maternal aunt had both PMR/GCA, and I got both about 5 years ago. Both of us experienced the onset of symptoms after physical injuries. My aunt hurt her back moving furniture and I hurt my ankle walking backwards. Ironically, my mother-in-law came down with it after a family reunion that involved a road trip from Ontario to Florida, probably very stressful for her. She was in her 80s at the time and had a tough time getting it diagnosed. A doctor she was referred to and some family members thought she was malingering.
I think there's a trigger which causes the immune system of a person predisposed to go into overdrive. I often think PMR/GCA was waiting in the wings to get me.