PMR Diet: Foods to eat and avoid

I believe that magnesium is related more to leg cramps than melatonin.

When I was on a high dose (60 mg) of Prednisone, I would awake with leg cramps and occasionally, my hands would cramp. I started taking a potassium supplement. The cramps eventually stopped, as I tapered down.

Well I just put some books on hold at the library regarding anti inflammatory cooking/diet. Since I’m a vegan (tho a lazy one) I always need to be jerked back to a better reality eating more Whole Foods. I just realized I hardly had any veggies this week!

@johnbishop As a Physician Epidemiologist, I am skeptical of any diet program that requires enrollment and money to participate without providing adequately sized, controlled, clinical trial evidence.

Hello @epidoc, Welcome to Connect. I'm also skeptical of any of the paid diet programs although years prior to my first occurrence of PMR I belonged to Weight Watchers when I was struggling at 300+ lbs. They helped me get to 250 and I kept going up and down from there.

I decided I had to make some lifestyle changes because Weight Watchers wasn't the answer nor was any paid program. After I joined Connect in 2016, I ran across a health blog by one of my Connect hero's Lee Aase which had an entry about "An Unfortunately Named Book - The Obesity Code" by James Fung, M.D. - https://www.social-media-university-global.org/2020/02/an-unfortunately-named-book/. That got me started on eating healthier along with intermittent fasting and I was able to get my weight down to around 210 and maintain it.

Good timing for me because my first occurrence of PMR was in 2007 and I was on prednisone for 3-1/2 years before I was able to taper off. My second round with PMR came in 2016 and I was able to taper off of prednisone in about 1-1/2 years which I credit with eating heathier and more exercise. I'm going on 7 years of remission for my PMR now so hoping it will stay in the background.

Have you made any lifestyle changes to help manage your PMR?

@johnbishop
Hi John,
I have always followed a fairly good diet, 5-6 days a week of exercise, walking several miles a day and maintained a normal weight for my height. I’m not a regular alcohol drinker but have an occasional cocktail. I am celiac, so I eat no gluten.
I started experiencing PMR symptoms in June-July. I thought the pain was due to too many squats and using heavier weights. We were in Maine for 4 weeks were I only walked, hiked and did pottery, but continued to have symptoms. Since my Father had PMR I figured out that this was likely the issue. As a consequence I decided to purposely increase my intake of anti-inflammatory foods…primarily vegetables and fish, decrease sugars (most difficult change), added fresh turmeric, and no alcohol.

It took several weeks to get to see a physician who agreed with my diagnosis and ordered ESR and CRP. I have had two doses of 15 mg prednisone so far.

Of interest was that while my ESR and CRP are elevated they are about half of what I’ve seen for mean levels in several studies. Has me wondering if the diet changes I made had an impact in my ESR and CRO levels. I plan to continue the more anti-inflammatory diet because I would like to taper off prednisone as soon as possible.

@johnbishop
You mention intermittent fasting which I do believe is helpful in losing and maintaining weight loss. My challenge right now on day three of 15 mg prednisone/day is how to prevent weight gain.

I am up at 6 - 6:30 am to take my prednisone. That necessitates eating food with the three 5 mg pills. So there goes my intermittent fasting.

I might try to have my last meal of the day at 3 pm and move prednisone dose to 7 am which gives me 16 hours of fasting.
Any thoughts?

@epidoc
Not sure why I never tried it but there are quite a few discussions on splitting the prednisone dose - https://connect.mayoclinic.org/search/. What helped me with tapering off of prednisone was keeping a daily journal with the prednisone dose and my level of pain when I first got up in the morning. It was suggested by my rheumatologist and we used my tolerable level of pain (2 on scale of 0 to 10). If my pain was 2 or less and it was time to taper to the next lower dose, I would go down to the next dosage. If my pain was more than 2, we would continue the current dose for a few days to see if it got better. If it didn't get better we went back up half of the previous taper to see if the pain went down.

I've found that I usually have my last meal or snack of the day before 3pm also for the same reason - so that I have at least 16 hour fasting window. There's also a great discussion on intermittent fasting you might find helpful.
-- Low-carb healthy fat living. Intermittent fasting. What’s your why?
https://connect.mayoclinic.org/discussion/low-carb-healthy-fat-living-intermittent-fasting-whats-your-why/

@epidoc Not scientifically proven, but seems you are right about really watching what you eat has a very positive effect on PMR and recovery. I was diagnosed early Jan 2026 and started pred on March 20. And yes, pain was gone in 1-2 hours after first 30MG dose. Tapered and last dose Sept 9. Six months only, I know how lucky I am compared to so many that suffer much longer. NO sugar, cut way back on cheese (which in Holland is a 'food group' and very challenging) salt and I never have eaten anything processed, or rarely anyway. I still have significant pain in both biceps and it lasts throughout the day. Guessing remnants of PMR just messed up the muscles. Sooooo physio and anti inflammatory foods for the month of October. Think fruit, winter squash/zucchini soup, bean chili with sweet potato. Salads. Soooo glad to be off prednisone. Hoping my hair will grow back. Cannot even tell you what this has done to my skin, yuck.

@epidoc I have gone to True North Health in Santa Rosa California since the early 1990s. They advocate: vegan SOS (no salt oil sugar) By no chance am I perfect, but if you eat salads, veggies, beans, etc, my weight has flown off. Add a glad twice a week, some cheese and traveling and it comes back on. Very very tough. This is a pretty bad ride we are on.