PMR Flair up From a Virus?

Hi, Christopherc, Okay, so this is how I understand it. A healthy person has working adrenal glands, which produce cortisol and send it out to your body as needed. So, when you become emotional, or active, or sick, the adrenals recognize this and they send out more cortisol to get you through your current "crisis". But when we take prednisone, your adrenal glands basically shut down and don't produce cortisol, because they sense that the prednisone is doing their job for them. The difference is, WE are controlling the amount of prednisone your body is getting and it's a stable amount every day. There is no producing more or less based on your changing needs each day. So if you get sick, or are more active than usual on a given day, or having something else that is stressing you out, the prednisone might not be enough to take care of those "special" occasions like your adrenal glands normally would. So this is why, it's a good idea when you're sick to up your dose of prednisone. (Of course, you would need to discuss this with your doctor.) Further it's also a good reason why you should pace yourself - not doing too much physical activity that is unusual for you two days in a row, and if your are fatigued, you need to allow yourself to rest. Recently I had covid, so I upped my prednisone by 5 mg/day (with my doctor's blessing) for 6 days. Then went right back down to my normal dose within 2 steps. No problem. I hope this answers your question. Just a little bonus aside - they also gave me Paxlovid and I rebounded on it. Covid for over 2 weeks. But again. All went well.

I find everyone’s experience, so interesting and different from one another. My naturopath recommended Cortrex, which is an adrenal support complex. Thorn is the company that makes it. I believe this has helped my tapering off prednisone considerably. My PMR started in June 2022 and I started on prednisone in July going up to a maximum of 8 mg. I just tapered off as of the end of December 2022. The jury is still out but so far I’m feeling pretty good. Prednisone really messed with my bone density… down by 8% in some areas. If the PMR returns, I may consider naltrexone …my doctor suggested that. Does anyone have any experience with that?

Hi, Christopherc, Okay, so this is how I understand it. A healthy person has working adrenal glands, which produce cortisol and send it out to your body as needed. So, when you become emotional, or active, or sick, the adrenals recognize this and they send out more cortisol to get you through your current "crisis". But when we take prednisone, your adrenal glands basically shut down and don't produce cortisol, because they sense that the prednisone is doing their job for them. The difference is, WE are controlling the amount of prednisone your body is getting and it's a stable amount every day. There is no producing more or less based on your changing needs each day. So if you get sick, or are more active than usual on a given day, or having something else that is stressing you out, the prednisone might not be enough to take care of those "special" occasions like your adrenal glands normally would. So this is why, it's a good idea when you're sick to up your dose of prednisone. (Of course, you would need to discuss this with your doctor.) Further it's also a good reason why you should pace yourself - not doing too much physical activity that is unusual for you two days in a row, and if your are fatigued, you need to allow yourself to rest. Recently I had covid, so I upped my prednisone by 5 mg/day (with my doctor's blessing) for 6 days. Then went right back down to my normal dose within 2 steps. No problem. I hope this answers your question. Just a little bonus aside - they also gave me Paxlovid and I rebounded on it. Covid for over 2 weeks. But again. All went well.

Thanks for your helpful and clear explanation. I find both Covid and polymyalgia rheumatica are still not fully understood and your information helped me to put my current experience into context. I tested positive for Covid three days ago and started anti-viral medication. My Covid symptoms are light, but the PMR flareup is quite painful so I am also upping my cortisone as I've been instructed to do by my doctor when I have flareups.

I had been off of Prednisone for about 2 months when I contracted COVID. It flared up a bit after having COVID, so I'm back on 2.5 mg now and think I can taper off .5 mg every 2 weeks. BTW, my first occurence of PMR was within a week after my 2nd Pfizer vaccination. It has always been relatively mild--no inflammation markers and only hurt at night while in bed.

I totally believe the PMR was induced by Covid vaccines because of the time frame. May 2021 first Pfizer and then neck and shoulder pain started all summer - went through so many pillows only to find out it was not the pillows. Whet for Chiro, Massage and Physio (useless). Then August 4, 2021 second Pfizer, 10 days later full blown PMR (although I didn't know until Jan. 2022). CRP had gone up to 42 and now-retired GP got me an emergency referral to a Neurologist here in Halifax, who diagnosed the PMR after 5 long months of excrutiating pain. It is not genetic. You've done well with your tapering btw. I'm now up to 60 mg and being checked out for GCA. CRP jumped from 3 to 24 last week with head pressure, jaw pain (not claudication), some eye involvement. 🙁

I totally believe the PMR was induced by Covid vaccines because of the time frame. May 2021 first Pfizer and then neck and shoulder pain started all summer - went through so many pillows only to find out it was not the pillows. Whet for Chiro, Massage and Physio (useless). Then August 4, 2021 second Pfizer, 10 days later full blown PMR (although I didn't know until Jan. 2022). CRP had gone up to 42 and now-retired GP got me an emergency referral to a Neurologist here in Halifax, who diagnosed the PMR after 5 long months of excrutiating pain. It is not genetic. You've done well with your tapering btw. I'm now up to 60 mg and being checked out for GCA. CRP jumped from 3 to 24 last week with head pressure, jaw pain (not claudication), some eye involvement. 🙁