Holistic medicine approach to PMR

Posted by pargeo47 @pargeo47, Jun 15 3:47pm

I'm new to PMR, about 5 months, and am presently on Dr. prescribed tapering by 1 mg every 2 weeks that started at 17 mg and I am down to 12 mg, with satisfactory relief. Today, my adult daughter posed an interesting question, "Many anto-immune issues are caused by environmental or dietary factors. Have you been to a nutritionist or holistic doc to see if your PMR was caused by something external or dietary?" My question is has anyone sought help from a nutritionist or holistic physician with any degree of success?

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

@janiceem

I am a registered dietitian and Gundry is a quack in the nutrition science world. He is just trying to sell something. Look at the Blue Zones in the world where people often live to 100 with very little chronic disease. They all have beans in common in their diets. If I were you, I would follow http://www.nutritionfacts.org . NUTRITIONFACTS.ORG is a science-based nonprofit organization founded by Michael Greger, M.D. FACLM, that provides free updates on the latest in nutrition research via bite-sized videos, blogs, podcasts, and infographics.

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Your comments about beans is interesting because I believe it was Gundry's research and living in a "Blue Zone" that got him interested in diet. Perhaps, he is onto something but hasn't got it quite right yet.

I think there is more to the "lectin" bit. e.g. a lot of our food that our ancestors ate has been altered either by GMOs or the way they are farmed. I have to agree with the theory that our parent's diets were better than ours. They had less preservatives. They ate more saurkraut, etc.

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@elizadolittle

Interesting conversation! I've been on 5mg of prednisone every other day for years. I'm fascinated by Dr. Gundry's thesis about "lectins." They're found in potatoes, tomatoes, peppers to name a few vegetables. My only question is, how did my ancestors survive on these? Well, I remember peeling potatoes every day for dinner. Perhaps, that's why there didn't seem to be a problem. I do like his suggestion to skip the grapes (too much sugar) and drink red wine! I like his suggestion only eat beef if it is grass fed and eat eggs from chickens that have a chance to run around in the backyard, like the "good old days.

What works for one person doesn't work for another. Frustrating. Be grateful, we have doctors and the free will to make our own decisions. Have a great day!

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As a child, we had potatoes at every dinner. My mom always peeled our potatoes, but as an educated adult and dietitian, I never peel my potatoes because of the additional benefits of the fiber for your microbiome and the additional nutrients that are lost when you peel them. But, I don't eat russet potatoes, but rather fingerling or the small red potatoes because you get a lot more nutrients with more peeling (same goes for smaller blueberries versus large ones). Also, eating the peeling slows the digestion and absorption, thus decreasing its glycemic index. I should also note that I only eat organic potatoes due to the fungicide used in conventionally grown potatoes. BTW, I eat potatoes at least 4 to 5 times a week. I realize that some state they are sensitive to them, so I won't argue that point.

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@janiceem

As a child, we had potatoes at every dinner. My mom always peeled our potatoes, but as an educated adult and dietitian, I never peel my potatoes because of the additional benefits of the fiber for your microbiome and the additional nutrients that are lost when you peel them. But, I don't eat russet potatoes, but rather fingerling or the small red potatoes because you get a lot more nutrients with more peeling (same goes for smaller blueberries versus large ones). Also, eating the peeling slows the digestion and absorption, thus decreasing its glycemic index. I should also note that I only eat organic potatoes due to the fungicide used in conventionally grown potatoes. BTW, I eat potatoes at least 4 to 5 times a week. I realize that some state they are sensitive to them, so I won't argue that point.

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I wonder if the it's the fugicides that's the problem and not the potatoes? I eat a lot of blueberries as well.

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I was diagnosed exactly 6 months ago. 20mg of prednisone and then 8mg of Medrol were not effective so I was bumped up to 48 mg of Medrol, tapering by 8 mg every 2 days until I got down to 16 mg. After 2 months, I was down to 12 mg and doing okay in terms of pain but very concerned about long term steroid use. My rheumy told me to plan on steroids for a minimum of 1-1.5 years and possibly as much as 3-4 years! I was not going to do that without a fight.

I started seeing a functional medicine doctor in February while at 12 mg. He ran a multitude of tests to determine my gut health, toxic exposure, oxidative stress, mineral levels, vitamin levels, hormones, thyroid, etc. My results showed lots of deficiencies and I've since been taking a multitude of supplements. I've cut out added sugar, cut back on carbs about 90%, on an anti-inflammatory diet and eating more organic than before. I'm also intermittent fasting. My tests showed a need for probiotics, digestive enzymes, Omega 3s, vitamins D3, K2, B's, Glutathione and Alpha lipoic acid and few others. I also started HRT. At my 3 month checkup nd repeat labs with the functional medicine doctor, I had dropped all the steroid weight (12 lbs), had tapered from 12 mg to 3.5 mg Medrol (not without some crazy challenging weeks, dosing up and tapering again). My labs are better in almost all respects. This is day 32 at 3.5 mg and I've been extremely fatigued, lightheaded and weak since around Day 21. Barely able to function. I'm so frustrated because I felt good on 3.5 initially, had a couple of rough days. It's taken me a while to wrap my head around the fact that it's probably the reduced steroids since I have no PMR symptoms - no pain, no stiffness. I hate to, but I guess I'll bump up and see. Time will tell.

I'm doing okay dealing with this beast called PMR at the 6-month mark. BUT I'm not without struggles. How many are due to the steroids vs tapering the steroids vs the disease is so confounding. Currently (it changes week to week, sometimes day to day), my biggest issues are extreme fatigue, skin so thin that I bump into something and bleed, and my hair is falling out like crazy as of about a month ago. I'm overwhelmed by the cost and ritual of taking so many pills, powders, creams and drops. Charting everything to try to determine cause/effect is getting old too. I feel without my functional medicine doctor, I'd be struggling more so I'll keep on doing what I'm doing for now. I truly am grateful that I've come this far but it's still hard to comprehend that this happened in the first place.

Best to all on your journey.

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@sandysomers

I was diagnosed exactly 6 months ago. 20mg of prednisone and then 8mg of Medrol were not effective so I was bumped up to 48 mg of Medrol, tapering by 8 mg every 2 days until I got down to 16 mg. After 2 months, I was down to 12 mg and doing okay in terms of pain but very concerned about long term steroid use. My rheumy told me to plan on steroids for a minimum of 1-1.5 years and possibly as much as 3-4 years! I was not going to do that without a fight.

I started seeing a functional medicine doctor in February while at 12 mg. He ran a multitude of tests to determine my gut health, toxic exposure, oxidative stress, mineral levels, vitamin levels, hormones, thyroid, etc. My results showed lots of deficiencies and I've since been taking a multitude of supplements. I've cut out added sugar, cut back on carbs about 90%, on an anti-inflammatory diet and eating more organic than before. I'm also intermittent fasting. My tests showed a need for probiotics, digestive enzymes, Omega 3s, vitamins D3, K2, B's, Glutathione and Alpha lipoic acid and few others. I also started HRT. At my 3 month checkup nd repeat labs with the functional medicine doctor, I had dropped all the steroid weight (12 lbs), had tapered from 12 mg to 3.5 mg Medrol (not without some crazy challenging weeks, dosing up and tapering again). My labs are better in almost all respects. This is day 32 at 3.5 mg and I've been extremely fatigued, lightheaded and weak since around Day 21. Barely able to function. I'm so frustrated because I felt good on 3.5 initially, had a couple of rough days. It's taken me a while to wrap my head around the fact that it's probably the reduced steroids since I have no PMR symptoms - no pain, no stiffness. I hate to, but I guess I'll bump up and see. Time will tell.

I'm doing okay dealing with this beast called PMR at the 6-month mark. BUT I'm not without struggles. How many are due to the steroids vs tapering the steroids vs the disease is so confounding. Currently (it changes week to week, sometimes day to day), my biggest issues are extreme fatigue, skin so thin that I bump into something and bleed, and my hair is falling out like crazy as of about a month ago. I'm overwhelmed by the cost and ritual of taking so many pills, powders, creams and drops. Charting everything to try to determine cause/effect is getting old too. I feel without my functional medicine doctor, I'd be struggling more so I'll keep on doing what I'm doing for now. I truly am grateful that I've come this far but it's still hard to comprehend that this happened in the first place.

Best to all on your journey.

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Sandy...thank you for relating your experience. I, like others (no doubt), can identify with your frustration with this affliction and the associated "fallout". "Functional doctors" and supplements are not covered by conventional health insurance/medicare, thus, representing no small personal, financial outlay, either. "When the pain is high, one will spare no expense to make it go away!" I'm down to 11 mg from 17mg of prednisone and am still experiencing little to no typical PMR pain in my shoulders or pelvic girdle. Further, though I'm hungry all the time, I've managed to avoid putting on more than a couple of extra pounds since starting the prednisone dosages in March.

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Thank you, you're so right about sparing no expense to make it go away. I wish you the best on your journey.

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@sandysomers

I was diagnosed exactly 6 months ago. 20mg of prednisone and then 8mg of Medrol were not effective so I was bumped up to 48 mg of Medrol, tapering by 8 mg every 2 days until I got down to 16 mg. After 2 months, I was down to 12 mg and doing okay in terms of pain but very concerned about long term steroid use. My rheumy told me to plan on steroids for a minimum of 1-1.5 years and possibly as much as 3-4 years! I was not going to do that without a fight.

I started seeing a functional medicine doctor in February while at 12 mg. He ran a multitude of tests to determine my gut health, toxic exposure, oxidative stress, mineral levels, vitamin levels, hormones, thyroid, etc. My results showed lots of deficiencies and I've since been taking a multitude of supplements. I've cut out added sugar, cut back on carbs about 90%, on an anti-inflammatory diet and eating more organic than before. I'm also intermittent fasting. My tests showed a need for probiotics, digestive enzymes, Omega 3s, vitamins D3, K2, B's, Glutathione and Alpha lipoic acid and few others. I also started HRT. At my 3 month checkup nd repeat labs with the functional medicine doctor, I had dropped all the steroid weight (12 lbs), had tapered from 12 mg to 3.5 mg Medrol (not without some crazy challenging weeks, dosing up and tapering again). My labs are better in almost all respects. This is day 32 at 3.5 mg and I've been extremely fatigued, lightheaded and weak since around Day 21. Barely able to function. I'm so frustrated because I felt good on 3.5 initially, had a couple of rough days. It's taken me a while to wrap my head around the fact that it's probably the reduced steroids since I have no PMR symptoms - no pain, no stiffness. I hate to, but I guess I'll bump up and see. Time will tell.

I'm doing okay dealing with this beast called PMR at the 6-month mark. BUT I'm not without struggles. How many are due to the steroids vs tapering the steroids vs the disease is so confounding. Currently (it changes week to week, sometimes day to day), my biggest issues are extreme fatigue, skin so thin that I bump into something and bleed, and my hair is falling out like crazy as of about a month ago. I'm overwhelmed by the cost and ritual of taking so many pills, powders, creams and drops. Charting everything to try to determine cause/effect is getting old too. I feel without my functional medicine doctor, I'd be struggling more so I'll keep on doing what I'm doing for now. I truly am grateful that I've come this far but it's still hard to comprehend that this happened in the first place.

Best to all on your journey.

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@sandysomers your loss of hair, extreme fatigue and skin thinning are symptoms that lead me to believe you may have hypothyroidism. Remember when you are fighting PMR symptoms of new problems are often comingled with PMR symptoms and so the new problem goes unidentified for an extended amount of time. You might ask your PCP or if you have an Endocrinologist you can see them and ask to have thyroid problems eliminated as the cause for your symptoms. There are several thyroid tests that tell the tale of thyroid health.
Steroids can play with your thyroid balance and production and contribute to symptoms of thyroid problems. In some cases steroids can cause thyroid problems. It certainly did with my journey on steroids and I was on only 10mg per day.
I have had hypothyroidism for decades. PMR has played havoc with my thyroid numbers. I have seen my Endo every 90 days for 5 years now due to my PMR. During my steroid treatment my thyroid numbers went off the rails again. Adjusting thyroid meds it a delicate balance and takes months to know the success or failure of a single minor adjustment.

Here is a Mayo Clinic article on hypothyroidism -
https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284

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@janiceem

As a child, we had potatoes at every dinner. My mom always peeled our potatoes, but as an educated adult and dietitian, I never peel my potatoes because of the additional benefits of the fiber for your microbiome and the additional nutrients that are lost when you peel them. But, I don't eat russet potatoes, but rather fingerling or the small red potatoes because you get a lot more nutrients with more peeling (same goes for smaller blueberries versus large ones). Also, eating the peeling slows the digestion and absorption, thus decreasing its glycemic index. I should also note that I only eat organic potatoes due to the fungicide used in conventionally grown potatoes. BTW, I eat potatoes at least 4 to 5 times a week. I realize that some state they are sensitive to them, so I won't argue that point.

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No potatoes for me. They trigger a terrible flare.

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Hello,
PMR is still not well understood however it is felt to possibly be autoimmune and viral driven. This was the case with myself after contracting covid. My Rheumatologist concurred (I combed many articles supporting viral etiology).
Diet and lifestyle are more or less a way of managing PMR. There are certain foods to avoid all together such as red meat. I found Yoga helpful and strength/weight bearing exercises. You may find Ayurvedic Medicine helpful. Mindful meditation/prayer. This will vary for each individual as to how they respond to steroid management. Never good in the long term due to side effects of prednisone, especially bone thinning.
Supplements can be helpful but not a cure. The lovely thing is having the ability to do our own research and connect with what does and does not work.
I wish you well!

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@jabrown0407

@sandysomers your loss of hair, extreme fatigue and skin thinning are symptoms that lead me to believe you may have hypothyroidism. Remember when you are fighting PMR symptoms of new problems are often comingled with PMR symptoms and so the new problem goes unidentified for an extended amount of time. You might ask your PCP or if you have an Endocrinologist you can see them and ask to have thyroid problems eliminated as the cause for your symptoms. There are several thyroid tests that tell the tale of thyroid health.
Steroids can play with your thyroid balance and production and contribute to symptoms of thyroid problems. In some cases steroids can cause thyroid problems. It certainly did with my journey on steroids and I was on only 10mg per day.
I have had hypothyroidism for decades. PMR has played havoc with my thyroid numbers. I have seen my Endo every 90 days for 5 years now due to my PMR. During my steroid treatment my thyroid numbers went off the rails again. Adjusting thyroid meds it a delicate balance and takes months to know the success or failure of a single minor adjustment.

Here is a Mayo Clinic article on hypothyroidism -
https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284

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Thank you for your reply. I suspected I had hypothyroidism about a year before PMR onset. My thyroid tests showed hyperthyroidism and my endocrinologist wanted to put me on meds. I was borderline and said no thanks. I've been tested twice since PMR and I'm still "hyper" not "hypo" which always surprises me. Imagine the fatigue and hair loss I'd have if I was "hypo"! I'm sorry you've been dealing with that on top of PMR. Hope you are in a good place managing your PMR and thyroid issues.

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