Tapering down and inflammation markers up

Posted by issyb @issyb, Aug 1, 2023

Diagnosed Feb with PMR/ GCA. Slowly tapered and now I am down to 10 mg from 40 mg with no flare ups 🙏🙏
Had SED rate test today 28 ( highest should be 20)
CRP 1.2. Highest should be 0.9
Bummer!!😩😩
I have no symptoms. I don’t feel great but mostly because prednisone side effects are miserable!
Hope she does not up dosage. Have appointment with rheumatologist Friday
Any thoughts from anyone.
Love hearing from my Mayo family ❤️🙏

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@issyb, As long as you are not having any PMR like pain, I think I would leave the dosage where it's at until you can discuss with your rheumatologist Friday.

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Yes will do ! I hope she does not raise dosage Friday . But will do what she recommends!
Thanks for your response 😊

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Agree with @johnbishop as usual 🙂

If you're not feeling an increase in PMR-specific symptoms, it's probably fine to stay on the same dose, and if you feel strongly about it, you could probably advocate to stay on the same dose and re-assess in a few weeks.

There are other reasons the inflammatory markers might go up, like if you're fighting off an infection. This has happened to my father twice, once when he had COVID and another time when it was less clear if he had a PMR flare or a virus, but he had diarrhea so we concluded mild viral infection and things leveled out in a few weeks.

Even so, his rheumatologist said his symptoms are the best guide, that some people may naturally have slightly elevated markers. But glad you'll see what your rheumatologist says, and hang in there!

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Thank you so much for your response. You have no idea how meaningful and helpful this is to me. You gave me great insight as well. Thank you again !
I’ll write back after my appointment Friday . 🙏❤️

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Ask your rheumatologist to add one of the biologics, Actemra or the latest one. I have had GSA-Polym since 2020 started Actemra 03/21,stopped Prednizone 10/21, markers have been at SED 2mm,C-reactive protein0.4 for 12 months Now reducing actemra to every 21 days.

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Those markers are great results! Good for you!

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Hello everyone! As a follow up to my above message. I had my meeting today with the doctor.
She feels the markers are slightly up because my body is adjusting to the withdrawal of the prednisone . She feels this way, because I have no symptoms of either condition PMR/GCA and I am in no pain.
she wants me to stay on 10 mg for 6 weeks and is hopeful that my body will adjust to the withdrawal of the prednisone and then I will take a blood test in six weeks. And that will be the determination of what to do next .
Anyone’s thoughts on this theory?

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@issyb

Hello everyone! As a follow up to my above message. I had my meeting today with the doctor.
She feels the markers are slightly up because my body is adjusting to the withdrawal of the prednisone . She feels this way, because I have no symptoms of either condition PMR/GCA and I am in no pain.
she wants me to stay on 10 mg for 6 weeks and is hopeful that my body will adjust to the withdrawal of the prednisone and then I will take a blood test in six weeks. And that will be the determination of what to do next .
Anyone’s thoughts on this theory?

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That’s great. I feel like that makes sense. And if you notice a drastic or prolonged worsening change in symptoms, you can always contact your doctor and/or adjust the dosage.

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