Lab testing

Another test besides the C-Reactive Protein (CRP) that has been important for me is the Sedimentation Rate. The Sed rate is separate from the CRP.

Here's a definition from the Mayo Clinic:

Sed rate, or erythrocyte sedimentation rate (ESR), is a blood test that can reveal inflammatory activity in your body. A sed rate test isn't a stand-alone diagnostic tool, but it may help your doctor diagnose or monitor the progress of an inflammatory disease.

When your blood is placed in a tall, thin tube, red blood cells (erythrocytes) gradually settle to the bottom. Inflammation can cause the cells to clump together. Because these clumps of cells are denser than individual cells, they settle to the bottom more quickly.

The sed rate test measures the distance red blood cells fall in a test tube in one hour. The farther the red blood cells have descended, the greater the inflammatory response of your immune system.

If you read my post you will see I mentioned the ESR as the first test - though not all labs do it nowadays, having substituted plasma viscosity, and some doctors do not consider ESR to be particularly meaningful as it is affected by many things - not least the fact it must be set up within 4 hours of taking the blood sample. That does not apply to plasma viscocity. CRP has been felt by experts to be more meaningful in the context of PMR and GCA. Whether it is or not is another matter! ESR will rise in response to many infections and states - not just the inflammation of PMR. CRP can rise 4-fold in response to a chest infection - something doctors should bear in mind when a CRP value returns elevated. No change in medication should be made in response to a single elevated value of anything - the test should be repeated a week later unless there are compelling reasons on the basis of symptoms. Whatever the blood tests suggest - they play only a supporting role: the symptoms are ALWAYS king.

The blood tests I suggested were on the basis of the British Society of Rheumatologists recommendations for the management of PMR/GCA. If it were me I would want some other tests checked at least once a year but I'm just a patient who worked in a lab!

Really about every 3 months or so - cholesterol will wait, once or twice a year would be fine there. A single fasting blood glucose doesn't tell anyone anything significant - an Hba1c is better. That is an indication of your average blood glucose level over the last 3 months.