ESR Readings
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So when diagnosed with PMR my ESR reading was 70. Two months later and its 23. I understand normal is around 20 or below so that's great. Quite a drop.
Just to understand clearly - is it the Pred that has decreased the inflamation - rather than me just getting better? If I were to reduce the Pred is it possible that the inflamation would increase again. Is it a good indication that I'm on the right level of Pred? I'm on 9mg, I have some niggles and feel the cold, but otherwise have no pain.
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EileenH sastew
Posted
Yes - at present that decrease is due to the pred, it is managing the inflammation which is due to an underlying autoimmune disorder that makes the immune system unable to recognise your body as "self" and it attacks the tissues by mistake. If the inflammation is reduced, the proteins that cause the increase in the sedimentation rate aren't produced. (Basically, ESR or sed rate is measured by putting whole blood into a long thin tube, standing it vertically and seeing how far the level of the top of the red cells falls in a hour, like sand sinking in a bucket of water. Lots of these proteins on the surface of the red blood cells makes them fall faster.)
Once your ESR has stopped falling and your symptoms (if you still have any) are stable, you should be starting to reduce in small steps to find the lowest amount of pred that still manages the daily dose of new inflammatory cytokines without a return of symptoms.
I can't remember if you have said - did you start at 10mg? To get to 9mg in 2 months is very good and it took me months to get to and years (literally) to get below that level. However - I have no doubt your doctor will try to get you to reduce further at some point! If you do reduce, have an ESR done a few weeks later to see if it is still steady. One raised level isn't a reason to raise the dose of pred but if you check it a few times and it is creeping up you should go back to the last dose - that's why it is a good idea to stick at a dose for a few weeks to be sure. ESR can be raised just by a cold - it isn't just PMR. CRP is felt to be a better indicator but it will shoot up with a chest infection too.
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