PMR and diet

Rheumatologists aren't taught this sort of thing. There is a whole body of literature about this subject, all of it confusing and cotradictory. I have been put on a rather severe diet cutting out all wheat and dairy, corn, and nightshade veggies. Also told to avoid sugar, syrup, honey. Of course I am not 100% faithful.

 

Yes, the types of carbs that might "spike" one's insulin level are surely implicated in a stimulated systemic inflamatory response. This is key.

As well, sugars and starches (which immediately become sugars in the stomach) stimulate appetite as they stimulate insulin, leading to a self-energizing condition of sustained elevated insulin.  Such is the recipe for excess inflammation, and if one pays attention they can actually feel it in their muscles and joints within a not-so-long period of time.

Human's intake of simple carbohydrates and high-glycemic meals has drastically increased over the last 20 years, causing much of the "age-related" sort of illnesses like diabetes and inflammatory conditions like heart disease and arthritis.

Carbohydrates eaten together with fats and soluble fiber have a lesser effect on the "glycemic load" that the liver must pass and attempt to regulate through various chemical storage mechanisms. This is because the fat and soluble fiber slow the absorption of sugars into the blodstream, making life much easier on one's regulatory organs and tissues (liver, pancreas, muscle), which together must prevent blood sugar from risng to harmful levels.

Post-meal exercise also has a regulating effect on blood sugar control, lessening the need for as much insulin secretion.

I did mean to type 200 years, but it came up printed as 20 years.

Wow what is the state of fisheries? I am in the eastern U. S.  

I think it may be the toxins found in "Atlantic" salmon (raised in river farms in Alaska btw) that comes from the food they are fed.

Also, wild populations of salmon are said to be threatened by new genetically-modified species that were/are supposed to boost yields of "wild-caught" salmon.

I eat canned wild salmon and sardines every week, every few days at least. Lucky for me, canned fish is inexpensive and I like eating it.

As our ever-so-helpful, resident educator EileenH might remind us, inflammation is not the root cause of PMR, it is merely a symptom (expressed as arteritis) that causes symptoms (such as pain and I suppose GCA).

So we can't quite expect that our eating what we understand to be a good, anti-inflammatory diet will prevent the onset of pmr in every case.

And as good of a diet as we pursue, I think that we all know that our efforts fall well short of perfect, or even of perfect "regulation" of known insulin-stimulating and liver-challenging "pro-inflammatory" foods and drink.

I would really love to know where PMR comes from. Is it a virus? a buildup of toxins from not eating the "right" diet? Genetic?  Why do some people get it and not others?

Dan keep me up to date on your cycling and skipping pred every other day. I used to ride 35-50 miles but not daily. And not in cold weather. Now I'm happy if I can get on the bike.

I don't think there is a viable wild Atlantic salmon industry any more.  The cod fishery collapsed decades ago (taking many fishing communities in Newfoundland with it).  Giant trawlers from several nations are wrecking the habitat of the ocean floor.  Climate change and warming water are changing the entire ecology of the North Atlantic.  Exploration for new sources of oil and natural gas continues apace.  Very bad scene. I only eat closed containment (land based) sustainably raised fish, or what little we can get (never oily fish) from a small hook and line business.

in the early days of pmr the fatigue was overwhelming, much pacing required, small doses and rest, too much activity one day nothing the next.

More recently, pred down to 4.5mg, less fatigue, I've been able to exercise more. Helped by coronary rehab.

I suspect there's a vast difference in nature and effect of exercise/activity. Carrying groceries from the car, hacksawing through a piece of steel, polishing, etc. which require a bit of strength or are very repetitive or stress the muscles most effected by pmr can be painful.

Stationary cycle and other gym equipment with relatively moderate exercise seem to have no bad effect on the pmr and all the good effects of exercise. The exercises seem to exercise muscles not obviously effected by pmr. Hard enough to get heart rate and breathing well up. Its getting easier as I become fitter.

On the diet front there seems to be a good corelation between what's good for the heart is also good for less inflammation (why am I not surprised!). Whether it changes the pmr symptoms I don't know. My pmr was stable before the coronary thing. My diet changed about 6 months ago.

Mainly through smaller portions, but also big reduction in carbs, I've been losing weight at 200g/week for the last 6 months, which adds up to more than 5kg. Feeling "normal" again.

Perhaps a sense of generally the things one would do for "healthy living" regardless of pmr.

Dan, I agree with your approach to handling PMR.  I run regularly and try to eat healthy(fruits, salads, seeds, nuts and beans.  Do eat some chicken and fish and less meat.  Energy level is good and no pain.  Only problem with me is my sleep and frequent need to urinate.  I'm up usually up for the day between 4-5 am, but am not tired at all.  My energy level is great.  Starting to go to bed earlier(around 10pm).  Also stopped drinking after dinner.  Some improvement in night-time getting up to urinate.  Any other suggestsions?

Thanks for reminding me of those healthy habits like not drinking late, which results in my eating too much before bedtime.

There seems to be a lot of interaction between what the gut has to digest and how often that one has to get up during the night to urinate.

There is some competition for space needed by the bowel and the bladder, so bulky or gassy foods make a half-full bladder feel quite full, and can further make urination diffcult to initiate and at reduced flow as the urethra itself can be restricted by even a slightly-bloated gut.

I strongly suspect that many men are treated for what are mistaken for prostate symptoms when digestive stress is the real culprit in terms of their frequent need to urinate and their difficulty in initiating urination.

You should cut out drinking liquids Earlier if possible. Some folk suffer from Type 2 diabeties. Frequent urination maybe be a symptom of this disease.

Please get further advice before following my suggestions. 

Clive - can I just point out to you that most of your recent replies I have read have been to very old threads. This says over a year ago - it could be 2 or even 3 years old. 

Hi Dan

i seethis post was over a year ago - but I wonder how this regime worked out for you re exercise diet and drugs.

Thanks

I'm still around, this year being much better, and at a lower (now just 1.75mg) pred dose than last year.

I've had pmr for 38 months now.

I'm also sleeping much better since my digestion is working more normally, which I attribute to dietary restraint in terms of the quantity that I eat of any food at one time, and of eating less in the hours before bedtime.

The last 12 months I have been taking a daily evening jog, in addition to morning bike rides most days. The frequent jogging helped with my hip joint pain, though at my low pred dose I sometimes suffer a short episode of bursitis in my left hip, but which is usually gone by the next day.

I also tug on an exercise bar and do a few sets of pull-ups daily at a low enough repetitions count to need only 24 hours of recovery.

Thanks for asking!

That sounds great Dan - I think the eating less generally and especially before sleeping a good idea - it has improved things for me in just a couple of weeks. I am at the 'beginning' of this process (however long that turns out to be) and it helps to know what others have done and how successful they have been. I do realise however that our experiences are all 'unique' in multifarious ways. Keep up the 'good work' !!