PMR and diet

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Anyone been counseled on dietary changes to reduce inflammation? If so has it worked have you noticed?

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  • Posted

    Only thing I've been told is to watch carb intake, but think that was mainly for weight control.  I've read that night shade veges should be avoided, but the rheumy has never said a word about it.
    • Posted

      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.

       

    • Posted

      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.

    • Posted

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

    I've had no guidance from my doctor but when I look at my diet it does reasonably match what is supposed to be good to fight inflammation.  As I have PMR I guess it didn't work, although I do seem to be a lot better off than some of the people who post on this forum so, who knows, maybe it has helped?  I'd like to eat more oily fish but the state of the fisheries means that I tend to avoid salmon now.   
    • Posted

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

      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.

    • Posted

      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.

    • Posted

      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.

    • Posted

      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.
  • Posted

    The effect of diet is always present.

    To the extent that a pmr patient takes a much-insufficient dosage of corticosteroid, appetite loss seems to occur, leading to a fasting effect that would tend to diminish one's systemic inflammatory response.

    So exercise (exercise being an accelerated fasting) and dietary restriction together should allow one to have a lower dosage requirement, and the severity of pmr symptoms may self-regulate to some degree when a "flare" that approaches feverish illness causes one to restrict their caloric intake. Unfortunately though, most people will also cut down on their physical activity when symptoms become severe.

    It should be every pmr patient's goal to determine the best-tolerated types of exercise allowed by their real-time condition, and to maximize the duration of such exercise.

    I've taken this apprach to it's limits lately, riding 30+ miles every day in the hills on a bike (2-3 hours), and literally skipping every other day of the 5-6mg of prednisone that I otherwise require.  I'm still holding back on conclusions as I have been at this for just one month and did even over-do it by skipping two days in a row a couple of times (the prednisone, not the riding).  I've had to resume normal daily dosing for this past 8 days, and just today skipped my first daily dosage since then.

    I now avoid restaurant meals since they tend to be fully double the size of what I should be eating. I really noticed the "day after" effect of a typical Mexican-style meal with all the chips and "heavy" ingredients.

    By the way, the effect on systemic inflammatory response to dietary restriction is described in much detail in several of Barry Sears' "Zone" series of books, modern-day classics from the 1990's that have maintained their relevence and credibility.

    As a pmr patient of nearly two years, I am intensely interested in this topic of the effects of diet and exercise. I am learning to enjoy even the morning rides that head out into near-freezing temperatures, and which are also improving my quality of sleep a great deal.

    I will post further updates on my progress in the weeks ahead, and am looking forward to other's postings (here) on what they have learned about therapeutic response from dietary modifications.

    So thanks for asking!

    • Posted

      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.

    • Posted

      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?
    • Posted

      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.

    • Posted

      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. 

    • Posted

      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. 
    • Posted

      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

    • Posted

      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!

    • Posted

      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' !!

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