Vitamin D level - ESR - CRP what's the norm?
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Hi, just got diagnosed PMR 12th November past (undiagnosed for 6 months).
I was put on 20mg pred. Was sent to Endocrinology 8th January where they have referred me to Rheumatology (no appointment yet). Endo consultant told me to drom to 15mg. I was seeing my gp the next day so confirmed with her that I was reducing to 17.5 which I am still on.
Got blood results from Monday ESR 20 CRP 6.6 Vit D 72. Receptionist rang me give me results and said ESR was still high and CRP is still high and Vit D is still low. I thought ESR was ok for my age (just turned 60) I also though ESR was good under 10 but was told it should be under 5. Dr. said keep taking calcium. Thanks in advance for any replies.
2 likes, 32 replies
tina-uk_cwall pat38625
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pat38625 tina-uk_cwall
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MrsO-UK_Surrey pat38625
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So your ESR and CRP results are really not bad. You're quite right in believing that ESR in fact, can be slightly more elevated as we age. If your results have improved since commencement of steroids, then reducing to 15mg should still allow those results a chance to improve further.
Normal Vit D is considered anywhere between 75 and 150/200, depending on which health authority you come under. You are just slightly low - perhaps your GP will consider giving you a 3 month course of high dose Vit D3 to improve it. But a reading of 72 is really not bad considering we are in the middle of winter and not able to get a boost from the sun.
pat38625 MrsO-UK_Surrey
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LisaCACO pat38625
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your CRP is rather high- here in the US most wouldn't have you wouldn't reduce unless it were lower than that (under 5). my question would be whether you're still having symptoms of PMR. Not sure why everyone is in such a hurry to have us taper down, esp since it can be so painful for us and frankly quite risky. I get the risks of staying on the steroids, but there are risks tapering too quickly as well. I'm curious to read what the long term members here have to say. good luck!
pat38625 LisaCACO
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I have a few aches and pains in my large muscles, thighs and upper arms but can manage. Thanks again
tina-uk_cwall LisaCACO
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This is my take on it. I don't want PMR, I don't want to be on long term medication, but I've got it so there it is. Prior to my diagnosis I was so incapacitated and in so much pain that I really believed that I was dying and even as a practicing Cristian there were days when I was so afraid for my future that I thought that death was preferable to the life I had lived for the past 3 months. When I was diagnosed and I took my first dose of prednisone and within 4 hours I was walking unaided up and down stairs, Turing my head left to right, which I had not been able to do for 2 or so months, most of the pain had vanished and I cried and thanked God for being alive. If prednisone hadn't been invented many of us I do believe would not be here today. Simply because, the inflammation that we suffer from that causes the pain must in its own way cause an enormous amount of internal damage, artery damage etc. GCA suffers would not just be blind but I'm sure would have suffered additional damage to the veins and arteries around the head area. So what is our alternative? Prednisolone. Yes it comes with new and unwanted side effects but many of the new and unwanted side effects can be regulated by other medication, what more medication? Well yes, but we must remember these conditions Whether it be PMR or GCA Are a. Pain in the neck, literally, it is not terminal and most of us will get better when the conditions burn themselves out and for the unfortunate sufferers whereby the conditions never burn themselves out they normally remain on a very very low maintenance dosage of prednisone for ever so the side effect risk is very minimal for them. I have suffered a flare when attempting to reduce from 9 to 8 and had to revert back to 10. I've now started my first reduction since that flare and I'm tappering so slowly, doing each taper in .5 reductions and staying on each dose, unless there's a reason to remain on the dose longer for a good 5 to 6 weeks. So yes I agree what's with the rush to taper us down quickly? There endth the lesson all the best, christina
pat38625 tina-uk_cwall
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tina-uk_cwall pat38625
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pat38625 tina-uk_cwall
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ptolemy LisaCACO
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pat38625 ptolemy
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ptolemy pat38625
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I think you are very sensible going to 17.5 first. My rheumatologist told me to reduce from 20 to 15 and it was a total disaster. The result being that I have taken much longer than I should have done in reducing and gone through a lot of unnecessary pain. The trouble was I was very naive in listening to doctors, I thought they knew what they were doing!
Sheilamac_Fife tina-uk_cwall
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LisaCACO ptolemy
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3014829/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4277693/
twigjean LisaCACO
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The normals for CRP are different in the USA. CRP normals our methodology dependent. So if you're wondering what your normal is look up CRP or ESR on Google. Remember to put which countries normals you are looking for, hope this helps. Barb
Sed rate normals are the same because methodology is most likely the same.
twigjean
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twigjean
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MrsO-UK_Surrey twigjean
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http://patient.uservoice.com/forums/141505-general-feedback/suggestions/7016180-editing-our-own-comments-in-discussion-forums
ptolemy twigjean
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Sheilamac_Fife MrsO-UK_Surrey
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twigjean ptolemy
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CRP 0 - 1 mg/dL USA
1 - 10 mg/L UK
Again methodology depend so there will a slight difference, meaning what manufacture the instrument the CRP was done on.
ERS or Erthrocyte Sedimination Rate (same test) this test is probably done by the same methodology the world over. Men 0 - 22 mm
Women 0 - 29 mm
Vitamin D (My hospital's lab)
30 - 100 nanograms/dL
Here in the States labs are either private or hospital. At hospital labs I can look up my own lab work. Before retirement, I was a medical technologist. When getting lab reports from the doctor, if you are going to compare results between the USA and the UK, you need to to be aware the difference between us. I cannot speak to other countries methodologies used and other in laboratories.
Hope this helps with the confusion.
twigjean
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EileenH twigjean
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The other thing that is confusing of course is just quoting numbers - blood glucose and cholesterol being two VERY confusing set-ups where you get millimoles and mg/dl where there is no connection between the numbers! The US and Italy use mg/dl - the UK millimoles. I can never remember the normal ranges of either and have to look them up!
Your vit D levels are still a couple of years behind the UK who, all of a sudden, have decided that they were accepting far too low levels as OK as people were appearing with rickets and other bone disorders!
twigjean LisaCACO
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ptolemy LisaCACO
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