I Have Polymyalgiareheumatic And My Last Blood Test Showed My Sed Rate At 89.

Question

Asked by Molly

I Have Polymyalgiareheumatic And My Last Blood Test Showed My Sed Rate At 89.

7 years ago I had a venal occlusion (sp?) in my left eye and my doctor sent me for many tests. At that time my sed rate was 90. She put me on 40 mg of prednisone for a month and I literally gained almost 50 lbs. My sed rate went down but I suffered damage to my left eye. This past year I had a mini stroke in my right eye and am being treated by a retina specialist. My recent blood test showed my sed rate at 89 so my doctor has ordered me to take anothr 40 mg for a month. How can I keep from gaining the weight and also what other damage can I have and how do I avoid these strokes.

Thank you,

Ruth Fisher

email - mrspeale@sbcglobal.net

Answer

An erythrocyte sedimentation rate (ESR) of 89 is high, but not terribly high. An elevated sed rate is so non-specific and can mean just about anything. ESR elevates naturally with age. Infections, cancer, vasculitis, polymyalgiarheumatica (PMR) and many, many more diseases can elevate the ESR. The one important message that an old, wise internist taught me was not to treat the numbers. If the ESR is elevated for a reason, find out what the exact reason is and treat it.

Your doctors must think that the elevated sed rate in you is related to the "strokes" in the eye, possibly a type of vasculitis (inflammation of the blood vessels that can lead to occulsion). Perhaps, in order to save your sight, they want to reduce inflammation quickly with prednisone (a powerful steriod that stops the inflammatory process).

Yes, prednisone has nasty side effects like weight gain and elevated blood pressure, but these risks must be deemed "worth it" in order to initiate prednisone treatment. Much of the weight gain is due to water retention (NSAIDS can also have the same effect). Restricting your salt intake will help to combat the water retention.

If your body is having a hard time controlling inflammation naturally (thus requires periodic use of prednisone), I strongly suggest looking into a concept called the anti-inflammatory diet. I first read about this in Dr. Andrew Weil's book called Healthy Aging . Good nutrition equals a pound of prevention. And, you know what they say, an ounce of prevention equals a pound of cure.

Dr. Christina Lasich, MD

Answered by Christina Lasich, MD