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Suggest Treatment For Elevated ESR Levels
Question: My ESR is 46 for the last 6 month , not under control, I am suffering from Rheumatoid Arthritis, just started from March14. Uric acid is 7.6, hemoglobin 11.70.last time I talk to Dr XXXXXXX Varshney, can I ask him if he is available.
Brief Answer:
Detail Follows.
Detailed Answer:
Dear Friend.
I remember you well. And I am always available for you.
If your ESR is still high that means the Disease activity is persisting.
Provide me following details:
1. Current status of joint pain and stiffness
2. List and dosage of current medications.
3. Your last and current ESR, CRP.
Revert with these details.
I'll help you my level best.
Detail Follows.
Detailed Answer:
Dear Friend.
I remember you well. And I am always available for you.
If your ESR is still high that means the Disease activity is persisting.
Provide me following details:
1. Current status of joint pain and stiffness
2. List and dosage of current medications.
3. Your last and current ESR, CRP.
Revert with these details.
I'll help you my level best.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
1. Very less stiffness feels in the morning
2.folitrax 20 mg once a week,
3. folvite 5 mg replaced with fesovit every 3rd day
4.HCQs 200 mg alternate day
5.Bon k2 daily
6.Bon DK2 ,60k once a month
7. Febustate 40 mg stop taking for a month, to watch uric acid,now increase to7.40
8. ESR. 23/11/13. 40, 22/05/14 46. 27/08/14. 46
9.CRP. 22/05/14. 1.80 27/08/14. 2.50
I am also suffering from itching problem in my fingers ( hand& foot) I am taking medicine on every 3rd day when started taking Lemav for the last 4 yrs.
Day time facing sleeping problem.
2.folitrax 20 mg once a week,
3. folvite 5 mg replaced with fesovit every 3rd day
4.HCQs 200 mg alternate day
5.Bon k2 daily
6.Bon DK2 ,60k once a month
7. Febustate 40 mg stop taking for a month, to watch uric acid,now increase to7.40
8. ESR. 23/11/13. 40, 22/05/14 46. 27/08/14. 46
9.CRP. 22/05/14. 1.80 27/08/14. 2.50
I am also suffering from itching problem in my fingers ( hand& foot) I am taking medicine on every 3rd day when started taking Lemav for the last 4 yrs.
Day time facing sleeping problem.
Brief Answer:
Detail Follows.
Detailed Answer:
Dear Friend.
Your Disease is definitely not under control. Even if your symptoms are less treatment modification is required.
Day time sleepiness is probably because of Lemav.
For itching you should consult a dermatologist. If you want to consult on HCM, you can consult Dr XXXXXXX Bansal.
As far as RA issues are concerned, I would advise you to take Injection Depomedrol 80mg Intramuscularly once a week for 1 month and then ever 15 days for 2 months.
After that you would require to get your ESR and CRP repeated.
I am hopeful this would settle.
Continue all the medicines the same way you are taking.
In fact after 3 months when you get your ESR and CRP done do get your Liver Function Test done along as you are on Methotrexate.
Before you start on these injections do get a Fasting Blood sugar done just to be sure that you don't have diabetes.
If you have any further query please ask me.
Stay Healthy.
Detail Follows.
Detailed Answer:
Dear Friend.
Your Disease is definitely not under control. Even if your symptoms are less treatment modification is required.
Day time sleepiness is probably because of Lemav.
For itching you should consult a dermatologist. If you want to consult on HCM, you can consult Dr XXXXXXX Bansal.
As far as RA issues are concerned, I would advise you to take Injection Depomedrol 80mg Intramuscularly once a week for 1 month and then ever 15 days for 2 months.
After that you would require to get your ESR and CRP repeated.
I am hopeful this would settle.
Continue all the medicines the same way you are taking.
In fact after 3 months when you get your ESR and CRP done do get your Liver Function Test done along as you are on Methotrexate.
Before you start on these injections do get a Fasting Blood sugar done just to be sure that you don't have diabetes.
If you have any further query please ask me.
Stay Healthy.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes I have done following test on 27/08/14
AST. 20. ALT. 23. GGTP. 10 Albumin. 3.78
Glucose,Fasting. 94
My CBC report
PCV 38.40. 40-50
MCV 71.80. 80-100
MCH 22. 27-32
MCHC 30.60. 32-35
RDW. 16.40. 11.50-14.50
Hemoglobin 11.70. 13-17
Iron. 49. 65- 175
Transferring Saturation 15.56. 20- 50
All other are ok
I am feeling tiredness & weakness.
You want me to continue with all medicine with injection suggested by u.
How long i have to continue these medicine.
Should continue medicine for uric acid or not, pl see my note.point no. 7.
AST. 20. ALT. 23. GGTP. 10 Albumin. 3.78
Glucose,Fasting. 94
My CBC report
PCV 38.40. 40-50
MCV 71.80. 80-100
MCH 22. 27-32
MCHC 30.60. 32-35
RDW. 16.40. 11.50-14.50
Hemoglobin 11.70. 13-17
Iron. 49. 65- 175
Transferring Saturation 15.56. 20- 50
All other are ok
I am feeling tiredness & weakness.
You want me to continue with all medicine with injection suggested by u.
How long i have to continue these medicine.
Should continue medicine for uric acid or not, pl see my note.point no. 7.
Brief Answer:
Detail Follows.
Detailed Answer:
Dear Friend.
Your Hemoglobin is slightly low. Increase green leafy vegetables in diet.
As far as uric acid is concerned you can continue with Febuxostat 40 mg once a day.
Also I would advise you to take a calcium supplement in case you are not taking.
The injection I have mentioned would make you feel better. Also your blood sugar is normal so you can take the injection.
Don't worry things would get under control.
You should discuss my opinion with your doctor before acting upon because here at HCM , we can't do your physical examination.
If you have any further query please ask me. Else Revert back to me after 3 months of depomedrol therapy along with fresh ESR and CRP.
Stay Healthy.
Detail Follows.
Detailed Answer:
Dear Friend.
Your Hemoglobin is slightly low. Increase green leafy vegetables in diet.
As far as uric acid is concerned you can continue with Febuxostat 40 mg once a day.
Also I would advise you to take a calcium supplement in case you are not taking.
The injection I have mentioned would make you feel better. Also your blood sugar is normal so you can take the injection.
Don't worry things would get under control.
You should discuss my opinion with your doctor before acting upon because here at HCM , we can't do your physical examination.
If you have any further query please ask me. Else Revert back to me after 3 months of depomedrol therapy along with fresh ESR and CRP.
Stay Healthy.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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