Dr. Anshul Varshney
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am suffering from inflammatory myopathy confirmed by EMG, NCS and biopsy with CPK 2300 range and SGOT, SGPT also were little higher. I have already taken five days 1 g Prednisone steroid injections and later was on oral steroid tablets Omnicortil for 1 to 1.5 months reducing doses gradually starting with 80 mg daily to bi-weekly reducing doses. Along with this, doctor had given Cellcept, 750 mg daily and Vitamin B12 and Vitamin D. Right after steroid that month only I feel little better improvement. After steroids effect or a month later like dilution, it goes away and I am back to my previous difficulty in walking and leg hitting floor condition since 2 to 3 years same.
I was thinking inflammatory myopathy was cureable or atleast walking condition would be better and treatment would stay on. I do not see any options and want help in best advice for recovery. Completely confused now. I want other option and for mobility not hitting ground while walking or to have steady balance. Physiotherapy made me very fatigue that I had to stop. Any tablets for balance control or leg devices to help lift little upwards or muscle tightnening substances like enzyme powder Coq10 if any please suggest, any.
Hi,
Welcome to icliniq.com.
To be very honest myopathy inflammatory in origin needs lifetime treatment. We just have steriods and other immunosuppressive therapy to control the disease progression. Definitely, Prednisolone works magically but since it has lots of side effects, we taper and reduce it to bare minimum.
I would recommend to discuss with your doctor to put you on lowest possible dose of Methylprednisolone based on your symptoms and total CPK levels. Co enzyme Q10 has controversial role. If you can afford you may go ahead with it.
Patient's Query
Thank you doctor,
Yes, I am able to afford it but my doctor was suggesting that I take it every two weeks and that is what I am not looking for. As per my report it showed inflammatory myopathy. Can you tell me in which type do I have? Is it myositis or different? Also, are all steroids the same? I was on Methylprednisolone or is there a better version of steroid available. But I have read that inflammatory myopathy is treatable. Why do they say that regarding every 2 weeks? Also, what are the anti-oxidants you suggest or meant which is effective?
Hi,
Welcome back to cliniq.com.
Myopathy is different from myositis. You have inflammatory myopathy. It is not a completely treatable disease most of the times. Methylprednisolone is better then Prednisone in terms of side effects. So I personally prefer to use it when we need steriods for long periods.
Patient's Query
Hi doctor,
Thank you for clearing those details but is it good to take and how much Calcium, Folic acid or Iron supplements? What do you suggest in my case. I take Vitamin D 60,000 IU mostly monthly, so I can take weekly?
Hi,
Welome back to icliniq.com.
It all depends on your Vitamin D level. Get 25 Hydroxy Vitamin D3 level done and I would guide you with the dose. In general you may take a supplement like capsule Gemcal Plus once a day for your daily needs for at least three months.
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Internal Medicine
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