Blood tests - are they necessary?

[nogutsnoglory]

If I was ok blood wise on 6mp prior do I need the monitoring on Azathioprine weekly in the beginning?

Which tests do I need?

 

[seebee]

On Azathioprine I started with bloodwork weekly. However, when I switched from azathioprine to 6-mp, I started the bloodwork on an every second week schedule until we found the correct dosage that lowers the inflammation without causing unwanted side effects. I would assume that it would be the same going from 6mp to aza.
The blood work that I have done is: cbc with diff., esr, crp, comprehensive metabolic panel.

Good luck with the switch.

 

[CeeCeeGo]

I would, because from one week to another my liver went haywire from being absolutely fine.
I know it is different here in the UK, but they generally suggest weekly full blood count, liver function tests for the first 4 weeks and then fortnightly or monthly.

 

[SarahBear]

I'd say so, as they're slightly different. It's usually better safe than sorry with these things, anyway. I think the main thing to make sure you get done would be LFTs, but I'm sure there are other tests they usually do as well. They always took six vials from me when doing blood work in relation to medications, so it seems like they had enough to do quite a few.

CeeCeeGo, I think it is usually similar here - I remember having weekly blood work done for the first month, then down to every other week for another month, then it finally settled on once a month.

 

[nogutsnoglory]

Ill have to be on top of them. I think I did CBC and LFT when on 6mp. I don't recall any others.

 

[DustyKat]

Yes you do need to go back to weekly regime for 4 weeks before moving to fortnightly, then monthly, then two monthly and finally 3 monthly. Some docs will then stretch them out to 6 monthly but I personally don't like them to be that far apart. I am most comfortable with 2 monthly.

CBC and LFT's would be the most critical ones. I would UEC's and CRP and ESR. The inflammatory markers, if they are a good indicator for you, will be one way of gauging response to treatment. Also ask about Faecal Calprotectin.

As a side note, since you would already be having blood drawn I would have the following tests added initially and then repeat as needed or every 6 months.

Iron stores
Folate
B12
Vit D
Magnesium
Zinc

Dusty.

 

[alex_chris]

New drug, new checks. I don't quite get the weekly tests, though.

The regime I was one the first and second time on aza (first time in 2003 to 2008 and second time since 2010) was after 2 weeks, 4 weeks, 6 weeks, 10 weeks and thereafter ever since every 8 weeks or so.

I see the testing as a good thing, I always demand a copy and have various things in addition to a complete blood count, ferritin levels, CRP, other inflammation markers, liver function etc. (such as protein levels). It's good to see how things progress. I had iron deficiency and anaemia for quite a long time, it was important for me to see how things change (and if you got anaemia your blood works looks all over the place...). Now things sort of are all in the normal ranges, which is actually amazing when you got Crohn's... at least I think so ;-).

 

[CeeCeeGo]

Thanks DustyKat & AlexChris for your useful posts reminding us what regular blood tests we should all be getting regularly.

I know since I have had regular blood tests and now understand how the levels fluctuate and why, I feel more in control of making decisions about which meds to try - ongoing until I find the one that does not give me awful side effects :ybatty:.

Dusty what do you mean by UEC please?

 

[DustyKat]

@CeeCeeGo:

UEC's stand for Urea, Creatinine and Electrolytes.

I don't know the make up of the blood tests in the UK but the comparison from Aus to US, in that order, is:

FBC (Full Blood Count) = CBC (Complete Blood Count) - That is all the Haematology, so red and white cells counts.

LFT's and UEC's (Liver Function Tests and Urea, Creatinine and Electrolytes) = CMP (Complete Metabolic Panel) - So liver and Kidney function.

@Alex_Chris:

I think the weekly tests would be due to the fact that the more serious side effects of the drug, that affect the liver and blood cell production, are generally apparent in the first 4 weeks.

Dusty.

 

[CeeCeeGo]

Thanks Dusty
I think they call it U&E here in the UK.