What blood test do they do when on azathioprine

[lottie1963]

My daughter has had a blood test since being on azathioprine which she started 6 wks ago since then the doc increased the dose, she is going back to the docs in 2 wks and is due to have another blood test what is it they are checking for levels etc she is curious . Also she has asked if its ok to drink alcohol in moderation? Since being on the aza she is feeling better but is more sensitive emotionally or is that just her coming to terms with the disease ?

 

[Jmrogers4]

The metabolites of Imuran called 6-TG and 6-MMP can be directly measured in the blood. Higher 6-TG levels correlate with clinical response to Imuran but also the risk of bone marrow suppression. Higher 6-MMP levels correlates with liver toxicity.
So basically they are testing to make sure she doesn't have too much or too little. My husband gets them done about every 3 months to continually monitor levels.
My husband has been on aza for about 7-8 years and will have the occasional drink. I think since it is processed through the liver she would want to be careful.

 

[CrohnsChicago]

They are checking her therapeutic levels (6-TGN) and her toxicity levels (6-MMP).

It is important while on this medication to check these two (1) because if the medication is not in therapeutic range, the chances of it putting her in and/or keeping her in remission are reduced and (2) if her toxicity levels are over the recommended range, she becomes at-risk for liver damage. If these levels get too high, it will require her to come off of the medication immediately.

These levels may or may not change over time which is why it is important to get routine blood tests for accurate monitoring.

* Low 6-TGN is defined as <235 pmol/8 ×108 and high >450 pmol/8 ×108. High 6-MMP is defined as >5700 pmol/8 ×10

http://www.google.com/url?q=http:%...KvVuD7jz4-oodQ

This chart was also provided in another thread and may help explain:

http://www.crohnsforum.com/showpost....27&postcount=8

Drinking alcohol in moderation MAY be OK, but your daughter will have to be the one to determine how she feels about this as everyone reacts differently to crohn's and alcohol and alcohol/crohn's/medication combinations.

It is not wise to go overboard with alcohol. These medications when taken are broken down in the liver, putting it to work. Add alcohol to the equation which also makes use of the liver and you are working your liver over-time.

Personally I find the hangovers to be FAR worse since starting 6-mp, a similar medication to Azathioprine. You will hear many people on here say they are fine with a few drinks here and there. You will also hear people say they absolutely cannot tolerate even a few sips of alcohol without feeling like crap while on their maintenance medications.

Aza is not known to have a mental/emotional side effect, I suspect she may be struggling with coming to terms as we all do with this medication. When I first started taking it I spent a few weeks just crying about it because of all of the uncertainty of the disease and the potential risks of medications, but I find that, despite a few minor bumps in the road, it has been helpful to me so far.

I do hope the medication continues to work for her and that she finds a way to cope with this disease. And we are always here on the forum to show support

 

[lottie1963]

Thankyou both for replying so promptly to my question, I will be looking at her results more closely when they come back next time. She is very up and down and your right I guess she has alot to think about with this disease. And thinking about what your doing just aint that much fun is it, she cant be spontaneous anymore and she cant plan anymore either the crohns seems to be runnning the show so far and just when I think were on the up she is very moody emotional and scratchy.. thankyou for being here each time ive needed your support, I have mentiond this forum to her but so far she seems to want to keep her distance, so at mo she asks me and I ask you guys thankyiu

 

[jamieariss]

I had a Full Blood Count, Liver Function, Kidney Function every month after my dose went up.
I didn't experience anything emotional on the drug but i was diagnosed with low testosterone (6.8) several times which could of been caused by the medication.
It also effected my energy levels a lot (not for the best).
I'm no longer on them as they didn't work for me. I hope your daughter is successful on them.

 

[jamieariss]

P.S i love your cat XD

 

[Jmrogers4]

It's all new and sometimes it's scary reading everything out there. Both my husband and my son have Crohn's and they both look at it differently.
My husband would totally ignore it. He was diagnosed 20 years ago at 25 years old and has always done exactly what the doctor says, taken whatever medicine has been suggested and follows doctors orders with no questions. Never wanted to get involved with any support groups, do any research, etc. Just wanted to take his meds and ignore everything.
My son who is now 14 was diagnosed at 10. He immediately started researching and while he relies on me for most of his information. He asks a lot of questions. He has done the CCFA walk for 4 years - recruits his friends to come. He has done radio and TV interviews and is very open about it. Always asks his doctor what all his options are and what are the side effects of different medicines.
As both of them say when you are not feeling well it really effects everything and your decisions but when you feel good you can go days or even hopefully months without thinking about it.
I hope she gets to the point where she can go a long time without thinking about it because her time is filled with other things.
Hang in there Mum. You are doing great. She may make it here in her own time but right now she probably just doesn't want to think about it when she doesn't have to and you are safe and she trusts you.

 

[CrohnsChicago]

Yeah,

Maybe I can help provide a tiny bit insight into your daughter's mind...not saying she is going through all of this, but she may be thinking about crohn's and how it affects her in at least a few of these ways.

I was very much like your daughter, active and somewhat spontaneous about my days. When I got sick I became afraid to even leave the house sometimes because I never knew if I was going to get sick. There were times where I would try and be brave and go out, only to make it three blocks and have to run back home to live in the bathroom for the remainder of the day. There were other times where I was in so much pain taking even a few steps across a room made me hunch over in pain and brought me to tears. some days you just want to forget about it. I became distant with a lot of people and lost a lot of meaningful and interesting connections while dealing with this disease. You come to recognize the people who are truly there for you and those who are not. I had to unwillingly give up a lot of the carefree mentality that young folks have about life.

I always tell those closest to me, when you are sick with crohn's and you are in a flare, your world literally does halt and you begin a waiting game full of uncertainty and pain and doctor visits and medications that mess with your body and your mind. Some days you just want to forget you were ever sick.

We all do our best to find ways to get through, some are more capable than others. Others need a little help now and then. And 6-MP has put me in the beginnings of remission. I was sick for so long and yo-yoing between being sick and being well that I felt I forgot what it meant to be well and healthy. I would get excited about feeling good that I would do all the things I used to before and fill my calendar up with activities that helped me to forget that I was ever sick. I had spent so much time being ill I didn't want to be reminded of it in any way. But I would often reach a point of burnout with this strategy. And I would have to face the fact that yes, though my symptoms are low or gone, I do still have a disease that I need to be mindful of. That reminder smacks you right back to reality and can leave you feeling down once in a while. Your body just doesn't bounce back like it used to and you DO have to be more mindful of how you take care of yourself, more so than the rest of the world it feels like.

I actually recently did a short stint of therapy to help me learn to cope with the idea of being well again. To help me learn to balance the healthy life that I want to live with the responsibilities of living with a chronic disease. I'm just now starting to implement these tools I learned through therapy.

Hopefully they will work, and hopefully your daughter will come up with a coping strategy that is well suited to her and that will allow her to live her life to the fullest and without flares or complications.

Today, I am nearing my first remission finally. I work full-time, I volunteer, I am participating in rehearsals for an amateur dance performance among other daily responsibilities. And as excited as I am about it and determined to power through, I still have my emotionally weak days, just like many of us do that live with chronic diseases. Because, despite being well right now, you really never know when it is going to strike again.

Day by day.

 

[lottie1963]

Yes its all you have written and more no doubt. Your right she seems to have less active symptoms but like you say the respite from the pain etc leaves a space where her mind can wander and obviously tho I understand this I still have to remind myself not to wrap her up but allow her to express herself. Its hard eithrr way as a mum I worry about her naturally. I have two sons my eldest is 26 and my middle son is 22 he has shown symptoms that remind me of charlottes just prior to her becomming unwell last yr, his stomach hurts, he has aches he cant explain why they are hurting, he rushes to the bathroom and he never has a good consistent bowl movement, always D. He has lost weight but eats well, tho has to rust to the toilet straight after, now could this just be ibs which is just as painful but without the damage to tissue or could this be more serious? My eldest he came back from holiday just this week and told me he has a painful tear which appeared just prior to his holiday and is wide and very sore, is this the start of something? Gosh I raised them all worried over them when they were littlle nievely thinking they will grow up and I can sit back a while and just enjoy but thats not the case at the moment,
am I just looking too closely at it all at the moment, probably. They are all sensible and im sure will go to the doctor's if they get more worrying symptoms. I just ask myself where the hell did this come from, no one in my family suffers nor any aunts uncles either,,,, its mind boggling to me and I struggle with the knowledge it may affect more than 1 of my children at some point, tho I dont dwell on it. Charlotte said to me the other day "I dont think I will be able to have children im always so tired" wow that got me but I just said yes you will cos you will have me to help you...you will never be alone you will have your family around always , I hope that is the case for all the people who struggle each day through this disease, praying for a better tomorrow for all