RA Routine/Annual Blood Tests

[BoneyC]

I have a rheumatology appointment this week (unless cancelled by doctors' strike). It's been more than 4 years since I last saw a consultant face to face and want to check I am having all of the routine and annual blood tests that are recommended.

I am on MTX and monthly have

FBC - full blood count

LFT - liver function test

U&E - kidney function

CRP & ESR - inflammatory markers

Annually, the GP surgery add in

HBA1 C - Diabetes/sugar

Full Lipid Profile - Cholesterol

Should I also be having?

Bone Profile/Calcium level

I also want to ask about checking my heart health and bone health. It's been so long ago that I had a DEXA scan I cannot remember when and I never get any sort of heart check. I'm 59 now and had RA for 52 years and wonder when someone will be checking in case I have any underlying problems not yet presenting symptoms.

I would be interested to hear your experiences. Thanks.

[MadBunny]

Hi.

I'm on mtx and Cimzia biologic, and I have the top 4 , as requested by rheumatology. As I understand , they are the standard ones. As a one off, many years ago, my B12 was checked, because I was anaemic. My GP surgery do the cholesterol, diabetes and thyroid annually. And check my blood pressure .

Do you have the annual GP review which patients with chronic illnesses are supposed to have ? This would be a good opportunity to ask any relevant questions.

I was supposed to have a dexa scan in 2020

( requested by rheumatology ) but have heard nothing .

I hope your appointment goes well and you can get some answers .It's been almost 4 years since I've seen a consultant or biologic nurse face to face, too. My last one was a phone call , although it was productive, and he asked the gp to run some checks as I raised some issues which he felt were not RA related. Which they have .

I'm finding these days I have to be more pro active and chase things up myself.

Sorry that was a bit long winded 🙄

[Egpa in reply to MadBunny]

I was recommended fir a DEXA scan 2 years ago, had it on Friday only after keep badgering them. Kept getting told the person is off on long term sick. Thing they need yo train another person so waiting list go down.

[AgedCrone]

Your best bet would be to have a word with your Rheumatology Nurses.

You could maybe get a consult with your Rheumatologist.?

You really need to get information from somebody who knows your actual health condition. We unfortunately cannot advise on things like this.

[helixhelix]

I have vitamin D tested as well.

[weymouth321]

Ring your nhs Rheumatoid Help Phone Line - they have time slots on certain days - the Rheumatoid Specialist Nurse is just as well informed.

[BoneyC]

Thanks all, hopefully Wednesday's appointment will still go ahead .... have to wait and see.

[Runrig01]

I must admit I do get 2-3 yearly dexa scans, but that I’m told is due to my life long steroids. I was found after my stroke to have an enlarged heart, which hadn’t been investigated when discovered 18 months previously. When my gp picked it up, she organised an echocardiogram. I got talking to the cardiac technician, and he said that most rheumatology patients will have some mild inflammation in the pericardium, but that they are incidental findings, and therefore they only proceeded with tests, when there were symptoms to justify checking. Otherwise patients could be over treated, when the heart was functioning fine otherwise. My rheumatologist said similar when I asked about it, also saying with each test the cost has to be justified, and not carried out purely for curiosity, where treatment would not change following the test.

These days it’s easy to self refer for tests like echocardiograms, for people who are just curious. My initial rheumatologist years ago on starting steroids wouldn’t agree to a dexa scan as a baseline, so I organised a private one for my own peace of mind. I have AS so my dexa scans have to be interpreted just using the hip, as lots of calcified deposits in the spine, make it look like my obe density is improving when it is not. Yet I still get it calculated many times with the lumbar spine, and have to have it recalculated.

[GinnyE]

I’m on 20 mg methotrexate and get blood tests every three months.

[Happy5]

I had what I call an MOT check up last month f2f with GP lovely lass who was very thorough.

Apart from tests you mentioned my cholesterol levels were done. She also listened to my chest my resting BP sat down BP & stood up BP as well as listened to my heart. I got this by doing an econsult explainig not seen GP f2f for four years next day was called for the appointment. Suggest to try contacting your surgery about your concerns?