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blood test

last week , i had my monthly MTX blood check .. taken at the surgery ... today i receive a telephone call from the surgery ,, saying that i have a few abnormalities in my last blood test and the doctor would like you to take another blood test tomorrow ..

when i asked what the abnormalities are ???

i was told ... haematinics ,, blood count ,,and liver function ...

this has left me abit confused ,, because last week i felt the best i had done in ages , an i was looking forward to finding the results from this test believing i would see some improvements .

so my question is ,, what is haematinics ,, blood count , and liver function .. can they a link between them all .. could all this be down to a MTX thing ????

10 Replies

Hi Andy

Haematinics is testing for Iron level, folate and vit b12 levels amongst others these are essential for you to produce red blood cells

blood count is testing for red blood cells white blood cells and platelets it also breaks down the different types of white blood cells

liver function tests are to test how the liver is working ALT, ALK PHOS etc and these may be related to methotrexate

Hope this is helpful

good luck and hope this is a blip



My liver function levels in my blood went way way up and i had no clue. You may not feel anything when your blood is doing poorly, that is why they look at the blood to see how things are coping underneath. It sounds like you have a few counts that are off and they may need to change your meds accordingly. Prepare yourself for a possible change in meds.


Sorry to hear that this has come up. Looking at what all the things should be in my blood test booklet, I see that as the mtx started to give me a great deal of benefit the levels of various things started to get a little bit worse here and there (although I'm lucky so far, nothing has got so high or so low that I've had to change anything.) Thinking about it, when mtx is helping the arthritis most it might also have the biggest effect on the body in a bad way, it's like it has maxed out. That is probably not what you want to hear but it could explain why the levels are out even though you feel good.

I hope you don't have to change meds and there is something else you can do.


Hi Andy - try not to stress over this (easy for me to say I know!). I thought they were assessing you for biologics now anyway so even if you have to come off the MTX (and more likely they will just lower the dose) it should help with the assessment if you can't tolerate DMARDs. Gotta dash - puppy pee/ poo time! Tilda xx


They often ask to have another test done if things are a bit out, just so they can see if it was a blip or is a more definite change. Some of those changes can be to do with whether you had a drink the night before, or if you were slightly dehydrated at the time of the test, or the difference between a fasting test and you having just recently eaten, or even the time of day the test was taken or how long the blood sat before they tested it. I wouldn't worry too much about it, but as Tilda said, if you do go onto anti-tnfs, then you would probably come off MTX anyway, and there wouldn't be anywhere near as much risk to your liver.


thanks guys ..

i am on a 2nd assessment for the anti tnf ,,next week .. so yes your right i am not to worried about being taken off MTX ,, also MTX isnt really the correct treatment for me ,, its only really used as a stand in ... but thats if i get offered the anti tnf ... my worry is , that this could stop the anti tnf ... i feel the system do look at any excuse not to put you on this treatmeat ...

what were more upsetting for me ,, over the last month ,, id felt the best id done in ages ,, seems always something to knock you back to square one again ..

keep you posted ..



Hi, I was originally put on MTX and I had my bloods tested every two weeks. I had abnormalities, in that my neutrophils and white blood count went down, this means that you are less able to fight infections due to having a low immune system. Apparently MTX can cause this, that's why they check your blood levels so often. My bloods went up and down every time I had them tested, but at one point my neutrophils went down to 1 (half of what they should be) so was told to stop taking MTX immediately. I am now on a different drug which seems to suit me better, so its just trial and error to find the right drug that suits you. I think of having this RA as being on a rollercoaster, one minute your up and the next your down again. Try to keep positive. :-)

Take care



Sorry Andy you not doing so good at the mo and like you say it's always the knock back that's the hardest to deal with many blogs I have read on this site have reassured me in that , it takes quite while to get your meds/treatment sorted and for your body to accept but once past this rocky bit it seems it all gets a whole lot easier ....

You've got a sense of humour thats obvious :))) and thats a huge help so keep smiling and hopefully after next weeks 2nd assessment it will all become a lot clearer ....enjoy your weekend Claire xx


I'd think that abnormal blood tests if they were thought likely to be caused by MTX would be MORE reason to put you onto anti-tnfs, not less - means you can't tolerate DMARDS. That would definitely be the way I'd be arguing anyway.


Hi Andy, please try not to worry too much. Repeat bloods are really common and, as often as not, the second set come back normal. They're just wanting to check whether the first results were a "blip" or a definite change of function. As Earthwitch said, in the latter case your are more likely rather than less to be offered alternative treatment if the think the impaired function is down to MTX. Chin up mate x


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