Is there an ideal blood request

[Sophiestree]

I've done a quick search but haven't found the answer so wondering if there was the ideal list when getting bloods done.

My GP, if I write to her, will pretty much ask me what I want so on top of the full blood count (and the usual thyroid tests I have to have) are there others that need requesting, assuming fbc includes crp and esr

Liver? The LVV caused issues for me which I think have resolved but would be good to know

B12?

potassium?

vit d

Calcium - mine was v high and now need an op to remove a parathyroid gland

Some of these might be part of it but love your thoughts on it so I can keep a note handy when she rings.

Thanks all in advance

[PMRpro Ambassador]

As purely routine I'd say ESR/CRP, electrolytes (urea, sodium, potassium etc), full blood count (and possibly differential of white blood cells), LFTs, calcium, renal function (creatinine).

Most of those are done on one or two multi-analysers these days - but they only report what is requested. Always seems a bit daft - no extra work but you might miss something.

Vit D in spring - when it is likely to be at its lowest. Hba1c every 6 months unless rising in which case every 3 months. B12 annually maybe - or if you have symptoms.

[Sophiestree in reply to PMRpro]

I'm supposed to have regular blood tests with the Toc, they've never requested any!So thought I'd get it all in at once!

[PMRpro Ambassador in reply to Sophiestree]

In that case, also cholesterol and triglycerides (TCZ raises cholesterol), LFTs also essential,That's all my rheumy dept does.

[Sophiestree in reply to PMRpro]

Yes, I was going to add cholesterol. I think it was slightly raised last time, but not dramaticallyI definitely want liver. thank you for all that

[DeepThought2]

Not sure if that would be covered by your insurance - my rheumy tests for serum calprotectin. He thinks this is the only blood parameter that gives at least an approximate estimate for disease (inflammation) activity under Actemra. It is not Interleukin-6 dependent but a measure for local inflammation. Still a bit experimental but my rheumy is convinced that it works.

[PMRpro Ambassador in reply to DeepThought2]

In the UK it isn't an insurance question - it is purely availability at a lab. I assume it isn't the faecal version but in blood? The faecal version is available in the UK - not sure about the blood assay.

[DeepThought2 in reply to PMRpro]

Yes it is the serum (blood) calprotectin - that might be not routinely available - but in Germany I get it not only from the Uni lab but also from the normal commercial lab my GP sends his samples to.

[PMRpro Ambassador in reply to DeepThought2]

There are labs in the UK that offer it I think - but can't find if it is routinely offered on the NHS.

[Sophiestree]

Can I ask another question re Pred and bloods. I know there are websites that tell you re drugs and contraindications but is there possibly something that would tell you what pred would do to mask results ie I know about CRP adn ESR, Calcium but I had an interesting appointment with the surgeon regarding my Parathyroid gland removal and although all the scans showed a clear tumour on one gland he said that my parathyroid blood results were normal. I mentioned how pred had changed the calcium but he said that it wouldn't have affected the parathyroid results. I have all the classic symptoms but he also mentioned that thyroid issues can cause the same. Hence wondering if there was a similar list re how it affects blood results. I am assuming know, but worth an ask

[PMRpro Ambassador in reply to Sophiestree]

ncbi.nlm.nih.gov/books/NBK1...

is a summary at the scientific level

I'll allow this from Dr Megan:

prednisonepharmacist.com/si...

I've no doubt if you search individual things you will get articles.

[Sophiestree in reply to PMRpro]

thanks, yes I had a quick search but got a bit bogged down and my brain isn't fully functioning right now so decided to have another go later.Thanks for these, had to do a wry smile at 'I'll allow this..' I have to be honest I don't really follow that particular website but skimmed in the early days.

[PMRpro Ambassador in reply to Sophiestree]

Occasionally she says something sensible

[Sophiestree in reply to PMRpro]

🤣

[musicality]

I've had problems with too much calcium in my blood. Now waiting for possible op on Parathyroid glands, Porcelain gall bladder, and heart valve replacement where too much calcium has settled where it is not needed.

What's next I wonder. Despair all round!