Blood tests

[Lclmlbls]

I started with 15mg of pred in February 2023. Currently tapering and now on 12mg. Since my initial blood tests I have had no further tests. Should my doctor be checking my blood and should I be requesting this?

[PMRpro Ambassador]

They should be looking at the ESR/CRP before each next taper step to be sure the current dose is controlling the inflammation. But they should also be checking most routine things like blood count, blood glucose AND Hba1c, electrolytes, blood pressure and weight every few months. And monitoring how you are getting on with pred.

But it seems such things are regarded by too many practices as optional ...

[Lclmlbls in reply to PMRpro]

Thanks for your replies.My doctor has been cooperative with my suggested taper but maybe when I next speak to her, which has been monthly basis, I could ask for a blood test. I just want to be sure there is a check for diabetes really. Initially my ESR was normal and CRP only 8.

I had read on here that a urine test should be done before starting pred. She didn’t do one until I asked for it.

[PMRpro Ambassador in reply to Lclmlbls]

Can't think why a urine test is needed ...

[Lclmlbls in reply to PMRpro]

Maybe I didn’t read it here but theNICE website says “Arrange the following tests in all people with suspected PMR to rule out other conditions before starting corticosteroids: full blood count, urea and electrolytes, liver function tests, calcium, alkaline phosphatase, protein electrophoresis, thyroid stimulating hormone, creatine kinase, rheumatoid factor, and dipstick urinalysis.

Consider the following tests depending on the clinical features: a urine specimen for Bence Jones protein,”

The NHS website also mentions doing a urine test.

[PMRpro Ambassador in reply to Lclmlbls]

I suppose actually a urine dip test is pretty well normal in a full work up. It was standard in a hospital outpatient dept whatever you were there for.

[Koalajane]

my doctor monitored my bloods for the first 6 months and after that said I could ask for ESR to be checked if I was concerned. She said to taper when I felt ready. I have since had reviews annually which include full bloods.

[DorsetLady PMRGCAuk volunteer]

First year [apart from first few months when it seemed to be weekly] mine was done monthly before I embarked on new taper. After that about every 3 months.

I think the problem nowadays stems back to covid times [as do so many things] when regular blood tests were put on hold due to shortage of resources whilst everything was thrown at containing the virus.

Unfortunately, as we know, service has not returned to normal in many parts of the NHS.

[Lclmlbls in reply to DorsetLady]

thanks for your reply. Will the service ever return to normal I wonder?

[DorsetLady PMRGCAuk volunteer in reply to Lclmlbls]

Not from some GPs….the rest of the surgery staff -probably yes.

As for operations etc, not for a long time unfortunately….

[Bcol]

Think mine were pretty regular for the first two three months, during Covid, then went to six months and now full check annually. To fair to my docs though, if I ask for any tests they always action them.

[Lclmlbls in reply to Bcol]

Thank for replying. To be honest I feel a bit awkward asking for tests to be done, even though I think they should. It makes me feel like I’m questioning their judgement somehow.

[HeronNS in reply to Lclmlbls]

Can you word it in such a way as to emphasise that you need this for your own reassurance? It has been three or four months, so it is reasonable to ask. The pred can affect so many things, in some people more than others, so it's kind of past time that they checked! Like it's important to know your blood sugar because that can be affected.

Also, from my own experience I suggest a visit to the eye doctor. A less common, but still significant, pred side effect can be increased ocular pressure. If it develops into pred-induced glaucoma it needs treatment, and the only way to know is for an eye doctor to check your pressure.

[Lclmlbls in reply to HeronNS]

Thanks HeronNS, good suggestions. 😊

[piglette]

In my case it was monthly for the first six months or so, then went down to quarterly. Now I have HbA1c, cholesterol and thyroid yearly. Full blood count, U & E, liver, folates, ESR and CRP usually at each blood test.

[HeronNS]

Pre-pandemic my doctor ran basic tests I think every month for a few months (not many months), then every three months until one day she said, see you next year (also with a prescription which would see me through the year)! She certainly monitored me closely at the beginning. As long as you continue to have good symptom control and a suitable supply of pred you should be okay, but they really need to make sure things are working well when you start pred and for a while after to make sure things are proceeding as they should.

[diana1998]

I request a full blood test every 3 months which has never been refused. My gp says cholestral and diabetes test every 6 months. Everything has been normal over last 7 years.

[TJ70]

I had a blood test prior to every visit to my rheumatologist which was monthly in the beginning- now every 3 months to check liver profile CRP and FBC

[Jbobby]

You shouldn't hesitate to ask for tests. You need reassurance. Personally, I question everything if Im unclear/unsure.

Maybe worth checking Vit D levels too? they did that for me when I started in Jan.