Should I Be Concerned

[crazybarbie]

As in previous posts, I've shared that my seizures have been increasing and changing lately. I've had my Trileptal levels tested at two different time and both were extremely low and actually seem to be dropping. Should I be concerned? I'm waiting on my Neurlogist getting back to me. Do you think this indicates that I need to change my medication? Or is it just a glitch that is reacting to hormonal changes or something of that nature?

[neilB]

When I first went on Keppra my levels were far below where they should have been and I was getting tested about once a week. Now after about 3 months the levels are in the proper range. My doc kept asking if I was even taking them, which aggravated me a bit. But you probably should push the doc to see what they want to do.

[Meetz1064]

possible that you are not processing the Trileptal properly for some reason. However, Trileptal is also known to affect your body's sodium levels, making them go low. This in turn upsets the electrolyte levels, which isn't too cool.

It MAY be a glitch. However, there is likely something going on in your body chemistry that is causing the problem. Don't know what, but nothing surprises me anymore.

Make sure that you're staying well-hydrated, preferably with sports type drinks, and not spending too much time in the heat. If you've suddenly started to peel, as if you would from a bad sunburn, say something IMMEDIATELY to the neurologist. He needs to know.

If there is a hormonal imbalance because of your TOM, or ovulation time, start making notes of it on a calendar, or a notebook, or something. What your body's doing, how you feel, etc. You may be placed on additional hormones to try to lift things back up to the "normal" serum levels that Trileptal should be at.

Seizure journals are an awesome thing, and I'd suggest starting one...it will help with this situation as well, as tracking what your seizures are like, when, how long, etc.

[Endless]

The whole issue of medication blood levels mystifies me. Other than dosage, time taken, and liver/kidney function, I don't understand what makes the blood levels go up or down. Maybe someone in here who is more knowledgable than me can educate us???

[Meetz1064]

see if I can help just a little.

Medication blood levels are based on what are called the half-lives of the medications themselves....or how long the med will last for a specific length of time in your blood once you have NOT taken it.

So, for an example, if Med A has been taken regularly, but has a half-life of 18 hours, then the serum level should stay pretty equal, without dropping until close to the 18 hour mark...it may start to a few hours before that, but not too much before.

However, if Med B has been taken regularly, and only has a half-life of 4 hours, then it's only going to show up in the blood for a couple of hours, tops. And so missing a dose just really can't be done without affecting a person's body.

Whether the meds are processed through the person's liver or kidney will depend entirely on how the med is made--there are some anti-epileptic drug's that are done through the liver, a few that are done through the kidneys, but not too many. Whichever way it goes, the processing of the med is cleansing the body of a "toxin"---the med.

The electrolytes in our bodies will also effect how the blood levels go up or down--so if you get dehydrated/overheated, etc, your blood levels will get out of whack as well. So it IS important to pay attention to what you're doing in the heat and cold as well. Not too much sodium, but not too little, either. Sports drinks are a great thing when you're working out.

Hormones can also effect the blood levels, believe it or not--yes in both men and women. Obviously the time of the month for women, as well as ovulation, but things like problems with prostate, and even thyroid and adrenal issues can cause issues in both sexes. So, these are hormone issues that may need to be considered and addressed as well.

Hopefully, that helped some, and didn't confuse you TOO much. If it did, feel free to ask, or PM me, and I'll be happy to answer.

Take care.

Meetz

[ddr1166]

Hi - quick question. My husband has been on Keppra since Feb 2010, but no one has ever mentioned checking his blood levels for the drug. Is that odd? Thanks, D

[Meetz1064]

depends. If that dosage is what his doctor plans on keeps him at now, for an extended length of time, it's probably time to see how the blood levels are doing, and you can ask for one.

However, if you haven't noticed any issues, and he hasn't either, then that may be the reason why the doctor hasn't ordered it. Some are prone to holding off unless issues (side effects) are noticed. Which is silly, the levels should be done on a regular basis........