What bloodwork is helpful?

[Dignan]

Hey all,

I am getting ready to make an appointment with my GP to get a physical soon. When I'm there I want to get a slew of bloodwork done to check for every possible area that could be affected by my meds (on Generic Keppra).

In the past, I had things go unnoticed by my neuro when I was on Dilantin and Tegretol, and it was only through testing through other docs on my own that issues were discovered.

So, I was wanting to get immune system (i had shingles 5 months ago), liver and kidney function, and anything else I can think of to make sure everything is okay and establish a baseline if nothing else. Anyone have any tests they recommend as worthwhile to check on for keppra users?? Does keppra affect the immune system at all? I haven't found anything definitive on that online..

Thanks,

D:rock:

 

[Nakamova]

Keppra isn't supposed to affect the immune system, but a standard CBC (Complete Blood Count) will reveal if anything unusual is going on. The CBC counts, measures and analyzes red blood cells, white blood cells and platelets, and also measures the amount of hemoglobin in the blood and within each red blood cell. You could also ask about having a chemistry panel done-- it would evaluate liver function among other things. A chemistry panel tests some or all of the following:
Fasting Glucose (blood sugar)
Uric acid
BUN (blood urea nitrogen): Measures liver and kidney function
Creatinine: A test used to measure kidney function
BUN/Creatinine Ratio: For diagnosis of impaired renal function
Estimated glomerular filtration rate (eGFR)
Sodium
Potassium
Chloride
Calcium
Phosphorus
Total Protein
Albumin
Globulin
Albumin/Globulin Ratio
Bilirubin: Evaluates kidney and liver function
Alkaline Phosphatase: Evaluation of liver and bone diseases
LDH (lactic dehydrogenase)
AST (SGOT): Evaluates liver function
ALT (SGPT): Evaluates liver function
Iron (serum)
Lipid Profile: Evaluates the risk for developing atherosclerosis (arterial plaque) and coronary heart disease.
Total Cholesterol
Triglycerides
HDL Cholesterol
LDL Cholesterol
Total Cholesterol/HDL Ratio

 

[Endless]

There are two blood panels, each of which test about 10-20 things at once. The names of them escape me, but they are pretty typical for a doc to order. They give a pretty complete pic of what's going on, including infection, organ function, etc. It includes most of the list above, but not everything is in those panels that your doc may want to know if there is a special concern that pops up with the generalized blood tests. A typical add-on for those of us on seizure meds is a blood drug-level.

One of those general panels is done for me every week, to monitor CO2 levels. Metabolic acidosis from meds.

Kidney and liver function are the typical things the docs watch carefully when we are on the AEDs. Also when first ramping up and if an increase in seizure frequency also drug levels in the blood.

 

[RobinN]

Vitamin levels

I have grown rather weary of blood work. One test will say that fasting blood sugar is fine, yet my daughter is down on the ground and her glucose is at 32. She has had multiple fasting tests and they all came out fine. It wasn't until she had a glucose tolerance test that it showed it drop to 50.

She has had other tests and I have heard many doctors say she does not have diabetes, yet her most recent test, came back with a note... High Risk for Diabetes.

Blood work can show levels of magnesium in the blood (magnesium is an anti convulsant) and yet it won't tell you the amount that is actually getting across the blood brain barrier.

There simply is no way to know if you are getting the kinds of test that your individual body needs. We are all in the hands of our insurance companies, as to what they will and won't allow. Doctors don't tell you the tests that are necessary if your insurance won't cover the test. You have to tell them you will pay out of pocket for the useful tests.

Quite crazy making. Connect the dots and ask for what your instincts tell you that you need. Keep asking... I had to wait a year before my daughter was given a glucose tolerance test. She had to have a seizure and be close to coma levels in order for the ER doctor to say it was a mandatory test at this time.

Good luck

 

[Chel]

I was wanting to get immune system (i had shingles 5 months ago)

That's your immunoglobulin levels (Ig). You might also consider checking if you're a coeliac (celiac). I searched online last night for a connection between celiac disease and shingles, and couldn't find one. However, there is a connection between Selective IgA Deficiency, an immune condition and celiac disease. I mention that, because you may have a poor immune system if you've recently had shingles. There are a lot of epileptics who do well on the gluten free diet (regardless of celiac diagnosis).

So, from the celiac.org website, here is a short list of possible bloods to recommend:
http://www.celiac.org/index.php?option=com_content&view=article&id=7&Itemid=13
* Anti-tissue transglutaminase antibody (tTG – IgA and IgG) commonly used whether or not symptoms are present and the most sensitive test available
* Anti-endomysial antibody (EMA-IgA) – highly specific marker for celiac disease
* Anti-deaminated gliadin peptide (DGP – IgA and IgG)
used when tTG or EMA is negative and in cases where patient is IgA deficient
* Total serum IgA – used to check levels to exclude selective IgA deficiency that results in a false negative test
* Anti-gliadin antibody (AgA – IgG and IgA) not considered sensitive or specific enough for adults, but used for children under 2 because tTG and EMA antibodies may be absent. The anti-DGP test is sensitive in this group.

Not all of these - read the blurb underneath on the site. Ppl with known IgA Deficiency need the DGP test for celiac disease, for example, and none of the others.