Blood test results

[LilStep]

When I first started Tec, 8 weeks ago; my Neuro didn't require me to have a CBC done prior. So when I visited my PCP, I asked if she would write a script for me to have one. I had already been on Tec for approx. 3 weeks.

I received my results and my AST level is at 35 U/L and my ALT level is at 45 U/L. My PCP nurse called me and said the Dr. that my liver enzyme is slightly elevated and wants me to get my blood tested every 3-6 months.

So for the long post, but here is my question. Does anyone know if these levels are something I should be concerned with and is there anyway of knowing if Tec is in fact causing the elevation. I have never been told before that my levels were elevated and prior to Tec, I was on Copaxone, Tysabri, and Rebif for just 1 month.

If anyone can give me some insight, I would really appreciate it. Oh and by the way, I've currently been on Tec for 9 weeks now.

[MallyCT]

I am going to take a stab at this (no pun intended): I know that when I was on Avonex it was not unsual to have my liver checked along with standard CBC. So based on that, I personally would not be suprised if for the next year or so my counts (CBC and liver and anything else) will be "off" (either up or down). Obviously, there is a point which a doctor will be concerned but trying to figure this out alone is scary. Let your neuro know and your PCP perhaps speak with one another. I hope this helps! Be strong

[izzieb]

Monthly Blood tests

I had a blood test prior to starting Tec. and have now been on it for 9 weeks. My neuro had me do a blood test after one month and my liver enzymes were elevated, so he is having me do a blood test once a month for 6 months to monitor it. I just had my second blood test (at the hospital) and the nurse said my liver enzymes looked fine but my WBC has dropped. I haven't spoken to my neuro yet about that but I see him again next month. I hope this helps. Take care!

[MSer102]

I've had elevated liver enzymes too. Yours aren't outrageously high, just high enough to be watched for awhile. Doctors generally monitor them for a few months and then decide whether the benefit from the medication is worth having elevated enzymes.

Under some circumstances a doctor will say that the levels that you have are OK to carry for quite a long time. It depends on the person and the doctor. So you should be aware of them but not necessarily concerned since the levels aren't terribly high and they haven't been elevated for very long. And the liver has a remarkable ability to repair itself and recover as long as whatever is bothering it stops.

By the way, the liver panel is not part of the CBC, so even if you'd had a CBC done before Tecfidera your liver enzymes wouldn't have been tested. Your PCP ordered a separate liver panel.

If your liver enzymes weren't high before starting Tecfidera then the assumption would be that Tecfidera is the cause. The two are so closely linked in time that, without something else happening that could also affect your liver, Tecfidera looks like the only likely cause. The only way to know would be to stop Tecfidera and see what happens to your enzyme levels.

Your enzyme levels might come down on their own anyway even if you don't stop Tecfidera. That's why your doctor suggested regular testing to see what happens. My doctor tested me every month, though, not every 3 to 6, so we could act quickly if the levels shot way up.

[LilStep]

Thanks for replies. The info you all provided helped me understand my results. I appreciate it.