[vanillasky]

#1059528

At the advice of some members here and after reading about Tapazole and it’s potential to reduce WBC, RBC, plus liver problems, I today called Dr. at Cleveland and asked him to add these blood tests to my standing order.

He wrote back, said I was misinformed by pharmacist (who also said what was said here) and said if blood cells go lower, it happens over night so I would get “false negatives.” I don’t know what to think. I suppose he knows what he’s doing so I certainly wouldn’t second guess him, but in other words, I have to wait for something to happen before I call him or go to ER? Sounds pretty scarey with this drug if you ask me.

[catstuart7]

#1175426

Just to share my experience I’ve seen two endos so far and both were willing to run those tests – though one said reactions with PTU particularly happen in the first three months so frequent testing after that was less needed. To put your mind at ease you could have your primary care doctor run those tests. It means a lot to me to have those tests run…Adenure can correct me if I’m wrong but I remember that she had no symptoms while her liver values were going wrong. Who wants to wait till they get symptoms???

ETA: I’m taking methimazole right now and have had a persistent sore throat this week and am waiting on results for those very tests! I’m hoping it’s just a cold.

[Bobbi]

#1175427

Typically, the WBC test is run when there is an infection, and, perhaps once during the early months of taking ATDs — if then. Expecting our doctors to do these tests more frequently for our peace of mind may not be the best way to use your health dollars.

[Kimberly]

#1175428

Hello – The latest medical guidance (which you can check out in the “Treatment Options” thread in the announcements section of the forum) notes that there is no “consensus” regarding the usefulness of periodic WBC/liver function testing in helping with early identification of side effects, although it does recommend baseline testing prior to starting on anti-thyroid drugs.

So for now, we are likely to see a lot of inconsistency in terms of which doctors order which tests.

If this is something that you are seriously worried about, I would suggest telling your doc you are willing to pay out of pocket if the insurance won’t cover — or perhaps going to your GP, as catstuart7 suggested.

[adenure]

#1175429

Well, that stinks! It might be that it isn’t necessary or doctors are willing to wait for symptoms and all, but I’m glad I got those labs run!

Catstuart, you’re right. I had NO symptoms at all that my liver enzymes were as high as they were. I had a very normal baseline right before starting methimazole. At my 7 week labs (after starting) my enzymes were 8 times the normal amount. I had no fever, jaundice, dark urine, sore throat etc etc… Needless to say, the doctor on call told me to stop the medication that night and get liver labs again 3 days later to make sure the enzymes were coming back down (which they were). Then I had labs a month later (they were back to normal) and an abdominal ultrasound.

If I had waited for symptoms, I hate to think what they would’ve been after more time on methimazole. I know I’m not the likely case, but it happens. I’d ask my general practitioner if your endo. won’t do it. The liver is important; most problems from ATD’s, when caught early enough, reverse themselves- but, who wants to be the one who might end up waiting too long? To me, it doesn’t seem like a big deal to test enzymes. I don’t know what the cost is involved, but it’s probably less than something like TSI.

[Carito71]

#1175430

Hello.

I just left you a message at your other post where you mentioned that you are feeling nauseated and tired. I think you should request labs if you are feeling nauseated. Ask to talk with the nurse and explain to her/him your symptoms and request they run labs to make sure that your symptoms are not related to Tapazole. Somebody suggested asking your General Dr if the Endo doesn’t want to run them and I agree. That is what I would do too.

My Endo Dr. asks for WBC, TSH, free T4, ALT every 4 weeks. Lately he has also asked for a complete CBC. He worries about Methimazole causing elevated liver enzymes and lowering my WBC b/c when I started the Methimazole my liver enzymes were elevated and my WBC was low from being hyperthyroid. Later on my WBC dropped a little more and that worried him so he is monitoring CBCs, ALT along with TSH and free T4. My liver enzymes and WBC are normal now but he still worries.

Caro

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