Inflammatory Markers-Does anyone know.........

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vixen
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Date Joined Jan 2010
Total Posts : 794
   Posted 3/24/2010 9:42 AM (GMT -7)   
 
I rang the IBD nurse to check son's blood results and whether he ok to continue on the azathioprine(which he is) Nurse asked how he had been and I said fine barring very tired on Sunday. He(IBD nurse) said it shows in his blood test results as in the inflammatory markers had risen. Can they just rise because of tiredness  or do they rise only because of inflammation, or does tiredness cause increased inflammation?
Sorry is that clear?
(He did have a very full day on the Sunday and I am not surprised that he was tired)

Ashworthml
Regular Member


Date Joined Jan 2010
Total Posts : 222
   Posted 3/24/2010 10:20 AM (GMT -7)   
As far as I know they only rise with inflammmation, But if he is tired it's probably because he's flaring a little too, or he has an infection somewhere in his body.
Michelle 40 years old
Diagnosed with CD 2004 (undiagnosed correctly +- 3 years, wrongly diagnosed with IBS)
Bowel resection 2005
medication: pentasa 500mg , Co-codomol 500mg/32mg codeine
loperamide 2mg (prn - take as many as 10-20 a day)
calcium tablets, multivitamin tablets, Omega 3
Ferrous sulphate(anaemia)
levothyroxine (thyroid)
questran light (3 sachets/day), 3 monthly B12 Injections


vixen
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Date Joined Jan 2010
Total Posts : 794
   Posted 3/24/2010 3:22 PM (GMT -7)   
Thanks for that,
I thought it was only for inflammation but I didn't know for sure. He spent 8 hours on Sunday at a racing event in a voluntary capacity as a Red Cross First Aider-he was done in by the time he had finished!

73monte
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Date Joined Mar 2007
Total Posts : 1494
   Posted 3/24/2010 5:46 PM (GMT -7)   
Just wondering, how long has he been on Azathioprine? It does take up to 6 months to reach effectiveness. Also, he may need to increase his dosage as well. They do a blood test for that as well. 
My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Has used Prednisone and Pentasa. Started Imuran (02/09), had an abdominal abscess (12/08). 2cm of Stricture.


debilitated
Regular Member


Date Joined Jan 2010
Total Posts : 448
   Posted 3/24/2010 5:56 PM (GMT -7)   
CRP : C-Reactive Protein.

This is what shows the amount of inflimation in the body. We tend to want to keep that number below 3.
Male, 22. Diagnosed with Crohn's officially since 2001.. Osteoporosis, Generalized Anxiety Disorder, Chronic Anemia.

Medications Used: Remicade, Humira, Cimzia, 6-mp, Pentasa, Flagyl, Prednisone, Zifaxan, Entocort,
TPN (Total Parenteral Nutrition), The whole nine.

Current: Methotrexate Injection, Entocort EC, Vitamin D, Fentanyl 25mcg / 72hrs - Zofran - Folic Acid
Currently On SSDI


debilitated
Regular Member


Date Joined Jan 2010
Total Posts : 448
   Posted 3/24/2010 5:56 PM (GMT -7)   
Oh, and with Crohn's We also look at White blood count and Platelets.
Male, 22. Diagnosed with Crohn's officially since 2001.. Osteoporosis, Generalized Anxiety Disorder, Chronic Anemia.

Medications Used: Remicade, Humira, Cimzia, 6-mp, Pentasa, Flagyl, Prednisone, Zifaxan, Entocort,
TPN (Total Parenteral Nutrition), The whole nine.

Current: Methotrexate Injection, Entocort EC, Vitamin D, Fentanyl 25mcg / 72hrs - Zofran - Folic Acid
Currently On SSDI


sr5599
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Date Joined Aug 2007
Total Posts : 1202
   Posted 3/24/2010 7:06 PM (GMT -7)   
CRP is one test... It changes more quickly when inflammation occurs or heals in the body so many docs use this. (Mine hovers around 8 but has been up to 20). Normal is <3 like debilitated said.

The other test is a sed rate (ESR). Normal values for that are 0-20 (currently I'm 73 :-( after 2 months on MTX, I know Navy, patience).

Sed rate seems to take longer to represent a change in inflammation levels. To the best of my knowledge, it's only inflammation that increases them. But someone might know more about whether anything else can affect the test. Not tiredness, though.
1 fistula, crohn's colitis, limited to large intestine
Compounded budesonide 3mg/daily, Cimzia, MTX . Dx Osteoporosis 10/08 started Forteo 1/27/09

Post Edited (sr5599) : 3/24/2010 8:11:20 PM (GMT-6)


vixen
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Date Joined Jan 2010
Total Posts : 794
   Posted 3/25/2010 1:42 AM (GMT -7)   
Hi.
He has been on the azathioprine for four weeks now, 2 weeks at 50mg and these last two weeks at 100mg.

I don't know what his actual numbers are/were (I will ask on Tuesday when we repeat the whole blood test/results scene :) )
I did google about the blood tests (crp etc) but it didn't tell me whether tiredness could affect them. When nurse said he could tell he was tired due to inflammatory markers rising it made me wonder whether overdoing it could directly increase inflammation

CrohnieToo
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Date Joined May 2003
Total Posts : 9448
   Posted 3/25/2010 4:18 AM (GMT -7)   
They are learnng more and more about inflammation. Did you know that "just" OSA (obstructive sleep apnea) can cause/increase inflammation? So, yes, stress can increase inflammation if there are already other possible causes. This is more likely when the immune system is somewhat low.

Don't let that concern or panic you about azathioprine. The dosage is adjusted to lower the OVERACTIVE immune system in the intestine. And keep in mind that it can take up to 6 months or so to take full effect and during that time other medications such as mesalamine (or prednisone or Entocort) are needed to "help" the azathioprine dampen the disease activity.

Simplified, but as explained to me. I've been on azathioprine since 2003 and been in remission or symptomatic remission since 9 months or so of starting it, but even now, if I reduce my mesalamine from 4 g a day to 2 g a day w/in a couple of weeks mild disease symptoms will begin again. Obviously I am one who responds well to mesalamine, they have found many do not. On the other hand, mesalamine could't put and keep me in remission on its own. It has taken the combination of both meds to keep me in remission and/or symptomatic remission.

Good luck and God bless to your son.
My computer says I need to upgrade my brain to be compatible with its new software.


vixen
Veteran Member


Date Joined Jan 2010
Total Posts : 794
   Posted 3/25/2010 10:52 AM (GMT -7)   
Thank you for that info. I didn't know about OSA, Most of what I know is useless information:)
I wasn't so much worried about the azathioprine(although must admit hate that he has to take it) Was asked by 73monte how long he had been on it and that he may need to up dose. I just wasn't sure whether over doing it directly caused inflammation or whether 'just' being tired would cause the markers to rise. He is still on the pentasa and entecort too (turning into a right druggy lol)
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