Prometheus Test Results

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Mommy pooh
Regular Member


Date Joined Apr 2008
Total Posts : 131
   Posted 7/15/2008 7:17 PM (GMT -6)   
  After being on 6-MP for over three months with no remission my GI raised my dose to 75mg and ordered a Prometheus test.  I am so thankful for all that I have learned from reading posts on this web site, because I asked for the Prometheus test when he wanted to raise the dose.
  I do not like 6-MP because of the possible side effects and I don't want to be pregnant on it which puts off adding to our family.  After starting 6-MP I started having trouble with mouth and nose sores.  I have never been prone to mouth sores/ulcers before.  I brought this up with my GI and he didn't think it was from the 6-MP.  On the internet I read that mouth sores are usually associated with high doses of 6-MP.  The mouth and nose sores were a red flag to me that I didn't think I was handling 6-MP well. 
   On the same day he raised my 6-MP we increased my Lialda to 4 per day.  I saw great results with the Lialda and am so excited to be in remission now for a couple of weeks.  I already scheduled an appointment with an IBD center (my GI referred me) at a research hospital prior to getting better.  I decided to keep the appointment to go ahead and get established with a secondary doctor and to get a second opinion on meds.  I want to get totally off the steriods and 6-MP and in my mind, live happily and in remission on Lialda.  My Premetheus test indicated "Lower Likelihood of Response" based on a 6-TGN level of 127 with normal being 230-400.  It also says "Higher Risk of Hepatotoxity" with a 6-MMPN level of 8102 with normal being <5700.
   I know a lot of you are way more experienced than me on this stuff and some of you have said that you had to stop 6-MP based on Prometheus results.  Does anyone know if these levels should indicate me stopping or just reducing 6-MP.  I go to the other doctor on Monday and I want to be armed with as much info as possible.  After receiving these results my current doctor wanted a CBC today so we'll have those results at the end of the week.  Thank you for reading this and any input! 

  • 25 years old
  • Ulcerative Colitis since Sept. 2004
    • 1st flare Sept-Nov 2004
    • 2nd flare Aug. 2007-present
  • Currently taking 1000mg Dipentum, 75mg 6MP, and weaning off Entocort at 6mg, 4 Lialda, Digestive Advantage Chrons/Colitis, and Women's One a Day

 


Red_34
Elite Member


Date Joined Apr 2004
Total Posts : 23551
   Posted 7/15/2008 8:46 PM (GMT -6)   
I'm not quite sure what those numbers mean so I'm guessing here, but it seems that you are not metabolizing the med properly and by reducing it, it will do you no good. It could also be that you are not at your thereupedic (sp?) level however, it seems that a higher level may mean that it is causing a toxic effect too (mainly your liver). So I think it's good that you are going to another doctor. Did the doc go over the results with you or did you just get the paperwork? Usually when I get mine, if everything's ok, the nurse calls me but if it's not the doctor will call me personally and go over the results.
 @--->--SHERRY--<---@
Moderator for Allergies/Asthma and Co-moderator for UC
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Mommy pooh
Regular Member


Date Joined Apr 2008
Total Posts : 131
   Posted 7/16/2008 8:54 AM (GMT -6)   
The nurse called me to tell me the results and that my GI wanted me to go for a CBC. I got a copy of the results to take to the new GI on Monday. That's how I got my hands on the results.
  • 25 years old
  • Ulcerative Colitis since Sept. 2004
    • 1st flare Sept-Nov 2004
    • 2nd flare Aug. 2007-present
  • Currently taking 1000mg Dipentum, 75mg 6MP, and weaning off Entocort at 6mg, 4 Lialda, Digestive Advantage Chrons/Colitis, and Women's One a Day

 


Paul L
Veteran Member


Date Joined Dec 2005
Total Posts : 647
   Posted 7/16/2008 11:33 AM (GMT -6)   
You are in a similar situation that I was in a few years ago. Because your 6-TGN levels are so low they would normally increase your dose, but because your 6-MMPN levels are so high it really isn’t an option. The 6-TGN is what will help you achieve remission and the 6-MMPN level is what can cause liver damage. I don’t remember my exact test results but my GI was so worried that he had the nurse call me immediately to tell me to stop the 6-MP.
Paul
Diagnosed in 2000 at age 43 with UC extending half way across transverse colon.
Bad reaction to Asacol, Pentasa and Dipentum - can’t take any more 5ASAs.
Prednisone - worked well for 1 month, then side effects became unbearable.
6-MP - blood tests showed not metabolizing properly.
Corticosteroid enema, Flagyl, Ciprofloxin, VSL#3, Adacolumn Apheresis – no effect
Methotrexate with Remicade - 7 infusions with no improvement
Folic Acid and B12 injections.
Abatacept trial - no effect
 


Mommy pooh
Regular Member


Date Joined Apr 2008
Total Posts : 131
   Posted 7/16/2008 6:55 PM (GMT -6)   
Thanks so much Shery and Paul! I too was thinking this proved 6-MP wasn't working. My GI's office was on my answering machine when I got home today, but they were already closed by the time I got the message and tried to call back. They have my CBC results. I am going to get in contact with someone in the morning before I take my medicine to see what's up. Maybe they will tell me to stop taking it.
  • 25 years old
  • Ulcerative Colitis since Sept. 2004
    • 1st flare Sept-Nov 2004
    • 2nd flare Aug. 2007-present
  • Currently taking 1000mg Dipentum, 75mg 6MP, and weaning off Entocort at 6mg, 4 Lialda, Digestive Advantage Chrons/Colitis, and Women's One a Day

 


Mommy pooh
Regular Member


Date Joined Apr 2008
Total Posts : 131
   Posted 7/17/2008 4:24 PM (GMT -6)   
My CBC showed normal levels for everything so my GI wants to keep me at 75mgs. I'm still a little worried and am going to go over all of this with the new GI on Monday. I don't want to take 6-MP if it's not working and puts me at high risk for liver damage.
  • 25 years old
  • Ulcerative Colitis since Sept. 2004
    • 1st flare Sept-Nov 2004
    • 2nd flare Aug. 2007-present
  • Currently taking 1000mg Dipentum, 75mg 6MP, and weaning off Entocort at 6mg, 4 Lialda, Digestive Advantage Chrons/Colitis, and Women's One a Day

 

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