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Crohn's Blood Work Panel Suggestions?

My gf has been sick on and off since about Halloween, it’s annoying and it’s general sickness/flu type stuff (up until too much work in the last few weeks caused her stomach to flare up, but it’s getting better)

This is a huge hindrance on her, her training, diet and overall outlook/motivation bc it’s an endless cycle.

Anyway, It’s gotten to the pt now where she is willing to get some bloodwork done (her worst fear in life, basically). We are in a college area and our college doc office has a very comprehensive list of blood panels to choose from bc they work with a few hospitals around here, and from what I’m gathering the list is more comprehensive than a typical hospital’s?

What are all of your suggestions for which blood panels to get done? I want to make sure she is assimilating all the basics for vit/min, but does anyone have any other suggestions for what to get that I may not be aware of?

Any and all advice is appreciated. Thank you!

Complete blood count with differential
Iron studys: i.e serum iron, serum ferritin, total iron binding capacity
Serum B-12
serum folate
Comprehensive metabolic panel
Stool for Ova, parasites, occult blood, fat
TSH, T4

This is totally the shotgun approach which I’m not a huge fan of and I’m sure there’s a few labs worth adding to this list.

As far as Crohn’s goes you it’s usually diagnosed clinically and then confirmed by an endoscopy (think camera where no one whats a camera) and biopsy (tissue sample). The lab work above work actually diagnose Crohn’s but it sure covers a lot of bases in terms of trying to see if anything has been thrown out of wack and may help narrow down causes, thats a conversation you/she should have with her doctor before pursuing tests. If it’s been going on for such a long time it may be time to ask to be refered to a specialist, if it’s mostly gastrointestinal symptoms then a GI doc…

Disclaimer: I’m not actually an MD yet, this doesn’t consitute medical advice, so talk to your doctor

Thanks for the quick response. Just to clarify, she has been already diagnosed w Crohn’s disease for several years. The main problems are trying to find out what she doesn’t have enough of in her body, or too much of that is allowing her to be sick for so long.

The shotgun approach seems to be the only thing that makes sense at this pt bc all the docs shes seen for her chronic flu/bronchitis/whatever have just gave anti-biotics, which helped, but not for too long. I shouldn’t have to research into what she is paying a doc for, but for someone in her condition and their lack of expertise it seems to be the only option.

[quote]VTTrainer wrote:
Thanks for the quick response. Just to clarify, she has been already diagnosed w Crohn’s disease for several years. The main problems are trying to find out what she doesn’t have enough of in her body, or too much of that is allowing her to be sick for so long.

The shotgun approach seems to be the only thing that makes sense at this pt bc all the docs shes seen for her chronic flu/bronchitis/whatever have just gave anti-biotics, which helped, but not for too long. I shouldn’t have to research into what she is paying a doc for, but for someone in her condition and their lack of expertise it seems to be the only option.[/quote]

Opps misread that…Two things 1 all the above blood work would probably be a good idea and 2 definately research Crohn’s specialists in your area. You may have to travel for it but a good doctor is usually worth the effort in cases like Crohn’s.
Crohn’s sucks, I’ve met a lot of people with it, good luck.

Just an anecdote about a close family member with IBD:

-Got diagnosed with IBD/Chrohn’s/Colitis at 17.
-He always seems to have stomach pain and has to go to the bathroom every time he eats a meal.
-When his disease isn’t under control, he tends to lose weight, eat less, and he experiences a lot of pain/bloating/tiredness/shitting problems.
-He has secondary symptoms that may be related to his disease-- early hair loss, oral health problems despite having good oral hygiene.
-His diet in general is usually quite simple and he seems to have become accustomed to favoring certain types of food over others–> pita, humus, bean salad, whole wheat bread, certain juices, tzatziki, yogurt, fish, chicken, and eggs would be some examples of foods he eats on a daily basis that seem to work for him. This seems to vary dependent on the person.
-His condition is reassessed every once in a while with a sigmoidoscopy (usually once a year), colonoscopy (once every 2-3 years), and blood work (usually once a year).
-His medical treatment usually involves adjusting his dose of mesalamine (standard low-severity IBD treatment) and using a special type of enema when he has a bad flare-up.
-His first doctor was a highly regarded Colorectal surgeon with no bedside manner. After a few years and no need for surgery, he switched to a top gastroenterologist who seemed to have better clinical skills when it came to taking care of his patients long-term.
-At about 22 years old, he began adding fish to his diet for the first time, eating yogurt, and supplementing with an expensive powdered probiotic product. After a year doing this, he got results that allowed him to go off of his medication for a couple of years. Upon stopping using the probiotic product and reducing his fish intake once again, he needed to go back on his medication.
-Basically, his condition has a lot of ups/downs (some months he has almost no symptoms/signs and other months you can tell that he isn’t feeling well) but it doesn’t prevent him from living a normal life and he is able to deal with it by adjusting the dose of his medication, making sure his stress levels are under control, eating a lot of fish, and taking probiotics.

VTT, I am a physician. It’s obvious you are concerned about your GF, and frustrated with the inability of multiple physicians to provide a definitive diagnosis and treatment plan. However, I have to tell you that a more-or-less random ‘lab shotgun’ is likely to be a low-yield endeavor. In fact, it may even delay a proper diagnosis by uncovering ‘abnormal’ labs that have nothing to do with her current condition, but end up leading to more tests and/or unnecessary treatments.

(In medicine we sometimes refer to these abnormal-but-clinically-irrelevant findings as ‘incidentalomas.’) It could also turn into a prohibitively expensive venture, as one lab test begets another, and another, etc.

A more productive approach would be to find a physician you feel you can trust, and allow him/her to use the history & physical process to determine an appropriate course of action. If your GF has biopsy-proven Crohn’s dz, I would suggest you turn first to a fellowship-trained GI specialist (a medicine doctor, not a surgeon) when searching for a physician in whom to invest your trust. My best to you and your GF.

My manager has severe Crohn’s and my housemate has it mildly. It’s a nasty disease, I would try and get the best information online, and the most specialist doctor’s you can. My manager only ate mung beans for years! He’s better now tho but still on drugs.

He had antibiotics for MAP’s (which is TB in cattle). It’s thought there is a link between Crohn’s and MAP’s in cattle so you may want to avoid dairy unless it’s been cooked. They are researching this currently. The antibiotics he took weren’t nice tho and gave him meningitis (or that could have been the other drugs he was on) but he seems a lot better now and can eat what he wants again! If you want further info on the MAPs virus i can message you…

[quote]EyeDentist wrote:
VTT, I am a physician. It’s obvious you are concerned about your GF, and frustrated with the inability of multiple physicians to provide a definitive diagnosis and treatment plan. However, I have to tell you that a more-or-less random ‘lab shotgun’ is likely to be a low-yield endeavor. In fact, it may even delay a proper diagnosis by uncovering ‘abnormal’ labs that have nothing to do with her current condition, but end up leading to more tests and/or unnecessary treatments.

(In medicine we sometimes refer to these abnormal-but-clinically-irrelevant findings as ‘incidentalomas.’) It could also turn into a prohibitively expensive venture, as one lab test begets another, and another, etc.

A more productive approach would be to find a physician you feel you can trust, and allow him/her to use the history & physical process to determine an appropriate course of action. If your GF has biopsy-proven Crohn’s dz, I would suggest you turn first to a fellowship-trained GI specialist (a medicine doctor, not a surgeon) when searching for a physician in whom to invest your trust. My best to you and your GF.[/quote]

Awesome reply, thx. That was a large concern, cost of said tests, plus the fact that she cant stand doing blood work

Metametrix GIFX 2100 for stool. Most insurances pick it up for $99. It is the best stool test I have run across clinically. Since digestion is a chemical process of sequencing events, it can be measured. The trouble will be finding a doctor (even a gastroenterologist) that runs a stool test, as most are trained to just look for polyps and cancer and run blood.

I would also recommend a food sensitivities panel to remove any foods that her immune system has tagged as offensive. If the doctor says something stupid like “diet doesn’t matter”, run the other direction because 80% of the immune system is in the gut.

Since she has an autoimmune disease there are certain areas to look for breakdown in physiology. There are the obvious things like vitamin D and essential fats. Nitric oxide isomer expression, glutathione levels, and dampening the immune response are of paramount importance. Since she has IBD, she has a leaky gut - fix that barrier quick. There is a blood/urine test called the Nutreval by Genova diagnostics that shows vitamin/mineral status, AA status, EFA status, urea cycle, kreb cycle, heavy metals, oxidative stress, etc. Insurance can usually pick it up for $169.

Lastly, find a doctor that practices functional medicine. Much better approach than shutting down the immune system with remicade and giving steroids for inflammation.