Raised MCH & ALT

[Eve]

Just a curiosity question, look out, Jenna has been googling!

Both are raised, not worryingly so I don't think but marked as abnormal and have an OH next to them (got a print out as forgot my methotrexate bloods records book).

From being nosy on both I've seen stuff to do with folic acid come up in googling, but not good with the more scientific stuff, so could it be from the methotrexate, hence why I'm on folic acid with it?

Am making an effort to learn what the results in my bloods book mean :)

[Sqad]

In simple terms.......

MCH is the amount of haemoglobin in the red cells.

ALT is a liver enzyme which "resides" inside liver cells.

Methotrexate "may" be the cause of the abnormal results, but unlikely as you have only been taking it for a short period of time.

This is not a comprehensive resume.

[LazyGun]

Methotrexate is a "folate antagonist" since it acts on an enzyme called dihydrofolate reductase, a pathway enzyme necessary in the folic acid pathway. Hence they prescribe a folic acid supplement to counteract this.

As Sqad has pointed out, MCH is a measure of the haemoglobin contained within a red cell, but does not really convey much information on its own other indicators, like MCHC and most importantly, MCV and Hb are important here to assess the relevance of a raised MCH.

From a functional perspective, they will be monitoring WBC/Neutrophils levels and platelet levels principally.

ALT is an enzyme synthesised within the Liver. Methotrexate can potentially harm some liver cells, so ALT is a way of monitoring that. For a result to be clinically significant, it would be a significant rise, maybe a 2fold rise from normal.

[Eve]

Thanks both, interesting.

Everything else was in normal range (:)) save ESR but nothing new (or unexpected) there.

Praying nothing interferes with taking the methotrexate, just over 4 weeks now and no nasty side effects so far, despite being upped on dose quicker than they were planning, and really need to get settled on something as getting stiffer and stiffer and having quite a few movement related issues and my hips and shoulders are being evil with knees close behind. My hands are a lot better than usual though and I have a lot more energy :)