Hi, @skjones. When I read your message of June 28, you were having concerns about your rising and lowering tacrolimus levels. And, I will add that I can understand because I do the same thing whenever anything is not "my normal" in any of my labs. I have recently remembered a conversation on Connect where members shared that they had noticed a change in tacrolimus levels when the pharmacy switched to a different supplier. I also remembered that I had received a notice, once from the Mayo Specialty Pharmacy (where I get my medications) when they switched. I don't recall that my level was affected for that, but it might be comething for you to consider.

Is it possible for you to contact your pharmacy and check your prescription/manufacturer history?
How are you feeling? Have you, or will you be seeing your nephrologist soon?