Dr. Divakara. P
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am 41 years old. I am suffering from hypothyroidism and for which I am taking Thyroxine 175 mcg daily. My height is 5 feet and 10 inches, and my current weight is 279 lbs. Two years ago, I had a sleeve gastrectomy and lost only 44 lbs. The surgeon now advised me to get gastric bypass surgery. But I am not comfortable with that. I have attached my recent testosterone report. I feel as if I have low testosterone. How to increase my testosterone levels? I have a history of nasopharynx non-Hodgkin's lymphoma, which was treated successfully by radiation.
Hi,
Welcome to icliniq.com.
I went through your query and the reports (attachment removed to protect identity). Your testosterone level is normal. Though on the lower side of the normal range, nothing needs to be done to increase testosterone. There are medications to increase testosterone levels, but it is not required in your case. You can try some natural methods like aerobic exercise, eating more citrus fruits, eating more onion and garlic, and wearing loose undergarments. While going through your reports, I noticed that your insulin levels and C-peptide levels are elevated. This suggests that you have insulin resistance which may lead to diabetes. So, kindly start doing aerobic exercise, which will reduce insulin resistance.
Patient's Query
Hi doctor,
Thank you for your response. Since the past six months, my weight has neither increased nor stagnant. My appetite is reduced due to bariatric surgery. I go to the gym at least five times a week for about an hour and religiously use the cross trainer, particularly for about 45 minutes at a stretch. It is only the past two weeks that I have been away from the gym due to constant headaches, body aches, and some infections as the WBC count is high. Is it fine to get second bariatric surgery again?
Hi,
Welcome back to icliniq.com.
Well, I sincerely believe there is no need to repeat bariatric surgery. But, it would help if you increased your exercise intensity more. I need to know your daily calorie intake and the kind of food you eat. I hope you have consulted a dietitian for a low-calorie diet, and if not, kindly do it. Wait for a few more months, increase your intake of fruits and vegetables, and reduce the intake of non-vegetarian food, cheese, butter, sweets, and carbonated drinks. Despite a good diet and more physical exercise, you gain weight. Consider bariatric surgery if you maintain the same weight or lose a little. There is no need for surgery but continue the diet and exercise.
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Internal Medicine
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