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Q. Why does my cousin have breathlessness on climbing stairs?

Answered by
Dr. Prathap
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 05, 2017

Hi doctor,

I have a 21 year old cousin, who is 181 cm tall and weighs 120 kg. He has slight breathlessness when he climbs stairs. He does not have any other health complaints and does regular health checkup. Please take a look at the attached test reports and kindly let us know what has to be done.

Dr. Prathap

General Medicine Internal Medicine


Welcome to

I have gone through his reports (attachment removed to protect patient identity) and found the following issues worth mentioning.

  • As his weight is 120 kgs, his BMI (body mass index) is around 37, which comes to severe obesity.
  • In the lipid profile, his HDL (high-density lipoprotein) cholesterol is high for his age.
  • Vitamin D levels are also low, and vitamin D deficiency is usually seen in people who are sparsely exposed to sunlight. His vitamin B12 levels are low, which is seen in pure vegetarians.
  • For vitamin deficiencies, try the following with the consent of your doctor.
  1. Tablet Vitamin D 60k units once a week for eight weeks.
  2. Tablet ME12 (combination of Mecobalamin, Pyridoxine, and Folic acid) once daily in the night for three months.

For further queries consult an internal medicine physician online -->

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Hi doctor,

Thank you for the reply. I have sent you all the details in the blood test report that are higher or lower. Please explain the following: ApoA1 and ApoB, high lipoprotein, high sensitive CRP, vitamin D deficiency, vitamin B12 deficiency, high ferritin level, low folate, low homocysteine, high cholesterol, high triglycerides, high LDL and high uric acid. Also, what is SGOT?

Dr. Prathap

General Medicine Internal Medicine


Welcome back to

  • Apolipoprotein A, B, and C are the carrier molecules for cholesterol in the body. Cholesterol in the body exists in five different forms. ApoB is for LDL (low-density lipoprotein) cholesterol, which is harmful to the body. The changes in the ratio of ApoA and ApoB speaks about the risk of cardiovascular disease.
  • Lipoproteins and hs-CRP (high-sensitivity C-reactive protein) are again cardiovascular risk factors.
  • High homocysteine also increases cardiac risk, but in your cousin's case, it is not so high to bother.
  • So in your cousin's case, there are multiple cardiac risk factors at a very young age, that is why in the previous answer I have suggested weight loss regime and change the sedentary lifestyle.
  • Ferritin is also low, but it is not a big concern, as it can be improved with iron-rich foods like jaggery, green leafy vegetables, etc.
  • I have already suggested medicines for vitamin D and vitamin B12 deficiencies. Please follow that.

For more information consult an internal medicine physician online -->

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