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Q. Can you explain the changes seen in my routine blood test?

Answered by
Dr. Geetha Priyadarsini Kamminana
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 25, 2016 and last reviewed on: Jul 17, 2020

Hello doctor,

I have done my routine checkup and blood test. My reports show some variation in the normal range, especially in CBC, hs-CRP, vitamin D and TSH. The night before the blood test, I met with an accident and my upper skin has been ruptured. Somewhere, I read that hs-CRP may significantly increase if tissues rupture. Around eight to nine months before, my weight was 85 kg and I reduced it to 83 kg now. Is vitamin D deficiency related to that? Because, I am not taking oily foods now. I have done cardio related test seven months back and my doctor found everything fine. But, I always have anxiety about my health.

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#

Hello,

Welcome to icliniq.com.

That was a very impressive and extensive list of investigations (attachment removed to protect patient identity).

  • Why do you feel anxious about having heart disease? Do you have chest pain or palpitations or shortness of breath?
  • Do you have any family history of sudden cardiac arrest or cardiac deaths? Do you smoke or drink more alcohol?
  • Let me tell you, hs-CRP (high-sensitivity C-reactive protein) testing has not been shown to be beneficial for cardiac risk assessment and is not recommended in asymptomatic high-risk individuals. That is, unless you have any of the above symptoms, hs-CRP is not indicated.
  • Yes, hs-CRP is not reliable when done following tissue injury or fever or any evidence of systemic infection.
  • Regarding the thyroid profile, it appears to be normal; except the TSH (thyroid-stimulating hormone), which is elevated just above the normal range. T3 and T4 are normal, which may be due to technical errors. If you want to retest it to rule out, you may redo the test following 12 weeks or 3 months.
  • A diet rich in vitamin D like fish, milk, fortified foods and cheese are to be consumed. Vitamin D is a fat soluble vitamin and hence complete restriction of oily food may also lead to its deficiency. Our goal is to raise it to above 30 ng/mL.
  • I suggest tablet Vitamin D2 Drisdol 50,000 IU once a week for eight weeks, followed by maintenance dose of 800 IU a day and food supplements. Recheck vitamin D levels after eight weeks of initial supplementation.
  • I also suggest tablet Calcium carbonate twice daily, tablet vitamin B12 and Folic acid like tablet Niferex 150 once daily. Consult your specialist doctor, discuss with him or her and take the medicine with consent.

For further doubts consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

Thank you doctor,

I do not have chest pain. I get palpitations some time when I feel anxiety. I never had shortness of breath. There is no family of cardiac arrest or death. I do not smoke. However, I do have alcohol twice a week. I am planning to stop the habit of drinking alcohol completely. As I had panic attacks occasionally, my doctor recommended Alprazolam.

#

Hi,

Welcome back to icliniq.com.

  • As the replies to all my queries are in negative, your risk for cardiovascular disease is low as per Framingham's risk stratification. You may calculate the risk in the calculator that is available online.
  • For that reason, you should neither feel anxious nor experience panic attacks. Stay happy, eat well, work well and be optimistic.
  • Yes, you can take Alprazolam for panic attack.
  • Do follow the treatment for vitamin D deficiency as at this young age, it may lead to bone problems like osteoporosis and many in the future if left untreated. Exposure to sunlight and diet rich in vitamin D are mandatory.

For further doubts consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician


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