Hello doctor,
Hope you are doing fine. May I come back to you with the following query? It relates to my son, who consulted with a medical doctor in our place with the diarrheal syndrome. He suffers from diarrhea after having certain types of meals and also when he drinks a glass of wine or beer. Attached to this message, you will find his recent lab test results. His liver values seem to be disturbed. My question is, what is the analysis and diagnosis on the grounds of these results? What to do next? Many thanks to you for sharing your valued medical expertise and advice.
Hello,
Welcome to icliniq.com.
I read your query and can understand you are worried about your son's health.
I have gone through the reports (attachments removed to protect the patient identity) and found some important things regarding his liver and lipid profile. He has a bad lipid profile. It is bad in the sense that he has to keep an eye on this issue and keep following up with his primary care physician. His bad cholesterol (low-density lipoprotein) is high. Good cholesterol (high-density lipoprotein) is low. The total cholesterol level is also high and needs attention. All of this means it is bad for the heart and blood vessels. The liver is also possibly having some issues with lipid maintenance. His liver enzymes are also raised, and all this adds up to the cause of his symptoms.
Diarrhea related to intake of food and alcohol may be due to liver issues. And this warrants a visit to a gastroenterologist or a hepatologist for proper evaluation and management. He will be able to do a battery of tests on him, including but not limited to hepatitis screening for A, B, C, D, and E, ultrasound of the liver, and, if needed, a biopsy of the liver. In my opinion, this is the next best step for him.
His sodium levels are also high, meaning that he has a fluid and electrolyte imbalance. It is due to prolonged diarrhea. Diarrhea causes loss of vital liquids and salts. He needs Pedialyte (oral electrolyte solution) to replenish body fluids. It is easily available from any pharmacy. He needs to avoid the known allergens, that is, foods that cause immediate diarrhea. If taking beer causes an issue, he also needs to think about it. It is damaging his liver tissues further. Hope it helps.
If you need further assistance, please feel free to ask me. I will be happy to assist.
Hello doctor,
Thank you for your detailed answer and guidance. My son went back to the lab to have a set of blood tests undertaken. I will come back to you when we receive the results.
Hello,
Welcome back to icliniq.com.
- I really appreciate your kind words and hope your son is doing well. Please feel free to upload the results when you get his labs. I would be more than happy to review and discuss the results with you.
Good day and regards.
For further queries consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist
Hello doctor,Thank you for your offer to have a look at the reports. We received them today. Is there something more that can be said about the interpretation of the results, infection, paracetamol use after headaches, and degenerative diseases? And, what else should be done to get a clearer picture of the liver issue?
Hello,
Welcome back to icliniq.com.I can understand your worry about your son's health. I have reviewed the labs. Thanks for putting up the effort to upload the reports to assist me in this case.
- Well, his liver profile is a little better than before, but still out of the range. In this case, it is best is to keep him away from alcohol as this can only add up to the worries by directly damaging the liver cells. We cannot say that the previous liver injury is caused solely by alcohol but this may have contributed to some extent. The avoidance of the foods that cause him to feel sick will help. If alcohol is the sole reason for liver injury, the test results would have a different pattern. Now, we can prevent further injury to the liver by avoidance of the known causes. This will allow the cells to heal up quickly and get better. He is young and his immune system will hopefully combat the disease process.
- His kidneys are doing a perfect job. There is no issue with the kidneys based on their performance.
- Your son has no viral infection from hepatitis B and C viruses. His immune system has the best possible capability to fight against hepatitis B. I hope he is already vaccinated against Hepatitis B. His physician had not felt a need to go for hepatitis A and E screening and this choice varies based on the area where the patient lives. If there is a prevalence of a disease, the physicians go for screening in patients more frequently. The liver biopsy is also something his hepatologist can decide about.
- You may ask what can be the next best step. To get a clearer picture of the liver issue, we have to wait and watch based on the serial liver enzyme studies. Periodic consultation with a hepatologist will be helpful in his regards. Certain medications also lead to liver injury and the result is a raised liver enzyme studies. In such cases, the numbers go back to normal as the liver cells heal up with time.
Hope this helps. Please feel free to ask anytime. I would be more than happy to assist you.
For more information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist
May I come back to Lab test results that I received today and which are supposed to check up my values (Thyroid, Lipids, Proteins, PSA, a.s.o.)
Are the problems as shown in the abnormal test result interlinked: for instance the hypoactivity of the thyroid and the disturbed lipids metabolism?
I would be interested in hearing your medical evaluation of the overall results. Also to see whether I would be well advised to follow a diet (which one specifically), do more physical activity, sports for instance.
what would be my ideal weight: Height 1.76 weight 80.90 kilograms. In 1995 [age 32 years] (according to my records I had a weight of 71,00 kilograms).
Also is the PSA value prone to be checked further, does it show a starting prostate gland problem?
I attach the current Lab Test result report and would pay for the session in the way you propose and guide me through the payment process.
Many thanks for your continued help and support, especially your health advice and guidance.
Best regards,
Marc ZEIMET
Mobile Phone: +352 621 677714
I would like to discuss every aspect of the labs you uploaded especially the most important and out of range findings:-
1.Folic Acid= Low. {Note: Folic acid is important for blood functions and also keeps the blood cells in limits. If levels are low it can be treated by giving supplemental Folate. Your Physician can assist you further in dosage and prescription for that}.
2.Creatinine= Normal but in higher normal limits. {Note: Creatinine levels in blood reflect functioning of the kidneys. Kidneys are responsible for clearing this waste material from the blood and keep a balance of it. If kidneys are not working normal, the creatinine levels go considerably high. Your levels are not that high. The best next step is to keep a follow up and see how the levels go in future. At this stage, nothing much to do for it}.
3. HDL (Good Cholesterol)= A little low. {Note: Taking low fat diet, regular exercise and a healthy lifestyle with least to no junk foods would help you take these levels in normal required range}.
4. LDL(Bad Cholesterol)= A little high. {Note: Taking low fat diet, regular exercise and a healthy lifestyle with least to no junk foods would help you take these levels in normal required range}.
5. Total Bilirubin= In higher normal limits. {Note: Doesn't look serious this time but in future I would recommend to keep a follow up with your Physician so that he keeps an eye on the levels and to see how it goes. Bilirubin is a product handled and cleared from blood by liver. Liver keeps bilirubin in normal limits in human blood. If liver isn't working perfect the levels increase. I can see you are negative for hepatitis C meaning you don't have hepatitis C. Alcohol consumption and certain medications can also raise the levels. Again you need to keep an eye on these levels in future follow ups}.
6. Alpha-2-globulin(a protein)= In lower normal limits. {Note: This is a protein produced by the liver and in case of any issues with liver functioning, the levels of proteins produced by liver may decrease. Fatty liver, alcohol consumption or certain medications that interfere with liver functions may cause lowering the alpha-2-globulin levels}.
7. TSH (Thyroid gland functioning test)= A little high. {Note: If your thyroid isn't functioning optimally and as needed more and more TSH is released from the pituitary gland. In simple words, hypothyroid gland may be the reason behind high TSH levels. Your treating Physician may refer you to an Endocrinologist if he feels it appropriate. Please discuss the matter with your Physician}.
8. PSA (Total)= A little high. {Note: Not always the cancer can raise PSA levels, benign causes can also be the reason for high PSA levels e.g. Inflammation of prostate, enlargement of prostate etc. Your Physician can better assist you in this regard in the light of all of your medical records related to prostate}.
The liver issues especially high levels of liver enzymes isn't a new issue here. I can see in our past conversations, you have this issue lingering on from the past. You should consult a Hepatologist for this issue for proper evaluation of the reason behind high liver enzymes.
Your specific questions and explanations to them:
1.Are the problems as shown in the abnormal test result interlinked: for instance the hypo-activity of the thyroid and the disturbed lipids metabolism??
Answer: Not at large interlinked. But constantly low thyroid function definitely leads to lowering all the metabolic functions of the body including lipid metabolism.
2. I would be interested in hearing your medical evaluation of the overall results. Also to see whether I would be well advised to follow a diet (which one specifically), do more physical activity, sports for instance?
Ans; You definitely need to go for a schedule of exercise and physical activity. At least 5 days a week, light to medium levels of exercises are very important for you. I have already detailed relevant information.
3. What would be my ideal weight: Height 1.76 weight 80.90 kilograms. In 1995 [age 32 years] (according to my records I had a weight of 71,00 kilograms).
Answer: Please visit this link and put in your details to compute your BMI. Keep this link saved use it in future too to see how you doing. https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
Hope it helps. Wish you best of the times ahead. Feel free to contact back if you need further assistance.
Regards!
Investigations to be done:
Liver ultrasound and a Hepatologist consultation.
Thyroid workup by an Endocrinologist
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