Dr. Vivek S Narayan Pillai
Cardiology
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Patient's Query
Hi doctor,
This is for my husband. On Saturday, he had a master health check-up and a few values are not good. I would like to hear your opinion on those. He is 35 years old. His weight is 158 pounds and height is 5'5". The abnormal values are as follows. Serum globulin 4.2 gm/dl - High (normal range 2-3.5), T4 - 11.46 ug/ml - High (normal 4.6 - 10.5) whereas T3 and TSH are normal, Vitamin D - 9.65 (low), Serum HDL 34.9 mg/dL (low) other triglycerides and LDL values are normal, Vitamin B12 - 144 pg/mL (low) (normal 180 to 914). Also, I attached his ECG where it was mentioned unconfirmed report. Please check and let me know the outcome of the report. He is an athlete who is active in a cycling race, running and swimming. But, he was out of the sport for one year and hence gained weight around 165 pounds from 149 pounds. Now, again he reduced 8 pounds in the last three months. But he is following bad diet plans such as paleo one week, intermittent for the next week, proper balanced normal food for one week. Hence, I am really worried about his health.
Hi,
Welcome to icliniq.com.
I feel his low vitamin B12 levels may be linked to his paleo diet, which can be deficient in legumes, nuts (which are beneficial for the heart). He need not be so fastidious about the diet, I feel and vitamin B12 can be got from dairy products, eggs, fish, and chicken. His low Vitmain D levels are almost very prevalent in Indians, and basically this can be rectified by more outdoor activity, and if need 60,000 units of D-rise once per week for six weeks. His HDL levels are low and although his LDL (bad cholesterol levels) are also low, I would recommend daily exercise (half an hour daily) to boost HDL levels. His isolated High T4 levels, mean you need to check for a thyroid goiter and possibly do a thyroid scan, but it could also be linked to high globulin levels. Isolated high globulins need work up too, possibly disorders of immunity or rare disease like multiple myeloma (possibly consult a hematologist). I hope this helps.
Patient's Query
Thank you doctor,
Please comment on his low HDL and ECG.
Hi,
Welcome back to icliniq.com.
His ECG is normal (attachment removed to protect patient identity). I already mentioned exercise as a method of increasing HDL even Niacin tablets are used, but I have no experience with them.
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Cardiology
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