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Hello Doctor, Please Let Me Know If I Have Any
Question: Hello Doctor, Please let me know if I have any major problem by looking at report. My triglycerides value is 300. Do I have cholesterol? Am I at risk? What should I do?. Also my gamma globulin and beta globulin also bit high than normal range. Am I at any risk as I have morning stiffness and pain in my fingers early morning every day for 15 to 25 min. Thanks in advance.
Brief Answer:
See detalied answer please
Detailed Answer:
Hi and Welcome to Ask A Doctor service. I have read your question and here is my advice.
Yes your labs show raised triglyceride and little raised gammaglobulin.To be very honest , nothing sounds very serious as most of the labs are normal but let me explain them little .
The raised TG is a risk factor for heart disease and stroke however alone it uncommonly cause any probelm and it is quite manageable. It only causes great concern if there is other risk factor like diabetes , hypertension , obesity , or family history of heart disease .Still there are drugs that can lower it quite effectively .Don't get panic for it.Yes you shoud focus on diet ( more fbers and vegetables , less sweets ) and some excercise. your doctor may also give you drug for it.
Regrading th raised gammaglobulin ,there are a number of causes like infections or auto immune diseases .This is important if you have other symptoms like fever, weight loss , or joint pain or swelling , or low HB .Your doctor may need to assess you in details .In the absence of any symtpoms , it does not seems to be any serious.I would advise you sould repeat it in month time.But if you have symtpoms as above then you sould discuss it with your doctor .
The joint pain and little sttifness may be due to vitamin d deficiency as shown in your test .I would advise you sould take some vit D and calsium for it.A normal ESR make any serious disease unlikely
Hops I have read your question .Please feel free to ask anything else you need to know. kind Regards Dr Rahman.
See detalied answer please
Detailed Answer:
Hi and Welcome to Ask A Doctor service. I have read your question and here is my advice.
Yes your labs show raised triglyceride and little raised gammaglobulin.To be very honest , nothing sounds very serious as most of the labs are normal but let me explain them little .
The raised TG is a risk factor for heart disease and stroke however alone it uncommonly cause any probelm and it is quite manageable. It only causes great concern if there is other risk factor like diabetes , hypertension , obesity , or family history of heart disease .Still there are drugs that can lower it quite effectively .Don't get panic for it.Yes you shoud focus on diet ( more fbers and vegetables , less sweets ) and some excercise. your doctor may also give you drug for it.
Regrading th raised gammaglobulin ,there are a number of causes like infections or auto immune diseases .This is important if you have other symptoms like fever, weight loss , or joint pain or swelling , or low HB .Your doctor may need to assess you in details .In the absence of any symtpoms , it does not seems to be any serious.I would advise you sould repeat it in month time.But if you have symtpoms as above then you sould discuss it with your doctor .
The joint pain and little sttifness may be due to vitamin d deficiency as shown in your test .I would advise you sould take some vit D and calsium for it.A normal ESR make any serious disease unlikely
Hops I have read your question .Please feel free to ask anything else you need to know. kind Regards Dr Rahman.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you so much doctor. My doctor has prescribed Folitrax 15 mg and Folvite 5mg weekly once. Can I take this? Folitrax is immunosuppressant. Will my immune system go down and I may be prone to infections and may not recover faster? I am scared to take immune supression medicine. Please share your thoughts and will these medicine screw up my immune system?. Thanks in advance for ur response and help.
Brief Answer:
Please see detalied answer
Detailed Answer:
Hi .
Yes you are right that folitrax is immunosuppressive however it is only used if it's benefits clearly overweight it risks.
If you could kindly tell us why your doctor precribe this?
We commonly use this medicine for joint diseases called Rheumatoid arthritis. If used judiciously ,it has been found to be quite safe .
Still we generally test people every few months to chek for any serious side effects of this drug which are not common. If we find any , we can always switch it off and the side effects are revirsible.
So if truly needed , its not something of great worries but we shoud keep an eye for side effects by doing some blood tests. You dr will tel you about that.
Hopes it's clear. Please don't hesitate to ask anything else you need to know.
Please see detalied answer
Detailed Answer:
Hi .
Yes you are right that folitrax is immunosuppressive however it is only used if it's benefits clearly overweight it risks.
If you could kindly tell us why your doctor precribe this?
We commonly use this medicine for joint diseases called Rheumatoid arthritis. If used judiciously ,it has been found to be quite safe .
Still we generally test people every few months to chek for any serious side effects of this drug which are not common. If we find any , we can always switch it off and the side effects are revirsible.
So if truly needed , its not something of great worries but we shoud keep an eye for side effects by doing some blood tests. You dr will tel you about that.
Hopes it's clear. Please don't hesitate to ask anything else you need to know.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you so much doctor for your response. My Dr has suspected that I might have rheumatoid arthritis (Sero negative rheumatoid arthritis ) since I have pain and stiffness in my fingers for more than couple of weeks now constantly as soon as I wake up for 30 mins. Also by analysing the reports which I shared with u related to beta and gamma globulin though it has elevated slightly only. So, chances it might flare up if treatment not started now and it might increase down the line in 6months or more anytime. He also asked me to get the tests done to see if I get side effects and the value for beta and gamma globulin. Now, my worry is if it is really rheumatoid arthritis or is it any low grade fever infection or viral infection or viral arthritis which can be treated by antibiotics instead of altering immune system. Pain exactly starts as soon as I open up my eyes. I find it stiffness in my hands and difficulty to form fist or close. Then after multiple retries or putting hands in warm water I am able to. I don't have any other symptoms. That's why I have these questions in my mind. I can take up medicine and I have started this Saturday. But only concern is later if it unable to fight any other infectious diseases after taking up these medicines. BIg THANKS for responding in details and making me understand very well.
Brief Answer:
Please see detalis below
Detailed Answer:
Hi and thanks for providing the good details.
Your concern is very right , as we shoud rule out infection first .
Howe'ver this more depends on your symtpoms .Of course viral nifection can cause joint pain .But the way you said , that small joints of hands , both hands involvment and stiffness in morning quite suggestive of Rheumatoid arthritis. Let me accept that's it's very difficult for me to exactly say it without proper examinationand history , but I assume your Dr is probably quite right as things more favour rheumatoid arthritis then any viral or bacterial Infection.
Yes one more factor to focus is duration of symtpoms , if duration of joint pains are long like more then few months then it also favour RA.However nothing is final and thier is a criteria for diagnosing RA .I would also suggest to get few more specific tests for RA like Anti CCP , also to get CRP .
you can discuss this with your Dr but at the moment don't worry a lot it looks less likely to be any infection. Even of its not RA , we can always come back and it's never too late .
Hopes it's clear now.
please dont hesitate to ask anything else you need to know.
Regards
Please see detalis below
Detailed Answer:
Hi and thanks for providing the good details.
Your concern is very right , as we shoud rule out infection first .
Howe'ver this more depends on your symtpoms .Of course viral nifection can cause joint pain .But the way you said , that small joints of hands , both hands involvment and stiffness in morning quite suggestive of Rheumatoid arthritis. Let me accept that's it's very difficult for me to exactly say it without proper examinationand history , but I assume your Dr is probably quite right as things more favour rheumatoid arthritis then any viral or bacterial Infection.
Yes one more factor to focus is duration of symtpoms , if duration of joint pains are long like more then few months then it also favour RA.However nothing is final and thier is a criteria for diagnosing RA .I would also suggest to get few more specific tests for RA like Anti CCP , also to get CRP .
you can discuss this with your Dr but at the moment don't worry a lot it looks less likely to be any infection. Even of its not RA , we can always come back and it's never too late .
Hopes it's clear now.
please dont hesitate to ask anything else you need to know.
Regards
Above answer was peer-reviewed by :
Dr. Remy Koshy
Brief Answer:
Please see detalis
Detailed Answer:
thanks for sharing the results .
Yes all you tests are normal .
The normal CRP and Normal ESR is quite reassuring .These points against any organic disease like viral infection or bacterial infection ( though it's still possible but less likely ) .
Similarly all these tests being normal make RA quite unlikely .
So yes it puts some doubts about it being RA.But it is still possible .
If your hand joints get swollen, or red , or very painful in the morning and stiff for more then an hour ( you said your joints are stiff for about half hour) then it looks like RA otherwise it may be related to your vit d deficiency.
What I personally think , I would have waited a month or two before starting methotrexate and repeated tests again .You can talk to your doctor and discuss this .
Another good idea would be to get an appointment with a Rheumatologist, this would be the best thing we shoud do .
But your normal CRP and XXXXXXX ESR Makes any thing serious very least likely you shoud not be panicking.
Hopes you get my point. Feel free to ask .
Please see detalis
Detailed Answer:
thanks for sharing the results .
Yes all you tests are normal .
The normal CRP and Normal ESR is quite reassuring .These points against any organic disease like viral infection or bacterial infection ( though it's still possible but less likely ) .
Similarly all these tests being normal make RA quite unlikely .
So yes it puts some doubts about it being RA.But it is still possible .
If your hand joints get swollen, or red , or very painful in the morning and stiff for more then an hour ( you said your joints are stiff for about half hour) then it looks like RA otherwise it may be related to your vit d deficiency.
What I personally think , I would have waited a month or two before starting methotrexate and repeated tests again .You can talk to your doctor and discuss this .
Another good idea would be to get an appointment with a Rheumatologist, this would be the best thing we shoud do .
But your normal CRP and XXXXXXX ESR Makes any thing serious very least likely you shoud not be panicking.
Hopes you get my point. Feel free to ask .
Above answer was peer-reviewed by :
Dr. Remy Koshy
Thanks a lot doctor. I am consulting a rheumatologist only. He only prescribed this medicine. Also, I do have severe pain and stiffness every day for past 2 weeks for half an hour. May be that's why he concluded that I might have sero negative rheumatoid arthritis beginning stage. Even I was confused when reports all normal why do I have stiffness. I used to have vitamin d as 4 also but I never had any problem. where as now I have vitamin d 22. That's the reason confused about all these. Should I go for any other immune related tests?..Thanks
Brief Answer:
No need of other tests
Detailed Answer:
Hi .
Yes if a rheumatologist think that this may be RA then Its very likely to be RA as RA is best diagnosed by examination and history; yours symtpoms are quite suggestive of RA .Sometimes tests can be normal.
There is no need to do any other immunallogic tests .
The raised gamma globulin and b2 glubulin can aslo be explained by RA so I don't think you need any other tests .
And don't worry as RA is quite mangeable disease.
Good luck .
No need of other tests
Detailed Answer:
Hi .
Yes if a rheumatologist think that this may be RA then Its very likely to be RA as RA is best diagnosed by examination and history; yours symtpoms are quite suggestive of RA .Sometimes tests can be normal.
There is no need to do any other immunallogic tests .
The raised gamma globulin and b2 glubulin can aslo be explained by RA so I don't think you need any other tests .
And don't worry as RA is quite mangeable disease.
Good luck .
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you so much doctor.
Brief Answer:
My Pleasure
Detailed Answer:
This gives me great pleasure if I could help you somehow.
thank you .
Stay blessed.
My Pleasure
Detailed Answer:
This gives me great pleasure if I could help you somehow.
thank you .
Stay blessed.
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Above answer was peer-reviewed by :
Dr. Kampana
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