Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully passed through your question and reviewed all your uploaded test reports and would explain as follows:

- Your cardiac ultrasound, resting ECG and cardiac stress test reports show a normal cardiac function and structure. From the other hand they have excluded the presence of coronary artery disease. So, you can perform as physical activity as you wish, because there are is nothing to worry about your heart. It is perfectly normal.

- Your liver fibroscan coupled with your abdominal ultrasound reveal a fatty liver with some degree of fibrosis. These changes have happened for a long time (they are chronic). But your actual liver function tests have resulted normal, which means that they are just some old changes and there is no active damage of the liver cells now. Chronic fatty liver can lead to fibrosis. I would just recommend trying to lose some pounds in order to avoid the progression of such liver changes. Anyway, they are not concerning.

- Your blood lipid profile is quite normal. Although your total cholesterol levels are a little elevated, the ration Total Cholesterol/HDL is within the normal limits for your age and gender. So, you are not at an increased cardio-vascular risk. I would recommend continue taking Crestor 5mg, if no contraindications. You can even stop it, according to this blood lipid profile, and repeat your blood lipid profile after 1 month. Some diet modifications (avoid sugar and fat, increase food rich in omega 3 fatty acids) would also be helpful to reduce cholesterol levels naturally.

- Your thyroid function tests are quite normal.

- Regarding alcohol, I would not recommend taking it, because it can exacerbate fatty liver and also liver cell damage. But a glass of wine once per day is not a problem.

-Regarding low blood pressure after eating, I would explain that this is called post-prandial hypotension, and is an exaggerated physiological response of your autonomic nervous system. I would advise you to avoid large meals and try to eat in small portions. Hypercaloric food can also trigger this situation.

Reducing the dose of Concor will help too. If the problem persists, I would recommend perfoming a Head Up Tilt test to exclude possible orthostatic intolerance, which is closely related to post-prandial hypotension.

Hope you will find this answer helpful!

I remain at your disposal if you have any other questions!

Kind regards,

Dr. Iliri

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Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again,

I would explain that, as far as you haven't any confirmed coronary artery or cerebrovascular diseases, Aspirin is not considered a necessity and it would not yield any obvious beneficial effect (several studies have confirmed that).

Nevertheless, if Aspirin is used, in general a daily fashion is the usual strategy.

So, you may use Aspirin 75 mg/day (even for its other beneficial affects) without being worried by the fear of any adverse interactions with Crestor. They may be taken together at nigh after food.

The most important issue to consider in your actual clinical conditions is to lose body weight and follow all the above mentioned tips, in order to stop liver steatosis (fatty liver) progression and stay in a healthy status.

In case of any further uncertainties, do not hesitate to ask me again!

Regards,

Dr. Iliri

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Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

Yes, it is true that Crestor can cause an increase in liver enzymes as an adverse effect.

From the other hand it is known that it can trigger a new onset Diabetes in up to 3% of the cases as a possible adverse effect.

But these adverse effects are usually expressed when it is used in high doses for a long time (which is not your case).

I recommend checking your liver enzymes and fasting glucose every 2 months to exclude these possible adverse effects.

You can also stop taking Crestor for a month, make some diet modifications (like above recommended) coupled with a lot of physical activity and monitor your blood lipid profile after a month, to determine if it is really necessary to be taken.

Regarding Aspirin, I would explain that it can increase liver enzymes and also trigger liver toxicity as a possible adverse effect. Even with aspirin these adverse effects usually occur when used in high doses. It is an acid and can trigger gastritis, bleeding and IBS. But as I explained it is not really necessary in your case taking aspirin. So, you can choose not to take it.

Hope you will find this answers helpful!

Wishing all the best,

Dr. Iliri

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