Brief Answer:
Don't worry about these minor lab derangements.

Detailed Answer:
Dear XXXXXXX
hope you are doing well .

First of all I would like to discuss about your hypertension . As you have mentioned you are diagnosed with hypertension about 8 years back but you have not mentioned about treatment you are taking and what about your blood pressure . Whether it is well controlled or not.Kindly provide me information about that.

Now I would like to inform You that in more than 90 % patients , hypertension has no symptoms and no cause that is its primary . What we need to do is its prevention and if you are correctly diagnosed with it then it's proper management to keep it within normal limit to avoid it's long term complications. For that not only antihypertensive medications but certain life style modifications are equally important such as
1. maintain your BMI less than 25
2. do regular exercise that is 30 minutes brisk walk at least 5 times per week
3. take salt and saturated fat restricted diet .
4. diet rich in fruits and vegetables is good for you.
5. take alcohol in moderation that is less than 2 drink per day.

These measures are very important and each has ability to decrease blood pressure about 5 to 8 mm of hg.
If still your blood pressure is not controlled then antihypertensive is to be taken. Its dose should be slowly increased with regular blood pressure monitoring .
And if you are already on medication then if you follow these life style modifications then dose may need to be decreased.

Now coming to your laboratory reports . Most of the reports are well within normal limit except few. I would like to assure you that these are not very significant in isolation and there is no need to worry about it. These may be because of few drugs or may be because of diet.
If you follow above mentioned life style modifications then these all will be alright in next report.

So be happy, maintain healthy life style, don't worry about these report values .
Hope this will help you. if you have any other concerns please feel free to message me .

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Brief Answer:
follow lifestyle modifications as we discussed

Detailed Answer:
Dear XXXXXXX
As you have mentioned you are taking nebuvolol 5 mg two times a day and your blood pressure is 135/95.its not within normal limit.you need to discuss about this with your physician .Blood pressure less than 120/80 should be our target.
Dear your weight is 98 kg that is more for your height . Maintain your weight less than 72 kg. This will bring your BMI less than 25.
In my opinion you strictly follow life style modifications as we have discussed in previous answer .This will help you in maintainng your blood pressure without giving any additional medicine .
For your pain abdomen and loss of appetite I would like to suggest you that you discus about this with your physician because complete history and proper examination is required to reach the correct diagnosis .
Hope this will help.
If you have any other concerns please feel free to message me.

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Brief Answer:
there is no need to consult endocrinologist .

Detailed Answer:
Dear XXXXXXX
I would like to suggest you that hypercalcemia , slight increase in lipase level ,homocystein level ,sgpt level ..In isolation is not significant .
Please don't worry about any of these reports .
You can manage your homocystein level by taking a vitamin B6 and B12 and by not drinking alcohol if you drink.
you have no symptoms suggestive of hypercalcemia
Isolated increase in lipase and sgpt is not significant. please don't worry about that..
You need to continue with life style modifications as we have discussed with continuation of antihypertensive .
I don't think there is any need of endocrinologist .
Still if you think to visit.its up to your personal satisfaction . Hope this will help dear.
If you have any other concerns please feel free to contact .

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Brief Answer:
There is no need to worry. You can discus.

Detailed Answer:
Dear XXXXXXX
Sorry for delay in reply.
I went through all your investigation reports.
There is no need to worry about any of these.
Few reports are purely laboratory errors such as high potassium level.
Now you yourself can compare in this report your homocystein, liver enzymes etc.all are within limit.
In my opinion don’t worry about all these reports. Just follow life style modifications as we have discussed. Take your antihypertensive.
I don't think there is any need of chest x ray or ultrasound.
Be cool dear and relax.
Hope this will help you.
If you have any other concerns please feel free to message me .

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Brief Answer:
Consult your physician for further evaluation.

Detailed Answer:
Dear XXXXXXX

I can understand your concern .

For your hepatomegaly with grade 1 fatty liver, again I would like to suggest you that it's your life style modifications that are the only treatment. Please go through that and follow that religiously. There is no need to worry.

Get your investigation done after 3 months, with your BMI less than 25 you will find most of things normal.

For your low grade fever morning stiffness of finger and back pain please discuss this with your physician. He will take complete history and do physical examination and can order few more test such CCP, rheumatoid factor and anti CCP if he think so.

Till then you can take simple painkillers such as paracetamol on SOS basis.
Hope this will help you
If you have any other concerns please feel free to contact me.

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