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What Does The Following Lab Report Indicate?

Posted on Wed, 11 Feb 2015

Question: I recently got my health profile done and in report few issues were highlighted. need to get consultation from physician to get advice on next step, medication, precautions etc.

Lab Report issues reported
HDL CHOLESTEROL - DIRECT 31 (range 35-80)
TC/ HDL CHOLESTEROL RATIO 5.4 (range 3-5)
BILIRUBIN - TOTAL 1.4 (range 0.30-1.20)
BILIRUBIN -DIRECT 0.52 (range 0-0.20)
ASPARTATE AMINOTRANSFERASE (SGOT) 42.8 (Range 0-37)
ALANINE TRANSAMINASE (SGPT) 10.9.8 (Range 13-40)

Please let me know if additonal information is required which can help in providing consultation.

Answered by Dr. Bhagyalaxmi Nalaparaju (2 hours later)

Brief Answer:
Suggestions below

Detailed Answer:
Hello XXXXXXX

I have gone through you reports.

Your HDL (Good cholesterol) is low but it is not big concern it is reversible with diet and physical exercises.
And TC/HDL ratio is altered due to low HDL.
Your triglycerides and VLDL are within normal limits but higher on side.
I suggest you avoid fatty food and eat healthy food like fruits, vegetables and omega 3 fatty acids contains food like nuts and fish.

Brisk walk for 30 minutes daily.

Liver enzymes are altered (increased): It can be due to altered cholesterol levels and can cause fatty liver.

But along with that your bilirubin levels also slightly increased. Values can be varied from one lab to other lab. Total bilirubin Up to 1.9 mg/dl can be considered as normal.
I would like to know do you have any symptoms like discoloration of skin or eyes?
Have ever done ultrasound scan?

If you have any queries I will be happy to help you.

Thank you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Bhagyalaxmi Nalaparaju (4 hours later)

Thanks doctor for your advice. Please find details and follow-up questions.

1. Do i need to avoid all the non-veg food or any specific non-veg food in order to avoid fatty food?
2. Will Seven Seas cod liver oil help in providing omega 3 fatty acid or i need to specifically target fish for that?
3. I don't have any discolouration of skin
4. I haven't got ultrasound done in last 3 year
5. In 2011 after my last health check-up, SGPT and SGOT were high at that time also, I did visited liver specialist and i was prescribed few medicine done with advice. I am attaching prescription and report for reference.

Please let me know if i need to repeat any medication from last prescription and if any other precautions or avoidance needs to be done to take care of current issues highlighted in medical report

Answered by Dr. Bhagyalaxmi Nalaparaju (11 hours later)

Brief Answer:
Avoid red meat

Detailed Answer:
Hello XXXXXXX

Thanks for your detailed information.
I have seen your previous reports.

Yes, I can see that increased levels of SGOT and SGPT.
Your doctor prescribed Udiliv and antioxidants for liver.
I also noticed that glycomet 500 mg, I would like to know do you have history of Diabetes, if yes, diabetes itself can cause fatty liver.

You can eat fish such as salomon and meckrel.
Along with fish you should eat nuts like walnuts, flax seeds and green vegetables.
Avoid red meet and restrict chicken.

You should do brisk walk other physical exercises for 30-45 minutes daily.

Liv 52 syrup from Himalaya will help you.

If you have any queries I will be happy to help you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Bhagyalaxmi Nalaparaju (9 minutes later)

My family has history of diabetes, my father has diabetes. I don't have diabetes as of now. I did got my fasting sugar checked and it was in normal range (report attached previously)

Apart from food restriction, i am summarizing medications below
1. Liv 52 from himalya
2. Udiliv 600 mg 2times a day for 3 weeks
3. Antoxid one times a day after lunch for 3 weeks

Please let me know if i need to add new medications or change frequency or duration?

Answered by Dr. Bhagyalaxmi Nalaparaju (37 minutes later)

Brief Answer:
Suggestions below

Detailed Answer:
Hello XXXXXXX

You can take Udiliv 300 mg twice a day.

Liv 52 twice a day and anti oxidant once a day.

Since these are prescribed medication you can ask you physician for prescription and discuss about dosage as well.

And repeat the test after one month and if you see still abnormal then I suggest you get ultrasound scan to rule out possibilities like bile stones.

Avoid fatty food.
Eat fresh fruits and vegetables like salad.

If you have any queries I will be happy to help you.

Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Bhagyalaxmi Nalaparaju (14 minutes later)

What all test i need to repeat after one month?

Answered by Dr. Bhagyalaxmi Nalaparaju (1 hour later)

Brief Answer:
Repeat LFT

Detailed Answer:
Hello XXXXXXX

Repeat liver and lipid profile.

If you have any queries I will be happy to help you.

Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Bhagyalaxmi Nalaparaju (4 hours later)

Will Seven Seas cod liver oil help in my case?

Answered by Dr. Bhagyalaxmi Nalaparaju (26 hours later)

Brief Answer:
Yes, it can help.

Detailed Answer:
Hello XXXXXXX

Yes, seven seas cod liver oil capsules contain omega 3 fatty acids, Vitamin A, D and E. Omega 3 fatty acid would help in reducing inflammation. It can be taken once in a day.

If you have any queries I will be happy to help you.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Bhagyalaxmi Nalaparaju (3 days later)

I started taking udiliv 600 mg twice a day from yesterday night, today i am feeling stiffness in stomach with lot of gas generation and burps. I am unable to visit doctor personally in next few days.

last time i has same problem in 2011, doctor prescribed me glycomet 500 mg along with udiliv 600 mg twice a day. Would glycomet would help in reducing side affect of udiliv? Please advice

Answered by Dr. Bhagyalaxmi Nalaparaju (11 hours later)

Brief Answer:
Stop udiliv

Detailed Answer:
Hello XXXXXXX

I suggest you visit an internal medicine specialist doctor (MD).

I already told you in earlier answer to consult a doctor to adjust dosage, doctor may decrease dosage. And you need to take this medication after clinical examination by doctor. Then doctor can tell how much dosage you need.

I suggest you do not take medications until you visit a doctor.

You can continue Liv 52.

I suggest you Omeprazole or pantoprazole once a day 30 minutes before breakfast for burps and gas.

Gylcomet 500mg is also prescribed medication and should take after consulting doctor since it can decrease your blood sugar levels in body and tends lead to hypogylcemic episode.

Do not take any medications on your own since these are prescribed medication that means should be taken after consulting doctor.

If you have any queries I will be happy to help you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Bhagyalaxmi Nalaparaju (1 hour later)

Thanks Doctor for the answer. I would stop medication and consult doctor over coming weekend.

For doctor should i see a liver specialist i.e. Gastroenterologist or Internal medicine specialist? Please confirm

Answered by Dr. Bhagyalaxmi Nalaparaju (48 minutes later)

Brief Answer:
Any doctor

Detailed Answer:
Hello XXXXXXX

Since your bilirubin level not significantly increased and you do not have any symptoms you can consult an Internal specialist doctor.

If you want and if you get appointment with gatroenterologist at earliest you can visit otherwise you can consult internal medicine specialist.

If you have any queries I will be happy to help you.

Thank you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar