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High BP, Over Weight, Altered Liver Enzyme, Take Sugar Drinks, And Urinates Often. What Tests To Take?

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Posted on Sat, 29 Jun 2013
Question: Yes. What lab tests does my husband need as a 49 yo male with high blood pressure, over weight, his liver enzyme were off last year, & drinks lots of sugar drinks, he has episodes where he urinates often?
doctor
Answered by Dr. Sadiq Mughal (2 hours later)
Hello,

Thanks for writing to us.

Your husband is 49 years old, hypertensive (having increased blood pressure), overweight, with altered liver enzyme a year ago and presently having increased frequency of micturation.

Any one at this age needs some basic investigation to rule out any treatable problems he/she might be having. This is the part of preventive health care system.

Since your husband is hypertensive, over weight with increased frequency of micturation,he needs some additional investigations also.

The Basic investigations he needs are as under:
CBC,that is complete blood count.
Blood sugar fasting.
Lipid profile.
Chest X-Ray
ECG.

Since he has history of altered liver enzyme, with increased frequency of micturation, additionally he needs;
LFT,that is liver function test and ultra sound abdomen.
Ultra sound will determine whether increased frequency of micturation is due to enlarged prostate or due to some other cause like increased blood sugar levels. Fasting blood sugar will also confirm or rule out increased blood sugar as a cause for his increased frequency of micturation.

Hope this answers your question.
Let me know if you have any more queries regarding your husband.

Take care.
Regards.
Dr Sadiq

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Sadiq Mughal (4 hours later)
Thank you for the quick response. I'm not sure micturition describes his urination issues. I've worried about his prostrate because when he urinates it is small amounts & stops & starts then he needs to go again 30 min later like he never emptied his bladder. Would he benefit from a PST? Would that indicate if the prostrate is swelling & interrupting the urination?

Also, his Mother is a diabetic...wouldn't an A1c hemoglobin show better his blood sugar status over the last 3 months?
Also, we live in Spokane, WA - Shouldn't the vitamin D level be tested as well?

Thanks for any additional information you can provide us!
doctor
Answered by Dr. Sadiq Mughal (2 hours later)
Thanks for your follow up.

Urination issues could be related to benign hyperplasia of prostate (BPH) and ultrasound is best way to diagnose BPH. Ultrasound will also reveal the weight of prostrate, identify the affected lobe and the amount of residual urine left behind in the bladder after emptying. It will also identify if the prostate is hypertrophied due to the enlarged prostate obstruction.

PSA (prostate specific antigen) test is used to diagnose cancer of prostate. It is not much of relevance to confirm increase in prostate size or obstruction is due to prostate. Moreover a single rise in PSA level is not clinically significant. It is the serial monitering of PSA level which is important.

Yes HbA1C is better way of monitoring blood glucose level over the past three months.

Vitamin D deficiency is not so common and its levels are not measured as routine; unless there is some specific indication for that. However there is no harm in getting the test done along with other tests.

Hope this answers your question. Let me know if you need clarifications.
If all your queries are answered, please close this discussion and review.

Regards
Dr Sadiq.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sadiq Mughal (3 days later)
Thank you!

I do wish it was routine for people over a certain age to have their Vitamin D checked...in our area of Spokane everyone I know that has been tested has been low & many drastically low & its amazing how much better they feel once they get that level to normal consistently. Which in many cases has taken clinical strength vitamin D with Vit. K2. The Pharmacist who has a PH D in the area that started me on the clinical strength: prior to this my level would only to 32 at the end of summer with taking 3000iu/day all year long & my D level in XXXXXXX was 8! Now my level is 75 & my whole body functions better. The PHD said "that of 1000 patients who he had tested only 2 were not low.

I have read a lot of great research behind this ie. from Mayo Clinic, Tufts Univ., & Stanford. So my question is why are physicians not doing Vit D testing more routinely especially in areas about the 45th parallel (? one study said about Salt Lake City but I'm not sure if I have the correct parallel) Anyway, am disappointed to see that important basic needs thousands of people are not be met because Vit D testing is not routine. I hope Doctors like yourself have the ability to change this one person at a time! Have a great day!
doctor
Answered by Dr. Sadiq Mughal (13 hours later)
Hello XXXXXX
Thanks for your feed back. We at XXXXXXX appreciate that. There are certain diseases are or deficiencies which are common in certain geographic area and not heard of in other part of world. So physicians practicing in a particular region do have this information and test keeping in mind the common diseases in that particular area guided by the symptoms of patient. For example here in our region we know that the whole northern Himalayan belt (a part of south Asia) has iodine deficiency leading to hypothyroidism and testing for TSH that is thyroid stimulating hormone is routine in this region ,which is not practiced in your region that is North XXXXXXX
It is said that most of the western populations are not exposed to sunlight which is essential to form Vit D in the body (nothing else helps). Every one has to stay under the sun for 40 minutes in a week to get the required prepared. The doctors there should be aware of this and test. XXXXXXX is second most searched medical site and you have put this feedback on the site. Physician and people will read it and will educate themselves; this is what called as continuous medical education.
Hope physicians will take this feed back into consideration while writing investigations to their patients. Thanks for sharing your knowledge.
Hope this answers your question.
Take care.
Best regards
Dr Sadiq.
Note: For further follow up on related General & Family Physician Click here.

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

Critical Care Specialist

Practicing since :1992

Answered : 1661 Questions

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High BP, Over Weight, Altered Liver Enzyme, Take Sugar Drinks, And Urinates Often. What Tests To Take?

Hello,

Thanks for writing to us.

Your husband is 49 years old, hypertensive (having increased blood pressure), overweight, with altered liver enzyme a year ago and presently having increased frequency of micturation.

Any one at this age needs some basic investigation to rule out any treatable problems he/she might be having. This is the part of preventive health care system.

Since your husband is hypertensive, over weight with increased frequency of micturation,he needs some additional investigations also.

The Basic investigations he needs are as under:
CBC,that is complete blood count.
Blood sugar fasting.
Lipid profile.
Chest X-Ray
ECG.

Since he has history of altered liver enzyme, with increased frequency of micturation, additionally he needs;
LFT,that is liver function test and ultra sound abdomen.
Ultra sound will determine whether increased frequency of micturation is due to enlarged prostate or due to some other cause like increased blood sugar levels. Fasting blood sugar will also confirm or rule out increased blood sugar as a cause for his increased frequency of micturation.

Hope this answers your question.
Let me know if you have any more queries regarding your husband.

Take care.
Regards.
Dr Sadiq