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What Do My Lab Test Results Indicate?

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Posted on Sat, 1 Oct 2016
Question: Doctor Sood Sir,
I am wating for your medicines "'sit & burn FAAT''. As in earlier mail i had told you in Liver function Test (LFT) that my SGPT Level is 43 (normal= 0- 35 U/L). I had gone to liver specialist, he recomended 3 more test which i have done. they are as follows:
C Peptide : 2.23 ( Normal= 0.78-1.89 ng/ml)
Blood sugar Fasting: 100 ( Normal=70-110 mgs%)
Serum Insulin: 12.10 ( normal= 6.0- 27.0 uU/mL)
My questions is whether:
a) i am diabetic as serum insulin level is low
b) What it means having higher C-Peptide. Am I having any metabolism problem ?
c)
doctor
Answered by Dr. Munish Sood (43 minutes later)
Brief Answer:
further assistance

Detailed Answer:
Dear
Thanks for reverting back.

1. As I have already whats app the courier docket number and told you about the same thus the medicine will reach by wednesday,also keep tracking the same online.

2. Your fasting blood sugar is normal and so are the Insulin level (don't understand why you said my insulin level is low)

3. Rise in C-peptide means that the pancreas (from which C-peptide is secreted) is working hard to overcome insulin resistance (as you are overweight ) thus at present means one is possible candidate for developing type 2 diabetes, so check regularly with blood sugar. ( problem with carbohydrate metabolism)

Dr. Munish
Naimittka
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Munish Sood (52 minutes later)
Dear Sir,
1) How can problem with carbohydrate metabolism be solved.Is this the reason for me being overweight.Will "sit and burn FAAT"help.
2) As per my knowlege Type 2 diabetes is a life style disorder, so maintaning normal weight is remedy
doctor
Answered by Dr. Munish Sood (18 minutes later)
Brief Answer:
further necessary clarification

Detailed Answer:
Dear
Thanks for reverting back.

1. As you have written correctly that it is a lifestyle disorder thus presently our main concern should be ideal weight management since as said earlier being overweight makes the patient falls in high risk category i.e. with Diabetes,high blood pressure, chest pain.

2. As far as controlloing carbohydrates metabolism problem nothing heroics to be done,all that is needed is weight reduction

3. As said earlier "Sit & Burn FAAT" is sugar-cholesterol -caffeine free thus will effectively work on overweight problem.

Dr. Munish
Naimittika
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Munish Sood (52 minutes later)
Dear doctor,
Is any metabolism assessment test required at this stage
doctor
Answered by Dr. Munish Sood (22 minutes later)
Brief Answer:
further assistance

Detailed Answer:
Dear
Thanks for reverting back.

1. presently I do not feel that you should go for any assessment test because much of the problem is related with weight issue and once you have attained ideal weight management through dietary regime and lifestyle modification one can think of the same.

PS. metabolic assesment usually means calculation and assessment of calorie(s) intake and output (energy expenditure) thus later may contact a certified/qualified dietitian/physicaI fitness trainer for the same.

Dr. Munish
Naimittika
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Munish Sood (23 hours later)
Dear Sir,
In my Liver Function test all parameters are normal except SGPT: 43 (Normal range: 0-35U/L). Does this indicates Non Alchoholic Fatty Liver Disease (NAFLD)
doctor
Answered by Dr. Munish Sood (32 minutes later)
Brief Answer:
further information

Detailed Answer:
Dear
Thanks for reverting back.

1. Since value of liver function test varies from laboratory to laboratory thus it will be wise to check with your liver specialist [Hepatologist] or with the laboratory about the same since slight elevation in SGPT is considered normal, its only when the value rises twice above the upper limit or other liver function tests are raised along with SGPT.

2. Here in XXXXXXX enquiring about the SGPT range in nearby laboratories, they have the following:
.5-39 units
.7-55 IU/L
.10-40 IU/L

3. recent studies have suggested NAFLD to be the most common cause of slightly elevated aminotransferase level, so in you it could be due to either of the component of the METABOLIC SYNDROME [hypertension, diabetes, hyperlipidemia, and OBESITY], thus reduction in weight will improve the outcome

Dr. Munish
Naimittika
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Munish Sood (14 hours later)
The liver specialist has asked to go for endoscopy and metabolic assessment.What are this test for?
doctor
Answered by Dr. Munish Sood (1 hour later)
Brief Answer:
necessary details

Detailed Answer:
Dear
Thanks for reverting back

1. Since endoscopy has got various reasons and multidimensional approach to a number of disease/pathology BUT as we are concerned with the liver thus here the role of endoscopy is both

- Diagnostic: i.e. it can be done in patients with specific symptoms of liver disease or unsuspected liver disease can be diagnosed AND
- Interventional: i.e. for screening purpose and treatment.

2. Metabolic Assessment test: Active Metabolic Assessment [AMA] identify the optimal heart rate zones where workouts are more effective [i.e. where the fat will be burned more]. The test is usually done walking or running on a treadmill and therefore by knowing your optimal heart rate your physical trainer will let you know to avoid over training [over exercising], and being less susceptible to injury.

Dr. Munish
Naimittika

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Munish Sood (23 hours later)
Dear Sir,
Digonistic labs at bharuch (gujarat) here are stating that Metabolic assessment involve certain specialised blood test.Bit confused regarding metabolic assessment Also liver specialist is asking me to to get testing for Tumor markers and Allergy markers.What are this
doctor
Answered by Dr. Munish Sood (1 hour later)
Brief Answer:
further assistance

Detailed Answer:
Dear
Thanks for reverting back.

1. Specialized blood tests [in relation with metabolism] under normal circumstances, should be

a. measurement of
- blood glucose and calcium
- Blood urea nitrogen [BUN] & Creatinine
- Sodium,potassium,carbon dioxide,chloride level OR
     
b.     It can be measurement of
- Indirect calorimetry for resting energy expenditure(COSMED K4b2)
- Metabolic holter/3 days for dynamic energy expenditure with Armband
- Oxidant status through real-time blood capillary analysis
- Antioxidant status through real-time blood capillary analysis

PS. Ask with the laboratory what exactly they want to perform

2. Tumor markers are intracellular proteins of cell surface glycoproteins released into the circulation from internal ‘malignancy’ and detected by immunoassays. Ask your Hepatologist whether he want to order all the markers or the one specifically related to liver

3. Allergy markers: offer reliable information for the diagnosis of respiratory allergic disease, and as far as I know allergies are related to poor liver function which reduces the efficiency of liver to clean [detoxify] the toxins resulting in overstimulation of immune system causing development of hives/rashes. Ask him again as for what any other condition he wants to check for the same.

Dr. Munish
Naimittika

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Munish Sood (1 hour later)
Dear Doctor,
The blood test I have conducted are as follows:
1)Haemogram(CBC+ESR): report normal,
Hemoglobin:16.30,WBC count:8030,Neutrophils:58.0,Lymphocytes:33.0,Platelet count:368000, RDW CV=12.50,RDW SD=41.60
2)Physical SmearExamination: No abnormality in report
3) Blood Sugar Estimation:
Fasting:100 (range:70-110mgs%),Post meal:90((range:70-140mgs%)
Urine sugar:Nil
Blood urea: 16((range:15-40mgs%),serum cacium:9.6((range:8.1-10.4mgs%)
Serum Creatinine:0.80((range:0.5-1.10mgs%),Serum uric acid:703((range:2.5-7.0mgs%)
4)HbA1c=5.2(range:6.0-7%),eAG:103((range:120-140mgs%)
5)Liver Function test: Details are as follows
SGPT=43((range:0-35mgs%),SGOT::29(normal:10-40U/L),Total Bilirubin:0.5(normal=0.2-1.0mgs%),Direct Bilirubin:0.2(normal=0.1-0.25mgs%),Indirect Bilirubin:0.30(normal=0.10-0.75mgs%),S Alkaline Phosphate:83(normal:40-130 U/L),GGT=30(normal=0-35U/L),Total Proteins:7.70(normal=6.0-8.0 gms%),S Albumin:4.70(normal=3.50-5.0 gms%),Serum Globulin:3.0(normal=2.0-3.2 gms%),A/G Ratio:1.6( normal=0-1.9)
6)Lipid Profile: S Cholestrol:115((range:100-200mgs%),HDL Cholestrol:40(normal.40mgs%),Direct LDL Cholestrol:68(normal<120mgs%),S Triglycerides:17 (normal<30mgs%)
7) Apolipoproproteins: APO A1 level:156((range:10-184mg/dl),APO B level=84(normal:44-170 mg/dl)
8) iron study: serum iron=104((range:37-145 ug/dl),Serum Ferritin:55.57((range:18.70-323ng/ml),Usaturated iron binding capacity:238.00(normal=112-346ug/dl)
9) Postrate Specific Antigen:0.53 ng/ml (normal<40 yrs:0.21-1.72)
10) Thyroid test: T3=1.06(normal=0.75-2.00ng/ml),T4=5.59(normal=4.00-10.50ug/dl),TSH=1.0524(normal=0.35-4.94 uIU/mL)
12)Vit D3:24.90(normal>30ng/mL),Vit D 12:225 (normal:200-900pg/ml)
13) Homocysteine:10.51 umol/L
14) C-Peptide:2.23(normal=0.78-1.89ng/mL)
15)Serum Insulin:12.10(normal=6.027.0uU/mL)

Doctor, my question are:
1) Apart from my overweight problem, do I having any other Liver Problem from the resuts of LFT apart from higher SGPT ?
2) Are any other specialised blood test like metabolic assessment test are necessary
for further diagonisis and what the test should be?
doctor
Answered by Dr. Munish Sood (2 hours later)
Brief Answer:
further recommendation

Detailed Answer:
Dear

Thanks for reverting back.
1. Since most of the reports are normal apart from Vit D [deficiency is there] thus please do the necessary:
i. Kindly attached the report of the same in Report section since I’m unable to verify the value of Vit. D which you have written i.e. 12:225?? And also of serum Insulin
ii. Check with your Vitamin B12 level
iii. Do share the normal value of homocysteine [value differ from place to place]
iv. There is no problem in the LFT panel
v. Do check with a Diabetologist [if situation demands]
vi. As said earlier, Metabolic assessment test are useful to determine how many calories your body will burn which will decide how many calories you have to eat to lose, maintain or gain weight [ more useful for gym goers/trainers/fitness freaks] but if one is interested [diet/calorie conscious] he/she can opt for the same.

PS
- eAG [estimated average glucose] is also normal.
- Serum uric acid is on the higher side kindly drink more water and avoid protein rich diet [can be because of overweight problem also]
- If possible kindly attach all the reports so that I can check myself.

Dr. Munish
Naimittika
Note: Deal with your health issues naturally by getting closer to Ayurveda. click here to learn more.

Above answer was peer-reviewed by : Dr. Priyanka G Raj
doctor
Answered by
Dr.
Dr. Munish Sood

Ayurveda Specialist

Practicing since :2003

Answered : 3694 Questions

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What Do My Lab Test Results Indicate?

Brief Answer: further assistance Detailed Answer: Dear Thanks for reverting back. 1. As I have already whats app the courier docket number and told you about the same thus the medicine will reach by wednesday,also keep tracking the same online. 2. Your fasting blood sugar is normal and so are the Insulin level (don't understand why you said my insulin level is low) 3. Rise in C-peptide means that the pancreas (from which C-peptide is secreted) is working hard to overcome insulin resistance (as you are overweight ) thus at present means one is possible candidate for developing type 2 diabetes, so check regularly with blood sugar. ( problem with carbohydrate metabolism) Dr. Munish Naimittka