Brief Answer:
Suggested lifestyle modification changes and repeat testing after 6 months

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. Bilirubin levels (total and direct) are at upper limit of normal.

2. AST and ALT are also normal.

3. Albumin and globulin are normal.

4. Alkaline phosphatase and GGT are normal.

5. Mild fatty liver might be due to increased intake of fatty foods, alcohol consumption, some people have it due to hereditary cause. Please find details explained later.

6. Glucose fasting and post prandial are normal.

7. Lipid profile shows total cholesterol is at upper limit of normal.

8. Amlodipine 2.5 mg and telmesartan 40 mg are recommended medicines for mild hypertension.

9. ECG, echocardiography and CTMT reports are normal.

10. In conclusion,
(i) The bilirubin levels being at upper limit of normal is not a problem.

(ii) Total cholesterol also at upper limit of normal is not a big problem right now

(iii) There are many causes of liver showing fatty changes including

Increased intake of fatty foods and alcohol
Over weight and obese patients.
Those who have fatty liver running in family members.
Any liver condition that is changing appearance of liver.
Mild fatty liver can also be there in many normal people

You can start taking a balanced diet of 2200 kcal daily including good sources of vitamins and mineral.

If you have regularly take alcohol and fatty foods then please reduce the amount. You can use olive oil for cooking at home and this is healthy for the heart.

For hypertension control please reduce extra salt with meal. You should take normal salt to maintain body function.

Doing 30 minutes of exercise and yoga on alternate days will also help in keeping your body and mind healthy.

Please take your hypertension medicines on time and try to follow lifestyle changes as above and after 6 months please repeat liver function tests and lipid profile.

If the lipid profile shows high cholesterol after 6 months even with following strict diet and healthy habits then you can consult cardiologist and take opinion and medicines to reduce cholesterol.

The mild fatty liver changes if present due to diet, then it will reverse in 6 months time. You might get another scan done, however this is not too important.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Please consult the ENT specialist for suspected oral thrush

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

1. The itching mentioned by you is unlikely to be related to liver disorder. The bilirubin level is at upper limit and itichng does not occur at this level. At higher levels, if anyone develops jaundice then itching might occur.

2. The possible cause for itching is seasonal allergy or exposure to something to which you are allergic including house dust, pollution and pollen. It can also happen due to the use of a soap or oil. Fungal infection causes severe itching but it is confined to a small area and not the entire body. Itching happen due to activation of mast cells due to an allergy. You might look around you to check if there is such an environment that might be causing itching. As a treatment, you can take ceterizine tablets 10 mg at night bedtime for 5 days. This causes slight drowsiness in some people and please go to sleep after taking this medicine.

3. The throat requires to be clinically examined by the ENT specialist since it is not normal to get oral thrush. Oral thrush is a fungal infection and is not usually seen in healthy people and if you say that you are sure about having oral thrush then it is a concern and requires investigations to know if your immunity level is normal. Stress can also cause conditions like oral thrush. This is treated by specific medicine after confirmation of the disease. Please consult the ENT specialist and then avoid getting stressed about once you get treated for it.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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