Brief Answer:
Your lipid profile is reassuring

Detailed Answer:
Hello,
Welcome to health care magic,

i have read your query in details and understand the concern.

This lipid profile report is not abnormal since chol/hdl ratio is more important than rather than merely cholesterol and HDL levels. It should be below 5.0 as per XXXXXXX Heart Association.
However,your HDL is low but it is not indicative of any disease or even a significant risk factor for cardiovascular disease.

Also, it is very difficult to say regarding health condition from just a lipid profile report but low HDL can be improved by appropriate diet and regular exercises.

The main reason for HDL to be low could be lack of enough muscular exercise.
Initial 20 minutes of walk goes in burning your sugar and then the fat start burning which should happen for another 20 to 25 minutes through a stable, moderate speed of 5 to 6 km/hour and then you will certainly see improvement in the HDL cholesterol.

So, you should do exercises for at least 40 to 45 minutes daily to improve HDL cholesterol.

In general, to reduce your Chol/HDL ratio and to increase HDL follow these dietary guidelines (from which you must be aware already)

- Avoid direct sugars
- Avoid fried snacks, bakery items
- Have ample of vegetable salads- at least 1 bowlful cut raw vegetables like cucumber, tomato, carrot and vegetables which you can eat raw.
- Snacks should contain healthy nuts like almonds or walnuts and a few dry fruits but no fruit juices
- Avoid soft drinks or hard drinks and smoking cessation.
- Simple Chapati and steamed rice or rotis made up of different whole grains should be your staple diet.
- Skimmed milk and milk items made up of skimmed milk are good to check on cholesterol
- Egg white is fine but avoid egg yellow means yolk.
-vitamin B3 (niacin) increases HDL cholesterol.

It might take some time (like 6 months to 1 year or may be more) to improve HDL cholesterol.

So,next time go for lipid profile (with fasting blood sample) at least after 6 months and not before that to see some significant change.

Hope this answer will help to understand it clearly.Let me know if you have more doubts.

Regards,

Dr.Sandip Kabra

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Brief Answer:
Will answer one by one.

Detailed Answer:
Hello,
Welcome to HCM.

1) The main reason of low HDL could be lack of enough muscular exercises as I said earlier or may be genetic or related to certain races.

2) Dropping down level of HDL is not good but your other bad cholesterols are within normal limits. So there is no need to be worried much.

Generally, it is seen that if HDL goes down, there should be simultaneous rise in LDL and VLDL but it is not there in your case.

So, you may repeat the test after couple of months on fasting sample.

3) Yes,below 40 HDL level is considered a risk factor for cardiac disease theoretically but we should also look at the other cholesterols which are very much within normal limits in your case. So, the chol/hdl ratio will not be much higher.

Also, we can change our HDL by proper diet and regular exercises as we discussed earlier.

4) Yes,LDL has come down because of your strict diet.

5) As I said earlier, it is very difficult to say regarding health condition (risk of cardiac disease) from just a lipid profile report where you have only concern with your HDL and other bad cholesterols are normal.

So, I do not think that you are at a higher risk of developing any cardiac disease at present.

Gastric problem is likely responsible for chest pain for which you can take antacids (pantoprazole 40 mg) with digene liquid on as and when required basis.

Yes, chest pain could be because of anxiety and too much thinking (stress or tension) is the major responsible factor nowadays for gastric problems.

From the facts you have posted here, you have most probably anxiety related panic attacks.

Clinically, it is very difficult to say why or how this excess anxiety or panic attacks comes but we can only manage them accordingly.

If I were your treating doctor, I would have advised you anti-anxiety drugs like recita forte 10 mg,opiprol 50 mg and lorazepam 0.5 mg since they are good drugs in the treatment of anxiety related panic attacks.

You can consult some local physician who will know about it and may prescribe you.

Also, If your thyroid is normal and if you are not anemic then, you should take these medicines with psychological counseling which will help to de-stress you and to alleviate the anxiety related symptoms.

In addition, here are some of the other precautionary measures which you should also follow to gain some benefit.

1) When you have such symptoms, breathe slowly and deeply through the nose and talk to your family and friends.

2) Do not take caffeine or alcohol (if you take) at night just before going to bed.

3) Do yoga and mind relaxing exercises like meditation to calm your mind in your daily routine.

4) You can also practice progressive muscle relaxation which is useful in anxiety by alternately tensing and relaxing the muscles.

Hope this detailed answer will be helpful.

Regards,

Dr.Sandip Kabra

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Brief Answer:
No need for cardiac tests.

Detailed Answer:
Hi,
Thanks for the reply.

1) Dizziness even in any position is concerning. It could be due to variety of causes or it could be transient or could also be related to anxiety or panic attacks.

So,If the dizziness is not troubling your day to day work, then you may wait for few days. Until then you may take proper hydration and electrolyte balance with some symptomatic antihistamines treatment like betahistidine (vertin 16 mg) or cinaarizine (stugerone forte 25mg) available over the counter. Do not panic.

However if the problem is persistent, you should see a doctor (ENT preferably) at the earliest and get evaluated further.

I will suggest you undergo routine blood count, ESR, blood electrolytes, tests for vestibular (balance) system like electronystagmography or rotation tests to diagnose the cause for dizziness.

2) You do not need to be evaluated for cardiac tests since you have already done EKG and 2D-echo which were normal earlier.

3) Your fear to go our alone could be related to anxiety for which you should see physician as we have already discussed in our previous conversation.

Hope this will help and let me know if you have more doubts.

Regards,

Dr.Sandip Kabra

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