Brief Answer:
My opinion is you need check up quickly.

Detailed Answer:
Hello Mr XXXXXXX
The details are very minimal to advice anything specific.
However I never delay a consultation in a nearing 60 yr old who has other chronic diseases like thyroid, fatty liver and is vomiting.
In my opinion you need to see your doctor soon.
Vomiting should never be ignored. There is a chance of disturbance in the metabolites like sodium, potassium.
If there is a thyroid crisis or infection of the gut it should be treated immediately.
Since your liver cannot function as normal it will not be able to detoxify and react to crisis situation you may have.
Once the diagnosis is benign you can relax.

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Brief Answer:
Test

Detailed Answer:
If it is a 30 yr old woman, it is important to check for urine pregnancy test first if she is sexually active.
Infections are still on the list.
Your description is short to think of other possibilities.

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Brief Answer:
Cholesterol tablet is not needed unless there is abnormal lipid profile

Detailed Answer:
Hi,

You uploaded only the ultrasound report four times. It says there is fatty liver no report about grade of fatty liver. There is small fibroid in the uterus as well which need gynecologist opinion.

YOu have not uploaded lipid profile report. No report about fasting blood sugar and liver function tests. I do not suggest cholesterol tablet for fatty liver unless there is abnormal lipid profile with other co morbid factors like diabetes, hypertension or morbid obesity.

Hope you understand what I am trying to say.

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Brief Answer:
Supplementation, weightloss, regular physical exercise and diet

Detailed Answer:
hello,

Thank you for the upload.
I could perceive that Ms Janki XXXXXXX has
1) Vitamin D deficiency with either Calcium and Magnesium deficiency. It would have been good if serum calcium was also measured.
2) Rising lipids including cholesterol, Non HDL cholesterol and Triglycerides.
3) There is rising ALT which could be related to Vitamin D deficiency.

I suggest Vitamin D supplementation along with calcium supplementation for 12 weeks. Retest Vitamin D and Serum calcium after 12 weeks.
Tab CALCIFEROL 60000 IU per week for 12 weeks and Tab SHELCAL 500mg once a day.
I do not suggest cholesterol medication as it can fall a brunt on liver along with Vitamin D leading further elevation in enzymes. I suggest a weight loss of at least 10% to the current weight in 6 months. This weight loss should come majorily from regular, sustained and increasing exercise time and better dietary practices. I suggest you consult a dietitian for the same.
Once you achieve 5% of the weight loss you can retest the lipid profile and notice them getting better.
This trial of life style modification can be done for at least three months before switching to cholesterol medication.

Hope this is clear.

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