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Suggest treatment for palpitations and anxiety related issues

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Posted on Thu, 19 Mar 2015
Question: Hi,recently When I went to visit my doctor regarding plapitations and anxiety related issues ,he mentioned that my bp was around 134/88 and he put me on alprox-0.5 mg twice a day and metoprolol 25mg once a day.He also ordered blood work and the results are back.In the results t4 is shown as 14 which I believe is slightly above the normal range.Inspite of taking bp medicine, I often feel weakness,dizziness ,anxiety.There is no change in that part.
Since I am on bp medication,would I be also needing a medicine for my elevated t4?
If so,I am concerned that they often have contraindications.
I am confused about how to proceed in this issue? I want to prepare myself much ahead before I see the doctor for follow up.I sincerely,request your suggestions in this regard.
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Follow up: Dr. Swarnava Dattagupta (4 minutes later)
Name: XXXXXXX XXXX
Age: 37
Gender: Female




Results


Order:
Cardiovascular Risk Assessment


Name Date Value Units Range Source

Interpretation 2/11/2015 NTAP Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD




Order:
Hemoglobin A1c


Name Date Value Units Range Source

Hemoglobin A1c 2/11/2015 5.80 % 4.8-5.6 Fairfax Family Practice Centers

Notes:

.
Increased risk for diabetes: 5.7 - 6.4
Diabetes: >6.4
Glycemic control for adults with diabetes: <7.0
Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD




Order:
T4 and TSH


Name Date Value Units Range Source

Thyroxine (T4) 2/11/2015 14.10 ug/dL 4.5-12.0 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
TSH 2/11/2015 3.06 uIU/ml 0.450-4.500 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD




Order:
Lipid Panel With LDL/HDL Ratio / Labcorp 235010 / Quest 2865F


Name Date Value Units Range Source

Cholesterol, Total 2/11/2015 198.00 mg/dl 100-199 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
Triglycerides 2/11/2015 225.00 mg/dl 0-149 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
HDL Cholesterol 2/11/2015 49.00 mg/dl >39 Fairfax Family Practice Centers

Notes:

According to ATP-III Guidelines, HDL-C >59 mg/dL is considered a
negative risk factor for CHD.
Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
VLDL Cholesterol Cal 2/11/2015 45.00 mg/dl 5-40 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
LDL Cholesterol Calc 2/11/2015 104.00 mg/dl 0-99 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
LDL/HDL Ratio 2/11/2015 2.10 ratio unit 0.0-3.2 Fairfax Family Practice Centers

Notes:

LDL/HDL Ratio
Men Women
1/2 Avg.Risk 1.0 1.5
Avg.Risk 3.6 3.2
2X Avg.Risk 6.2 5.0
3X Avg.Risk 8.0 6.1
Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
Comment: 2/11/2015 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD




Order:
Basic Metabolic Panel (8) / Labcorp 322758 / Quest 10165X


Name Date Value Units Range Source

Glucose, Serum 2/11/2015 81.00 mg/dl 65-99 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
BUN 2/11/2015 10.00 mg/dl 6-20 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
Creatinine, Serum 2/11/2015 0.94 mg/dl 0.57-1.00 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
BUN/Creatinine Ratio 2/11/2015 11.00 8-20 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
Sodium, Serum 2/11/2015 138.00 mmol/L 134-144 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
Potassium, Serum 2/11/2015 4.30 mmol/L 3.5-5.2 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
Chloride, Serum 2/11/2015 98.00 mmol/L 97-108 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
Carbon Dioxide, Total 2/11/2015 24.00 mmol/L 18-29 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
Calcium, Serum 2/11/2015 9.60 mg/dl 8.7-10.2 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
Glom Filt Rate, Est/eGFR If NonAfricn Am 2/11/2015 78.00 mL/min/1.7 >59 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
eGFR If Africn Am 2/11/2015 90.00 mL/min/1.7 >59 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD




Order:
CBC, Platelet; No Differential


Name Date Value Units Range Source

Hematocrit 2/11/2015 41.50 % 34.0-46.6 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
Hemoglobin 2/11/2015 13.40 g/dl 11.1-15.9 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
MCH 2/11/2015 27.00 pg 26.6-33.0 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
MCHC 2/11/2015 32.30 g/dl 31.5-35.7 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
MCV 2/11/2015 84.00 fL 79-97 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
Platelets 2/11/2015 281.00 x10E3/uL 150-379 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
RDW 2/11/2015 15.20 % 12.3-15.4 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
Red Blood Cell (RBC) Count 2/11/2015 4.97 x10E6/uL 3.77-5.28 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
White Blood Cell (WBC) Count 2/11/2015 9.30 x10E3/uL 3.4-10.8 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD
NRBC 2/11/2015 Fairfax Family Practice Centers

Notes:

Dear Ms XXXX
General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges.
Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches.
M. Silverstein MD




Order:
CHEST PA AND LAT VIEWS


Name Date Value Units Range Source

CHEST PA AND LAT VIEWS 1/3/2014 see details Fairfax Family Practice Centers

Notes:

FAIRFAX RADIOLOGICAL CONSULTANTS, P.C.
RESTON IMAGING CENTER

XXXX EXAM PERFORMED AT:
0000 DOB:08/19/1977 100 ELDEN STREET, SUITE 16
01/03/2014 AGE:36 Gender:F Physicians Only: 703-698-4443



XXXXXXX SILVERSTEIN MD [H]
555 HERNDON PARKWAY STE 100
HERNDON, VA 20170





doctor
Answered by Dr. Swarnava Dattagupta (2 hours later)
Brief Answer:
ADVICE REGARDING HIGH BLOOD PRESSURE AND VARIOUS LABORATORY BLOOD RESULTS

Detailed Answer:
Hi,
Thank you for posting your query in healthcaremagic.com
This is Dr. Swarnava dattagupta answering your query.

I understand your concern.
Firstly, you have done a complete set of blood investigations and that is very good because any problem could be detected from the above and appropriate measures can be taken.
From the above investigations, i have shortlisted some values which need to be carefully monitored-

1.HbA1C value which is at a risk of future diabetes
2.Lipid profile, mainly cholesterol and VLDL levels which are not higher than normal but at an alarming level
3.T4 value which is slightly elevated

for the above, i would suggest you the following-
1.Take fresh fruits and vegetables, avoid more of fatty food and junk food, also take less starch and sweets.
2.You have not mentioned your weight and height, you can be overweight and try to reduce weight.
3.Avoid food with high iodine content like seafood, sea salt etc
4.Start doing exercises regularly, even brisk walking for half an hour a day will help.
5.Get your lipid profile, PPBS, HbA1c and T4/TSH done after 4-6 months.
6.Start taking tab atorvastatin 10 once daily after dinner.
7.Take tab pantoprazole-domperidone combination once daily before breakfast.

You have asked about T4 levels. It is slightly elevated but it cannot be stamped as hyperthyroidism, i have asked you to take reduced iodine containing food. Hopefully, it will help to keep it under control, after the next test results come we can plan what to do accordingly.
And regarding your anxiety and palpitations, you need to continue taking metoprolol and alprax regularly and it will be better eventually.
You can also take some multivitamin syrup twice daily. This will help you to regain your energy.

Hope i have answered your question.
If you have any further questions i will be happy to help.
Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Swarnava Dattagupta (12 minutes later)
Thanks doctor.you have asked me to take Pantaprozole and atorovaststin.may I know the reason. I started metoprolol, and Alprox since 2 weeks.
Do you think it needs some more time for me to get the real benefits. Also, is 25 MG of metoprolol a high dose for me.thanks
doctor
Answered by Dr. Swarnava Dattagupta (21 minutes later)
Brief Answer:
pantoprazole for better digestion, atorvastatin for high cholesterol

Detailed Answer:
Hello again.

Yes, definitely you should know about the medications i suggested.
Atorvastatin is given to combat your slightly high cholesterol and VLDL. It serves more as a prophylactic drug.
And the pantoprazole-domperidone combination is prescribed for better metabolism and digestion and to combat mild dizziness and nausea.

Also, metoprolol 25 is not a high dose. It can be given. But it depends on your prescribing doctor. I suggest you to contact him.

I might add you to take salt restricted diet too.

Hope this was helpful.
Regards
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Swarnava Dattagupta

General & Family Physician

Practicing since :2013

Answered : 906 Questions

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Suggest treatment for palpitations and anxiety related issues

Name: XXXXXXX XXXX Age: 37 Gender: Female Results Order: Cardiovascular Risk Assessment Name Date Value Units Range Source Interpretation 2/11/2015 NTAP Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Order: Hemoglobin A1c Name Date Value Units Range Source Hemoglobin A1c 2/11/2015 5.80 % 4.8-5.6 Fairfax Family Practice Centers Notes: . Increased risk for diabetes: 5.7 - 6.4 Diabetes: >6.4 Glycemic control for adults with diabetes: <7.0 Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Order: T4 and TSH Name Date Value Units Range Source Thyroxine (T4) 2/11/2015 14.10 ug/dL 4.5-12.0 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD TSH 2/11/2015 3.06 uIU/ml 0.450-4.500 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Order: Lipid Panel With LDL/HDL Ratio / Labcorp 235010 / Quest 2865F Name Date Value Units Range Source Cholesterol, Total 2/11/2015 198.00 mg/dl 100-199 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Triglycerides 2/11/2015 225.00 mg/dl 0-149 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD HDL Cholesterol 2/11/2015 49.00 mg/dl >39 Fairfax Family Practice Centers Notes: According to ATP-III Guidelines, HDL-C >59 mg/dL is considered a negative risk factor for CHD. Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD VLDL Cholesterol Cal 2/11/2015 45.00 mg/dl 5-40 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD LDL Cholesterol Calc 2/11/2015 104.00 mg/dl 0-99 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD LDL/HDL Ratio 2/11/2015 2.10 ratio unit 0.0-3.2 Fairfax Family Practice Centers Notes: LDL/HDL Ratio Men Women 1/2 Avg.Risk 1.0 1.5 Avg.Risk 3.6 3.2 2X Avg.Risk 6.2 5.0 3X Avg.Risk 8.0 6.1 Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Comment: 2/11/2015 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Order: Basic Metabolic Panel (8) / Labcorp 322758 / Quest 10165X Name Date Value Units Range Source Glucose, Serum 2/11/2015 81.00 mg/dl 65-99 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD BUN 2/11/2015 10.00 mg/dl 6-20 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Creatinine, Serum 2/11/2015 0.94 mg/dl 0.57-1.00 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD BUN/Creatinine Ratio 2/11/2015 11.00 8-20 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Sodium, Serum 2/11/2015 138.00 mmol/L 134-144 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Potassium, Serum 2/11/2015 4.30 mmol/L 3.5-5.2 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Chloride, Serum 2/11/2015 98.00 mmol/L 97-108 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Carbon Dioxide, Total 2/11/2015 24.00 mmol/L 18-29 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Calcium, Serum 2/11/2015 9.60 mg/dl 8.7-10.2 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Glom Filt Rate, Est/eGFR If NonAfricn Am 2/11/2015 78.00 mL/min/1.7 >59 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD eGFR If Africn Am 2/11/2015 90.00 mL/min/1.7 >59 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Order: CBC, Platelet; No Differential Name Date Value Units Range Source Hematocrit 2/11/2015 41.50 % 34.0-46.6 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Hemoglobin 2/11/2015 13.40 g/dl 11.1-15.9 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD MCH 2/11/2015 27.00 pg 26.6-33.0 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD MCHC 2/11/2015 32.30 g/dl 31.5-35.7 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD MCV 2/11/2015 84.00 fL 79-97 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Platelets 2/11/2015 281.00 x10E3/uL 150-379 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD RDW 2/11/2015 15.20 % 12.3-15.4 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Red Blood Cell (RBC) Count 2/11/2015 4.97 x10E6/uL 3.77-5.28 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD White Blood Cell (WBC) Count 2/11/2015 9.30 x10E3/uL 3.4-10.8 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD NRBC 2/11/2015 Fairfax Family Practice Centers Notes: Dear Ms XXXX General chemistries and fasting glucose are normal. Thyroid functions are in stable normal ranges. Hg A 1 c minimally elevated recheck yearly and work on weight loss and avoid excessive starches. M. Silverstein MD Order: CHEST PA AND LAT VIEWS Name Date Value Units Range Source CHEST PA AND LAT VIEWS 1/3/2014 see details Fairfax Family Practice Centers Notes: FAIRFAX RADIOLOGICAL CONSULTANTS, P.C. RESTON IMAGING CENTER XXXX EXAM PERFORMED AT: 0000 DOB:08/19/1977 100 ELDEN STREET, SUITE 16 01/03/2014 AGE:36 Gender:F Physicians Only: 703-698-4443 XXXXXXX SILVERSTEIN MD [H] 555 HERNDON PARKWAY STE 100 HERNDON, VA 20170