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    What do my lab test reports indicate?

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Posted on Thu, 2 Jun 2016 in Lump
Question: Hello Doctor,

My face always looks swollen/puffy. I do exercise daily, but still I'm not losing fat from my face, though I heard like if we lose weight overall, we do lose fat from face as well.

below are my vitals -
Pulse rate - 56/min, BP - 110/80 mmHg, weight - 68 kg, height - 168 cm, age - 32

I consulted doctor and he told me to take TSH (thyroid) test, CBC, Urine routine (CUE), creatinine - serum/plasma, total protein AG-ratio & ultra sound of neck and salivary gland.

I did and all the test are normal. I have attached the results. My doctor said that Im perfectly normal.

1) Now my question is then why do I have fat on my face? apart from the stereotypical reply like genetics. I have very good diet, I sleep properly, I do exercise regualry & no stress in my life. How do I reduce fat on my face?

2) Is it something related with cortisol in the body or the thyroid? why do doctor always recommended me to take thyroid test? I did it 2 years back also. That time also it was normal. Does thyroid in anyway fluctuate in our body, like, it may be below/high from the normal limits?

3) Is it daily exercise the reason behind? as I do 30-40 min jogging/running. Might be strain in the body causing excess cortisol production, which may indirectly contributing to the hypothyroidism. well, Im not sure about it. My doctor said - Cortisol has nothing to do with it.

4) do I have to depend on surgery. Like - buccal fat pad removal or liposuction. Please advice me. How risky is it?







doctor
Answered by Dr. Mukund Savaskar 2 hours later
Brief Answer:
Cause of swollen face / Under Assessment

Detailed Answer:
Brief Ans-Cause of swollen face / Under Assessment

Hi Dear !! Thanks for your query to HCM.

Read and reviewed your query and feel concerned about your health issues.
I understood your health concerns as follows-
I am really concerned for your health concerns,as after going through the ordeal of you still are anxious to know about the cause of it?,as for your age you feel that is disfiguring and compromising your self confidence.

Though more information from your side would be helpful in giving exact reply about the correlation of your lab reports with cause of your Swollen face, I would try to give My primary Impression on your reports first.

My Impression--Meaning of your pathology report-
After primary study of your lab reports in context to your health concerns.
Dear, Prima facie-it means that you are overweight by 10% plus for your height and its is contributing to your facial swelling by virtue of higher diastolic blood pressure.
More detailed suggestions would be given after getting more information as asked below-
Do you have any burning / or frequency of Urination?
Any history of Urinary infection? Are you single or married ?
Give more details on your diet- is it more of non-veg or veg most of times in a Week?
Do you eat more of non-veg/ fried / high protein / high fat diet?

More details on your daily work schedule and dietary schedules-if you really want to reduce your face fat? or face swelling?
Update on Any history of Diabetes in your family or distant family also?
Any history of renal or diabetic diseases and history of Blood pressure ?

Any updates of recent Fasting / Post-prandial-Blood Sugar and your lipid profile reports?

Update photograph of your face? fat / or Face swelling to assess your health concerns in more details in My own way with My expertise?

Opinion on your 4 Questions -
After reviewing your 4 asked questions, Your queries are still seem to be hypothetical to Me,as You need to give Me more information as asked above.


Please update more info if you want to know more on this reply.

I would need more information about your past surgery when this histo-pathological report was given to you.

Welcome with more query in this regard.

Good Day !!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. Mukund Savaskar 12 hours later

Hello sir,

below are my reply's

1) Do you have any burning / or frequency of Urination?
Ans: No

2) Any history of Urinary infection? Are you single or married ?
Ans: No history of Urinary infection. Yes, Im married.

3) Give more details on your diet- is it more of non-veg or veg most of times in a Week?
Ans: I mostly take veg. Non-veg only once in a week (fish) thats too cooked in less oil

4) More details on your daily work schedule and dietary schedules-if you really want to reduce your face fat? or face swelling?
Ans: I work in IT sector (9-6). breakfast at around 8 am (oatmeal, with omelette and tea). lunch around 1-2 pm (2 chapati and sabji) evening 5-6 pm (tea & snacks). dinner 8-9 pm (chapati/rice & dal).

5) Update on Any history of Diabetes in your family or distant family also?
Ans: No one has diabetes. though My mother is BP patient. she is very old (50 years)

6) Any history of renal or diabetic diseases and history of Blood pressure ?
Ans: I don't have any

7) Any updates of recent Fasting / Post-prandial-Blood Sugar and your lipid profile reports?
Ans: Nothing as such

8) Update photograph of your face? fat / or Face swelling to assess your health concerns in more details in My own way with My expertise?
Ans: updated.

thanks for your query, but i didn't get reply for my few general concerns. Im writing it below again.

1) Is it something related with cortisol in the body or the thyroid? why do doctor always recommended me to take thyroid test? I did it 2 years back also. That time also it was normal. Does thyroid in anyway fluctuate in our body, like, it may be below/high from the normal limits?

2) Is it daily exercise the reason behind? as I do 30-40 min jogging/running. Might be strain in the body causing excess cortisol production, which may indirectly contributing to the hypothyroidism. well, Im not sure about it. My doctor said - Cortisol has nothing to do with it.

doctor
Answered by Dr. Mukund Savaskar 1 hour later
Brief Answer:
Your face is normal and not swollen as thought by YOU !!

Detailed Answer:
Brief Ans-Your face is normal and not swollen as thought by YOU !!
Reduce on dinner ration by half on carbohydrates and consume dinner early by 7 pm.


Hi Dear !! Thanks for your nice updates to My lead questions.
Read and reviewed your updates and your face-picture in context to your health concerns.

My Impression-
Dear, My Humble suggestion to YOU- Don't go hypochondriac by googling.
You are getting unnecessarily anxious and over-confused from the googled data. Leave it to your expert doctors only.

Here are replies to your few general concerns-

Q-1) Now my question is then why do I have fat on my face? apart from the stereotypical reply like genetics. I have very good diet, I sleep properly, I do exercise regularly & no stress in my life. How do I reduce fat on my face?

Ans-1-You don't have much fat on your face.On the contrary your eye sockets are deep and appear stressed much from over work.
To Reduce on your face work on few IMP- following suggestions,as given here in below-
Based on weight / height data of your's, you are overweight and could reduce another 7 kgs if it suits Your work load and work-psyche.
-Your face is OK - but stressed and strained and over-worked a bit.

Please update a side View- after which I would suggest if your face is swollen or not ?
-Reduce on diet by 35% of what you take now-Be more on liquids and less on solid intake.
-don't overload food and fluids(limit to 1500 ml / 2000 ml)
Add 1 Fruit -in morning and after evening tea/coffee.
-Restrict your sleep to 6-7 hrs for your age and activity.
Your body is stressed with food and gym .Reduce them to suit your satisfaction.

Take your life with all the COOLNESS you can maintain. You are too Young to be under stress, especially when you have good job.
Don't be- TYPE A personality(Highly Ambitious/and anxious), take things lightly and as they are. Don't expect perfection from every event and action in life.

Q-2) Is it something related with cortisol in the body or the thyroid? why do doctor always recommended me to take thyroid test? I did it 2 years back also. That time also it was normal. Does thyroid in anyway fluctuate in our body, like, it may be below/high from the normal limits?

Ans-2-IN your case your face is not swollen and this is not related to your excess Cortisol and hypothyroid functions in your case. These tests are recommended just to rule out any disturbed functioning of your hormones, which are leading to overweight- and swollen face, which worries you the most.Hence these tests are suggested.
As suggested in last reply,I would not suggest these in a case like you repeatedly,as the factors / variables are different in your case, than what they are supposed by YOU.
Its your diet, which is surplus for your sedentary job, which is causing stress on your cardiac status and your face too.



Q-3) Is it daily exercise the reason behind? As I do 30-40 min jogging/running. Might be strain in the body causing excess cortisol production, which may indirectly contributing to the hypothyroidism. well, I m not sure about it. My doctor said - Cortisol has nothing to do with it.

Ans-3-It is good that you do jogging and running. I reviewed your hormone levels. They are ok. Your urine is bit acidic and for which add 1-2 fruits morning evening and reduce on quantity and frequency of tea/ coffee if you can.Just follow few suggestions (IMP) given here in above.


Q-4) do I have to depend on surgery. Like - buccal fat pad removal or liposuction. Please advice me. How risky is it?

Ans-4-Not at all. Leave these hypochondriac thoughts from googling, being IT professional.
So I would not advise buccal fat liposuction. Besides being risky its not indicated in your case, after reviewing your front picture. Do update Me your side view picture.

The above suggestions about your lifestyle /and about your diet-especially about fruit inclusions/ and volume reduction, would recoup your face fitness to normal in 6-12 weeks, or even before that.

Hope this reply would satisfy you and resolve your worries.
Do write few pleasing excellent comments from and rate this reply , which would boost morale of incoming patients like You at My virtual Clinic at HCM.

Welcome for any further query in this regard.


Good Day !!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Mukund Savaskar 22 hours later
Thank you very much for such a thorough and meaningful reply!

I have just one query (general question)

1) For a person whose Thyroid is always normal whenever the test has been taken till so far, will always remain normal till the end (in future)? If not, then what are the factors which will contribute to make it go high (TSH high). Im specially talking about TSH - high which may lead to hypothyroidism.
doctor
Answered by Dr. Mukund Savaskar 4 hours later
Brief Answer:
Just GO COOL.....!!

Detailed Answer:
Brief Ans-Just GO COOL.....!!

Hi Dear,Thanks for the appreciative comments.
Read and reviewed your update and almost repeat query,expressing hypothetical query from googled anxiety.
No need to think on hypothetical questions.I have answers for this also,but would add more hypochondriac thoughts and anxiety, which is not the aim of this HCM service.
My Impression-for your satisfaction .
High TSH does not lead to Hypothyroidism.Its the other way round.Hypothyroid functioning is responded by your body with HIGH TSH, which keeps your functioning NORMAL, a auto-regulatory mechanism, which if fails or is over-stressed, could give rise to Hypothyroid Complaints, very lately.

So as your thyroid levels are normal , Just forget on the forecast in future,as the variables by future period after SAY 10 yrs, are not predictable and are in anybodies hand, as they are controlled by one's unknown- DESTINY.


Hence JUST GO COOL......!!

Do close this query with few pleasing excellent comments from YOU and rate this reply , which would boost morale of incoming patients like You at My virtual Clinic at HCM.

Welcome for any further query in this regard.


Good Day !!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS


Above answer was peer-reviewed by : Dr. Deepak
doctor
Answered by
Dr.
Dr. Mukund Savaskar

General Surgeon

Practicing since :1978

Answered : 3607 Questions

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