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What Do These Blood Reports Indicate?

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Posted on Wed, 16 May 2018
Question: Hi Doctor,
I have been doing my annual blood test every year since 2015.
I have some concerns regarding my total protien, albumin and Bilirubin levels.

As per April 2015 tests,

Total protien is 7.9 ( As per lab, the normal level is (6.2 to 8.9))
Albumin is 5.4 (As per lab, the normal level is (3.3 to 5.5))
Bilirubin is 1.2 (As per lab, the normal level is .2 to 1.2)

As per Oct 2016 tests,

Total protien is 8.0 ( As per lab, the normal level is (6.1 to 8.1))
Albumin is 5.3 (As per lab, the normal level is (3.6 to 5.1))
Bilirubin is 2.1 (As per lab, the normal level is .2 to 1.2)

Since there was a eleveation in Bilirubin level, My primary care physician referred me to ultrasound, it came out just fatty liver. nothing specific was identified.

He also requested me to complete all hep-b tests to rule out all possible infections. they all came out negative.

He then directed me to gastroentrologist, he asked me to do bilirubin panel test. I did that and the results are below.

Direct bilirubin is .4 ( As per lab, the normal level is <=.2)
Indirect bilirubin is 2.2 (As per lab, the normal level is .2 - 1.2)
Total Bilirubin is 2.6 (As per lab, the normal level is .2 to 1.2)

After reviewing this my gastroentrologist doctor confirmed that its due to XXXXXXX syndrome.

Then i repeated my annual in March 2017 and the levels are as below

Total protien is 8.3 ( As per lab, the normal level is (6.1 to 8.1))
Albumin is 5.3 (As per lab, the normal level is (3.6 to 5.1))

Direct bilirubin is .4 ( As per lab, the normal level is <=.2)
Indirect bilirubin is 2.4 (As per lab, the normal level is .2 - 1.2)
Total Bilirubin is 2.8 (As per lab, the normal level is .2 to 1.2)

Now my questions are as below.

1) I want to get it one more time confirmed with you that increased bilirubin is due to XXXXXXX syndrome
2) My albumin level is fluctuating between 5.3 and 5.4. one lab says its normal, while other one says its abnormal. should be i concerned about this.
3) My total protien is fluctuating between 7.9 and 8.3. one lab says this level is normal, while other one says its abnormal. should i be concerned about this.
3) looking at all the blood reports, should i be concerned about my liver functions. or is it genetic.

Can you please help to clarify these

I have attached all reports for your reference.
doctor
Answered by Dr. Ramesh Kumar (5 hours later)
Brief Answer:
Please go through detail answer sir.

Detailed Answer:
Hi,
Thanks for query my dear patient.
Have gone through your details.

As per your query answers are-

1)The combination of normal blood and liver function tests and elevated bilirubin levels is an indicator of Gilbert's syndrome. No other testing usually is needed, although genetic testing can confirm the diagnosis.
So get a liver finction test done if its normal then you are XXXXXXX
To confirm it you can also go for genetic testing.
2) Not at all.
Get a blood sample withdrawn submit it in 4 best labs of your area there would be mild change in every lab result and it has no clinical significance for a clinician.
3)Every lab has different machine maufactured by various companies world wide.So range depend on the sensor designed by engineers of a particular company.
Mild moderation have no significance in a other wise normal patient.
Body has thousands of parameter and its not feasible to have every parameter in normal range always.
We as doctors treat symptoms and not numbers(unless they are grossly deranged).

Suggestion-
Get a liver function test done if its normal you are XXXXXXX .
Bilirubin less then 3 mg/dl has no clinical significance for a gastroenterologist.Even if you have XXXXXXX it has no effect on a persons life.You can live a normal life.Neither does it has a treatment.

Going through your reports my two main concerns are-
High level of triglyceride-zyou should start fenofibrinate for that for 3 months.
Second one is hydronephrosis in kidney that can lead to renal damage if neglected.
From Gastro point of view you are normal.
Regards!

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar (2 hours later)
Thanks doctor for the response.

1) do you want me to repeat the liver function test and provide the results .
2) my primary care doctor didn’t prescribe any medication for the high level of triglyceride. He just asked me to take care of diet. Should I ask him to prescribe me medications.
3) can you please advise what do I need to do for hydroneprosis? Any diet or life style needs to be changed or any medication need to be started.
4) I also remember seeing prostate calcination in my ultrasound report. Should I be concerned about this .
doctor
Answered by Dr. Ramesh Kumar (13 minutes later)
Brief Answer:
follow up.

Detailed Answer:
Hello my dear patient XXXXXXX
As explained earlier XXXXXXX means-
Elevated bilirubiin
with normal liver function test which inclute(SGOT and SGPT)
I cant see then in attachments my dear.

2)Try to take olive oil in food.
Treadmill daily for 10 minutes at elevation of 12 speed 6.1 km/hr.
Take flex seeds daily
Add Tab Fenofibrinate 145 mg once daily for 1 month and repeat serum lipid after that.
3)
For Hyfronephrosis you should go for a CT scan of Kidney.
So that we could access the degree of damage.

4)Get a prostate specific antigen test done.

Right now to keep you on very safe side i would start only fibrofibrinate 145 mg once daily at bed time.

Follow up with reports of these tests.
Regards and get well soon.

If satisfied do write a review.
You can send me a direct query when further reports are with you!
In case you have more query feel free to revert back.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar (29 minutes later)
Hi doctor,

1) I have provided all my blood reports doctor. Aren’t you able to see them. It has ALT(SGPT) and AST(SGOT) levels in it. They are in normal range in all my tests for last 3 years. Please have a look at them

2) ok doctor. I will follow the suggestions provided

3 and 4) sure Doctor . I will request for those tests.
doctor
Answered by Dr. Ramesh Kumar (1 hour later)
Brief Answer:
Follow up.

Detailed Answer:
Hello again,
Oh sorry actually i think i missed that in scanned copy.
You are a XXXXXXX patient but hey good news is that you can live a normal life.Period!

For hydronephrosis-One of these tests should also be done along with CT scan kidney.
Voiding Cystourethrogram (VCUG): a type of radiology study to diagnose the backflow of urine from the bladder to the ureter and kidney.

Mag 3 Lasix Scan: a type of radiology study to evaluate the kidney function and drainage.

DMSA scan: a type of radiology study to evaluate the kidney function.

Choice depends on availability of test dear patient.

Fenofibrinate should be started initially for high TG and exercise lifestyle modification should be started along with it.Once the levels are normal we would taper off the medicine and would maintain you on proper diet and exercise.

Please feel free to ask your queries if any i would be glad to help.
For future follow up you can follow this link.
http://doctor.healthcaremagic.com/doctors/dr-ramesh-kumar/72660

Thanks get well soon and regards!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar (9 hours later)
Thanks for the response doctor. i will do the further tests and revert with the reports.
doctor
Answered by Dr. Ramesh Kumar (6 hours later)
Brief Answer:
You're welcome.

Detailed Answer:
You're welcome.
Revert back with reports.
Please do rate answer and any suggestion for improving explainations are welcomed.
Get well soon and good day.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2832 Questions

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What Do These Blood Reports Indicate?

Brief Answer: Please go through detail answer sir. Detailed Answer: Hi, Thanks for query my dear patient. Have gone through your details. As per your query answers are- 1)The combination of normal blood and liver function tests and elevated bilirubin levels is an indicator of Gilbert's syndrome. No other testing usually is needed, although genetic testing can confirm the diagnosis. So get a liver finction test done if its normal then you are XXXXXXX To confirm it you can also go for genetic testing. 2) Not at all. Get a blood sample withdrawn submit it in 4 best labs of your area there would be mild change in every lab result and it has no clinical significance for a clinician. 3)Every lab has different machine maufactured by various companies world wide.So range depend on the sensor designed by engineers of a particular company. Mild moderation have no significance in a other wise normal patient. Body has thousands of parameter and its not feasible to have every parameter in normal range always. We as doctors treat symptoms and not numbers(unless they are grossly deranged). Suggestion- Get a liver function test done if its normal you are XXXXXXX . Bilirubin less then 3 mg/dl has no clinical significance for a gastroenterologist.Even if you have XXXXXXX it has no effect on a persons life.You can live a normal life.Neither does it has a treatment. Going through your reports my two main concerns are- High level of triglyceride-zyou should start fenofibrinate for that for 3 months. Second one is hydronephrosis in kidney that can lead to renal damage if neglected. From Gastro point of view you are normal. Regards!