Brief Answer:
Information requested

Detailed Answer:
Hi
I am Dr Mittal.
I have read your response.
In response to your second question, Thyrocare reports are usually reliable. However, a change may be present due to the three days of travel time.
As for the interpretation, the reports need to be considered in clinical scenario- and you have told me no clinical condition, so I assume all is well.

First for the reports labelled XXXXX.
Anti CCP is mildly raised.
This is ideally a test of rheumtoid arthritis- so if there is a complaint of joint pains, a rheumatologist needs to be consulted.
Folic acid is mildly low. So I suggest starting supplements like Tab Folate 5 mg daily for 15 days- taking a combination like Dexorange would be better in view of abnormal Blood indices-MCH, MCHC.
Kidney functions are low- urea/uric acid and creat- thats good- no need to worry.
Gross lipid profile is normal, however ratios are reversed- exercise is needed, as a part of daily routine.
Vitamin D is low- needs supplements- Calcerol XXXXXXX 60000 once a week for 6 weeks should be enough.
No need to worry about ALP, Monocyte, Basophil and lipoprotein- if there is no prior cardiac or hepatic problem.

Second, reports of XXXXXXX
HS-CRP, Homocysteine, Lipid profile, Folate are abnormal. Vitamin B12 are almost low and MCV is abnormal. You need a cardiac check up and a CV Doppler. Start Tab Atorvastatin 10 mg at bedtime (then as per local cardiologist) daily for 3 months and Tab Dexorange once a day for 15 days.
Vitamin D is low- follow same medicine -Calcerol XXXXXXX 60000 once a week for 6 weeks should be enough (after meeting the cardiologist).
Testosterone is mildly low- not to worry if you have no problems- the standard are international references and not XXXXXXX variations.
The TLC is suggestive of infection- I have no clinical details there.

Finally, reports of RAMALA-
Apolipoproteins report is abnormal, Homocysteine and lipid profile is raised, Vitamin D and folate is low. Vitamin B 12 is on border and MCV is raised, so is HbA1c and sugars are raised.
You need to meet a cardiologist. Start with Rosuvastatin 10 mg daily till you meet the cardiologist. Initiate Tab Dexorange once a day. Vitamin D can be replaced in lower doses- Shelcal OS is needed.
For sugars, meet your diabetician for dose adjustment of sugar medicines- if no diabetes medicines, check FBS and PPBS.

I have tried to make it as simple as possible.
Best of luck,
Dr Mittal

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Brief Answer:
specific information

Detailed Answer:
Hi
Thanks for your response.
I will be answering your specific questions in this section.

1st about kidney function tests- yes, they are low. The Kidney function tests are worrisome if the levels are high. Low levels may simply be due to a low muscle mass. No remedy is needed- all the suggestion about drinking water or supplements for this purpose are not needed.

2nd about Amway and Nutrilite- these supplements are routinely prescribed in practice by many doctors. However, there is no study on their products that has not been sponsored by them. And there have been reports that the products have higher than required levels of supplements. So, I usually suggest my patients to avoid them when traditional good quality supplements are available. I have done the same for you- when I suggested calcerol, folate and dexorange, which are supplements.

3rd, supplementary foods are always advisable. But not when the deficiency is evident in reports. So I think at least temporarily, the supplements should be taken. The foods will be advisable after taking the supplements and repeat samples after 3-4 months.

4th, your query on dusty environment- yes it definitely does affect your lungs unless you use protective devices. None of your reports were done for this, so I could not comment on it. And as you rightly said, you had not given me clinical details.

5th, HS-CRP, Homocysteine are abnormal in your reports. Now it is beyond the scope of the query to explain you exactly what they are. Lipid profile suggests that your cholesterol profile is abnormal. But know this that they are indicators of a cardiac risk. Hence I suggested a cardiac check up. A CV Doppler is a Doppler of the neck vessels that may be important again in patients who may develop stroke- where the above mentioned tests are again abnormal.

6th, MCV, Folate and Vit B are abnormal (as described before). Because of the deficiency, MCV is affected in a report called CBC (that you attached). This means you have abnormal red blood cells. So supplements have been suggested for the same.

7th, as already explained, Dexorange is a supplement. And no, Atorvastatin cannot be replaced by a supplement.

8th, about Calcerol as already explained is a supplement.

9th Testosterone depends a lot on levels of musculature and height and weight. These are usually higher in Caucasian population. In XXXXXXX population, that is widely known to be smaller and less muscular then Caucasian people, the levels are usually lower.

10th TLC or total leucocyte count is a marker of infection. This needs clinical history from you that may suggest an infection like fever etc.

11th, for your hair, deficiencies is a possible cause of baldness sometimes. So, you may try the supplements suggested. However, the way you have mentioned it, it sounds more like male pattern baldness where supplements will not help. As for Dr Batra’s solution, I am not a homeopath. You will need to consult a homeopath regarding the affects of the solution on the blood reports- as per the usual claims of homeopaths, there should be no effect.

12th, for the cardiologist suggesting Vitamin D, I would need to know the complete advice given by the cardiologist. Anyways, I still suggest the medicines I have already suggested. Maybeyou can discuss the options I suggested with him/her.

13th, HbA1c, FBS, PPBS are tests for sugars. These I suggest because HbA1C may be altered in the long transport, and the average glucose is high. So it needs to be tested to make sure there is no abnormality.

14th, I have not suggested a medicine. As you said, the report say good “control”. Which means a person who is diabetic and on treatment is on good control. I quote what I said “For sugars, meet your diabetician for dose adjustment of sugar medicines- if no diabetes medicines, check FBS and PPBS.” Please avoid reading between the lines.

Lastly, if the cardiologist there has suggested a medicine, it should be initiated. And yes, he/she has started medicines for BP as well.

Best of luck.
Dr Mittal

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