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Why is a cardiac MRI not recommended every five years similar to colonoscopy?

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General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Hello, Dr. Shanthi. Further to what we discussed before, why would it not be the case that despite lack of other symptoms a cardiac MRI should nevertheless be recommended every five years in an age when so many people are found to have some kind of blockages just as a colonscopy is recommended every five years for people over 50?
On a related matter, my fasting glucose (from 119 to 106) and cholesterol numbers (from 220 to 196) improved lately due to my change in diet, but the A1C number remains at 6.0 or 6.1%. Is this considered of greater concern than improved glucose numbers?
Also, is it possible to live out one's lifetime with a "prominent fatty liver" without resorting to Pioglitazone, or does the condition worsen without medication and weight loss? My wife has normal glucose and cholesterol numbers and does not drink alcohol, but was found to have fatty liver.
Posted Thu, 23 Aug 2012 in X-ray, Lab tests and Scans
Answered by Dr. Shanthi.E 12 hours later

Thanks for posting your query.

MRI is a costly investigation which cannot be set as a national guideline for screening purpose. An ideal screening test should be cost-effective to the individual and to the nation as a whole.

It should benefit a large number of people. More than 50% of people over 50 years of age cannot afford it and the insurance companies cannot take such a huge budget too.

These may be the reasons as to why it is still not set or recommended as a national guideline in the US. It may happen in the coming years.

For now, fasting lipid profile is cost-effective and best way to recognize early cardiac disease and so it is set as a national guideline.

Your fasting blood glucose, cholesterol and HbA1C levels are all well within the normal range. Please continue to follow the same diet.

Recent studies have shown that strict glycemic control of less than 6 is not advisable and may be deleterious to the patient.

You are on the right track; do not worry about your HbA1C status.

Non alcoholic fatty liver do exist in the absence of alcohol intake. It usually does not require medication. Rapid and sudden weight loss can increase the fat deposition in liver.

Hope I have been of some help to you.

Do write back for further discussion on this.

Above answer was peer-reviewed by
Follow-up: Why is a cardiac MRI not recommended every five years similar to colonoscopy? 1 hour later
Thank you very much. About A1C, in XXXXXXX we are told that it must've below 5.7% and that even 6.0% represents impaired glucose processing. Are they wrong with that?
I didn't consid er that a cardiac screening would be more of a cost issue than coonoscopies every five years....
I have noticed sensations of pricking in my leg or an electric zap in my foot which I ascribe to a sciatica or herniated disc issue which seems to be relieved if I maintain my posture when standing or sitting. But is it still inevitable that someday I would need surgery and that the condition will just worsen? I have not yet done any xrays etc.
Answered by Dr. Shanthi.E 19 hours later

Thanks for writing back.

No, the authorities are right in what they are saying. Ideally, it should be in the range of 5.7 to 6.0%. In the US, obesity, lack of physical activity, unhealthy diet in the form of processed and packed food is on rise. As you know, obesity is becoming a big public health issue in the US.

The need to keep HbA1C below 5.7% may be a preventive strategy against type 2 DM and just to make people a bit more aware and pre-cautious about DM.

Regarding your sciatica or herniated disc issue, you should follow simple physiotherapy exercises, walk at least for 30 minutes in a day. If the symptoms do not progress, there is no need for surgery.

You can consider taking nerve supplements like Neurobion forte that is available over the counter in the US.

Hope I have answered your queries. If you have no more queries to ask, you may accept my answer and write a review.

I wish you good health.

Above answer was peer-reviewed by
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