Hi doctor,I am suffering from dullness and tiredness all the time. Also, I have anxiety and irritation. My current medication includes Lodoz 2.5 and Cilaheart 5, VALZ 40. My medical report shows some abnormalities. Please suggest.
Hi. I feel sorry for the dullness and tiredness you feel. It is really troublesome for a patient at this early age. I have carefully gone through your case and thanks for making it easy to evaluate on the basis of the attached reports (attachment removed to protect patient identity).  1. You have a very high body mass index that makes the heart issues justified even at this young age.  2. Your ideal weight for this age and height must be between 60 kg and 65 kg. Above 65 kg means a very high risk.  3. You need to keep a balanced diet intake, physical activity on a regular and healthy pace. Do not go for any heroic measures or faster weight loss measures that may even make you more unhealthy.  4. Your laboratory reports, which are out of range, will be discussed here in detail as you need to know about them. Please follow the suggestions so that you may live a long healthier life.  5. Avoid smoking, alcohol, spices and fried foods, junks and energy drinks. Only a bland diet, homemade and good hygienic. No refined foods. Keep wholegrain foods in your scheduled menu.  6. You have a high level of cardiac marker that shows a risk to the heart due to its own blood supply. In simple words, the pipes which supply blood to the heart's own muscles are somewhat at a high risk of blockage due to the disease inside them. This situation may lead to future heart attacks or pain and discomfort in the chest.  7. Your symptoms also suggest the heart disease related to the muscle's blood supply. This kind of symptoms warrants a prompt, thorough evaluation of the heart from a cardiologist who will need to run a specific laboratory tests on you to see what is happening inside.  8. The cardiac evaluation is also necessary, because sometimes there is not any cardiac disease and the values of the above said test that the hs-CRP is still high. And sometimes, the symptoms you have right now are also due to anxiety and other non-cardiac causes. So, clinical evaluation is the most important next step. Make an appointment as soon as possible to see how is your heart.  9. Fortunately, as for many other tests, your blood cholesterol levels are also very much in the normal range and this is very encouraging sign for your good health. Please keep away from oily edibles and remain physically active.  10. You have high levels of alkaline phosphatase, an enzyme that is high in liver damage and disease related to the biliary system that is attached to the liver. You also have high liver enzymes that once again indicate you have some liver problems, for example hepatitis or other issues. You need to go for a thorough abdominal ultrasound and viral marker test from the same laboratory test for this purpose.  11. Other test derangements also implicate the same liver issues. When you get the laboratory results I mentioned below, come back with uploading the results as you did before. I will review and let you know how to proceed further. 1. HBsAg (hepatitis B surface antigen) and anti HCV (hepatitis C virus), both by ELISA - enzyme-linked immunosorbent assay. 2. Abdominal ultrasound. Revert back with the reports to a general practitioner online -->