Archive for September, 2012

The liver is a very important organ as its job is to filter all the blood in your body.  It continually filters toxins, drugs, wastes generated from the body, chemicals and alcohol.  A healthy liver is necessary for the body to function correctly.

human liver galbaldder

Why the Recent Increase in Liver Damage?

  1. Increased use of prescription, over-the-counter and illegal drugs
  2. Increased alcohol consumption

The liver has to break down alcohol and drugs to remove it from the body.  Excess of either drugs or alcohol can damage the liver.  Increasingly, people are mixing both drugs (e.g. Acetaminophen) and alcohol which can lead to acute liver failure.

Cool Facts about the Liver

  1. It’s the only internal organ that can regenerate itself
  2. The liver stores vitamins (fat soluble) and minerals (i.e. iron) and releases them to the blood as necessary
  3. It produces bile to break down fats

The Liver Function Test

There is a blood test (also know as a hepatic function test) to screen the liver to see if it is functioning normally.

Levels for the following are included in the test:

  • bilirubin
  • liver enzymes
  • blood proteins

Understanding the Liver Function Test Results

There are many acronyms associated with the different components and there are acceptable levels that physicians use to help diagnose problems with the liver:

Albumin, Globulin and Total Protein – Measures the amount and type of protein in your blood. They are a useful index of overall health and nutrition. Abnormal results are an indicator of malnutrition, liver or kidney disease, cirrhosis, multiple meyloma, sarcoid, amyloid, lupus, and/or major infections. Globulin is the “antibody” protein important for fighting disease. If one of these values is high, but the other values are within expected ranges, the result is probably not significant, but only your physician can confirm this.

LDH (Lactate Dehydrogenase) – An enzyme found in blood and tissues. Elevated levels are found in various diseases including myocardial infarction, cancer, and anemia. A hemolyzed blood specimen can falsely elevate levels. Slightly decreased levels are usually insignificant but only your physician can confirm this.

Gamma GT (GGT) – A liver enzyme whose elevation may indicate liver disease. Moderate intake of alcohol and some common medications may cause elevated levels to occur.

Bilirubin – Primary pigment in bile. It is derived from hemoglobin and processed by the liver, and builds up when the liver is functioning poorly or when some other disorder reduces the normal flow of bile. It is increased also when there has been destruction of red blood cells.

AST & ALT – Injury to cells releases these enzymes into the blood. Liver disease and heart attacks, as well as serious physical injury can cause elevation of these values. Low values are probably not significant, but can only be confirmed by your physician.

Common Liver Diseases

Fatty liver disease -Fatty liver disease when there is extra fat in the liver cells and is typically associated with those that drink too much alcohol.  This type of diseases generally does not have any symptoms.  If diagnosed, fatty liver disease will go away once alcohol is eliminated from the diet.

Hepatitis B – Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). Hepatitis causes the liver to swell and become damagedHepatitis C – Hepatitis C is an infection caused by a virus that attacks the liver and leads to inflammation.

Cirrhosis – Cirrhosis is the scarring of the liver; hard scar tissue replaces soft healthy tissue Cirrhosis occurs in response to chronic damage to your liver.

Take Control of your Health!

Medical Disclaimer:  The information included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her health care provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.  The writer is not a physician or other health provider.

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Hypothyroidism : Get a Thyroid Hormone Test

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 What is the Thyroid?

The thyroid is a small shaped gland that is located in the neck near the Adam’s apple.  The gland has several functions including:

  1. controlling the body’s metabolism
  2. producing thyroid hormones (thyroxine/T4, triiodothyronine/T3)
  3. producing calcitonin to regulate calcium levels in the blood

Thyroid Gland Location resized 600

As with most hormones, there is an elaborate communication network that controls the amount of thyroid hormones released into the blood stream.  When thyroid hormones decrease, the hypothalamus signals the pituitary gland to release more thyroid stimulating hormone (TSH).  TSH tells the thyroid gland to produce and secrete more thyroid hormones.   When enough thyroid hormones are in the blood stream, TSH decreases and the thyroid hormones, T3/T4 would remain constant.

Thyroid Diseases

It is estimated that 20 million Americans have some form of thyroid disease.  Since some people are asymptomatic, it is believed that even more people have thyroid disease but do not know it.  Both men and women can have thyroid problems, but women are more likely than men to have thyroid disorders.

Symptoms for Thyroid Disorders

Many of these symptoms could be indications of thyroid disorder, but they could also be related to other health issues, so be sure to discuss all your symptoms and test results with your health provider.

  • Fatigue
  • Weight Gain
  • Heavier menstrual periods
  • Brittle hair and nails
  • Increased sensitivity to cold
  • Constipation
  • Joint or Muscle Pain

 Hypothyroid

Hypothyroid is when the body has too little thyroid hormone.  Untreated hypothyroidism is serious, so early detection and treatment should be conducted.  Hypothyroid is determined by taking a Thyroid Panel Test which will test for TSH, T4 and T3.  Additionally, it is recommended that the individual test for

Certain drugs such as lithium and amiodarone can promote hypothyroidism.

Treatment

Levothyroxinen is the most commonly used medication to replace the thyroid hormone that is lacking in the body.

  • Doctors typically prescribe the lowest dose that will bring your hormone levels back to normal while relieving any symptoms.
  • If you are an older patient and/or have heart disease, your physician may prescribe a very low dose as well.
  • Since a thyroid disorder is usually permanent, most individuals will receive thyroid replacement therapy for their entire life.

It is important to monitor your thyroid levels once you start taking synthetic thyroid hormones.  Most physicians will want to check your hormone levels every 2 months but some may want testing done more frequently until the level of medication is well established.

Take Control of Your Health!

 Medical Disclaimer: The information included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her health care provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. The writer is not a physician or other health provider.

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Diabetes Lab Tests: Order These Important Tests

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If you are diabetic or pre-diabetic, it is very important to monitor your blood sugar levels.  Below are a list of tests that are recommended for people with diabetes.  Talk to your health provider to discuss how frequently you should get these tests and to address your results with a plan of action to keep your diabetes under control.

diabetes magnified image resized 600

  •  A1c Blood Test – The blood test shows the average amount of glucose (sugar) that is in your blood during the past 2-3 months.  This test provides an indicator on how well your glucose is being managed.
  • Glucose (sugar)– Fasting values are usually high in diabetes. Certain drugs, such as thyroid, diuretic, and birth control pills as well as recent intake of food, can elevate glucose levels.
  • Blood Lipid Test – This blood test checks for various fats in your blood such as LDL, HDL, cholesterol and triglycerides.
  • Kidney Function Test – Diabetes can damage the kidneys this test screens for kidney problems before they become severe.

Keep your diabetes under control in order to prevent or delay damage caused by high blood sugar.  Order your own blood tests to monitor your sugar.  The typical costs for each of these tests is relatively small.  All three tests should cost you less than $99* and can easily be ordered online with results ready for review by the next day.  Take control of your health today.
Take control of your health.

* Note – current special for Diabetes Tests: A1c, Microalbumin, Lipid, CMP is $99 at the time of this posting

 

Medical Disclaimer:  The information included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her health care provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.  The writer is not a physician or other health provider.

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People are ordering their own lab tests and it is increasingly popular with those that:

  1. Have high deductible insurance policies
  2. Are uninsured
  3. Want confidentiality so it is not reported to their health insurance carriers
  4. Impatient to see a physician or
  5. Do not want to pay for an office visit for a lab test order/prescription

Since the majority of those that are self ordering blood tests are not health professionals, the common question is whether or not they will be able to decipher the data on their lab results.  Unlike an MRI, sonogram or x-ray, lab results are fairly simple to read.  Each test component is listed along with a (1) reference range, (2) your actual values and (3) a flag notification if your values are outside the reference range.

For instance, if you are testing your blood sugar, or glucose, the test results would look like this:

Glucose High graphic

The person’s Glucose level is 196 mg/dL and is flagged as HIGH because the levels should be within the Reference Intervals of 65-99 mg/dL.   Uric Acid, Serum levels are normal and not flagged since they are within the reference interval provided.  Reference Intervals are based upon gender and age and are constantly being updated for the current recommended standards.

So, generally speaking, the lab test results can be easily read by those that order the test.  It is recommended that you establishes a relationship with a health provider that can review your family history, your lab test results and conduct a physical examination to diagnose and further explain your test results.

Go ahead and order those tests yourself – it’s simple, easy and inexpensive and can provide important health information.

Take Control of Your Health.

 Medical Disclaimer: The information included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her health care provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. The writer is not a physician or other health provider.

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Blood Test : Comprehensive Metabolic Panel

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A comprehensive metabolic blood panel is a blood test that evaluates the level of glucose in the blood.  It also measures the balance of electrolytes and fluids as well as evaluating kidney function. An abnormal test could indicate a problem that needs to be addressed by a physician.

A physician may order a comprehensive metabolic blood panel as part of an annual wellness examination.  The doctor may also order the test to check and see if certain medications are affecting the kidneys. The test is many times ordered in the emergency room, so that doctors can quickly assess bodily functions.  To perform the test, a vial of blood is collected from a vein, usually in the arm.  Fasting for 10 – 12 hours before the test, may or may not be required, depending on why the test is being performed. After the blood is drawn, a specialized machine processes it and results are usually available to the doctor within 24 hours or less.

The Comprehensive Metabolic Panel is also called the CMP 14 (as opposed to the Basic Metabolic Panel or BMP 8) and tests the following:

  • Glucose
  • Urea Nitrogen (BUN): A waste product of the liver excreted by the kidneys. High values may indicate kidney malfunction and/or dehydration
  • Creatinine: This is a waste product of muscle metabolism that is discarded by the kidney. It is elevated in kidney disease, muscle wasting disease, and sometimes the day after strenuous physical exercise.
  • BUN/Creatinine Ratio: Both BUN and creatinine are elevated in kidney failure, but they are elevated differently depending on the cause of the failure. This ratio helps determine the type of kidney failure.
  • eGFR: Estimated Glomerular Filtration Rate
  • Sodium, Potassium, and Chloride: “Electrolytes” help make up the salt balance and acid/base balance in the body. They can be affected by diuretics or water pills, high blood pressure, heart failure, kidney and lung disease. The balance among these elements is important for proper functioning of the heart and brain.
  • Carbon Dioxide: Part of the electrolyte panel used to detect, evaluate and monitor electrolyte imbalances.
  • Calcium: screens for range of conditions relating to the bones, heart, nerves, kidneys, and teeth. Blood calcium levels do not directly tell how much calcium is in the bones, but rather, how much total calcium or ionized calcium is circulating in the blood.
  • Albumin, Globulin and Total Protein: Measures the amount and type of protein in your blood. They are a useful index of overall health and nutrition. Abnormal results are an indicator of under nutrition, liver or kidney disease, cirrhosis, multiple meyloma, sarcoid, amyloid, lupus, and/or major infections. Globulin is the “antibody” protein important for fighting disease. If one of these values is high, but the other values are within expected ranges, the result is probably not significant, but only your physician can confirm this.
  • Alkaline Phosphatase: A bone and liver enzyme. High values are associated with liver and gall-bladder disease. Expect to see higher values in adolescents and pregnant or breast feeding women. Low values are probably not significant, but can only be confirmed by your physician.
  • Bilirubin: Primary pigment in bile. It is derived from hemoglobin and processed by the liver, and builds up when the liver is functioning poorly or when some other disorder reduces the normal flow of bile. It is increased also when there has been destruction of red blood cells.
  • AST & ALT: Injury to cells releases these enzymes into the blood. Liver disease and heart attacks, as well as serious physical injury can cause elevation of these values. Low values are probably not significant, but can only be confirmed by your physician.

This simple and inexpensive test provides extensive information about the health and wellness of your body.

Take Control of Your Health.

 Medical Disclaimer: The information included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her health care provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. The writer is not a physician or other health provider.

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What is VAP cholesterol?

VAP cholesterol is a measurement of many levels of cholesterol and other fats, or lipids, present in the body. Vertical auto profile (VAP) cholesterol testing has been perfected and adapted into clinical testing by a biochemical company called Atherotech.

What’s the Difference?

Traditional lipid profile blood tests consists of three components:  cholesterol, triglycerides and HDL, or high density lipoproteins,  HDL is the so called “good” cholesterol, which is beneficial in reducing heart risk and “sweeping” away the bad cholesterol to the liver for disposal.  With the levels of these three lipids measured, a calculation gives a low density lipoprotein, or LDL level. Doctors originally want the LDL to be less than 140, then less than 130, then less than 100.  VAP cholesterol measures a total of 15 different fractions of HDL, cholesterol and very low density lipoproteins (VLDL) by weight.

By measuring the subfractions of the lipoproteins, a more accurate detailed prediction of heart disease, diabetes and metabolic syndrome can be analyzed.

Should I Get it Done?

The traditional lipid profile: HDL, cholesterol, triglycerides and LDL,  may not appear abnormal in patients who have suffered a heart attack.  For these patients, the VAP cholesterol would certainly be worth the extra cost and testing detail.

Patients whose traditional lipid profile is showing some abnormal results, especially after taking cholesterol lowering medications, should have the VAP cholesterol testing done.

Adiponectin is another fraction of total lipid measured in the VAP testing. This may be linked to heart disease progression.  Therefore, any patient who has had a previous heart attack should definitely have the VAP cholesterol testing in the future.  Patients who are at increased risk for heart attack, suc as previously elevated cholesterol levels, low HDL levels or who are overweight and have high blood pressure should also consider this more accurate predictor of heart attack risk.

Before you choose to have the VAP cholesterol tested, if you are at risk, make sure you are willing to make the changes to reduce your risk.  There is no point in having the test if you plan to be non-compliant by not changing your diet or taking medication.

VAP Cholesterol Testing

sample result of a VAP test

Take control of your health.

 

Medical Disclaimer:  The information included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her health care provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.  The writer is not a physician or other health provider.

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Both Men and Women Need Testosterone Tests

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What is Testosterone?

Testosterone is a sex hormone produced in males in the testes and in females in the ovaries. It’s the hormone responsible for male secondary sex characteristics and sex drive.  In both sexes, testosterone plays a role in maintaining bone and muscle function.  The levels are significantly lower in women and children than in men.  Its levels also decline with advancing age.

testosterone chemical resized 600
Function

Since the pituitary gland is the “master” gland and regulates all other glands and hormones, it can directly affect hormone levels, including testosterone. During puberty, testosterone levels increase in boys and cause the voice to deepen, pubic hair to appear and muscle mass to increase.  It also allows for sperm formation in the testes.

Why Test for it?

Testosterone hormone level testing would likely be indicated in men if they are having trouble fathering a child, obtaining or keeping an erection, experiencing a low sex drive, or are depressed and fatigued without explanation.  Higher than normal testosterone levels in boys would be suspect if signs of puberty are occurring at an earlier than normal age or male secondary symptoms are appearing in females.

Why It’s Helpful to Know Your Testosterone Levels

Low testosterone levels would be the most common reason in men and women for a low sex drive.   High testosterone levels in men could be indicative of a tumor in the testes or prostate gland. In women, testosterone levels can be affected by abnormalities of the ovaries.  Abnormalities or growths in the pituitary gland  may also cause an increase in testosterone in either sex or effect bone density, increasing the chances of fractures.

Symptoms to Know

Low sex drive is the most common sign of low testosterone in both sexes.  A doctor may want to test for levels of this hormone, along with other hormones if a woman is experiencing irregular periods, having difficulty conceiving, or is exhibiting excessive body or facial hair. Low testosterone levels can also be sign of illegal anabolic steroid use, be a side effect of obesity or a sign of pituitary or hypothalmus inflammation.  Excessive amounts of testosterone can cause agitation and aggression.

Hormone levels can be quite sensitive and  dependent on other glands and  hormones. However, once identified, the levels are relatively easy to regulate with medication in pill or patch form.

Other Interesting Testosterone Facts

Both liver disease and alcoholism in males can decrease testosterone levels. Androgens and steroid drugs can also decrease testosterone levels.

Many men receive androgens for prostate cancer, so many men with advanced prostate cancer receive these drugs will have lower testosterone levels.

Drugs such as anticonvulsants, barbiturates, and clomiphene can cause testosterone levels to rise. Women taking estrogen therapy may have increased testosterone levels.

Types of Testosterone Tests

There are many testosterone tests, but for general screening the following are recommended:

Testosterone, Serum test

Testosterone, Total & Free test

Take control of your health.

 

Medical Disclaimer:  The information included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her health care provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.  The writer is not a physician or other health provider.

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