Description and Possible Medical Problems

Since the primary function of the liver is to detoxify the blood, if the livet fails to do its job properly, the problem will immediately become evident through a routine blood test. An abnormal liver function test can be caused by many diseases, including hepatitis, viral inflammation of the liver, an injury to the liver, such as cancer or alcohol abuse, gallbladder disease, and certain medications, such as Cognex and Mevacor.

Treatment

Since each specific liver disease requires its own individual treatment, if your doctor discovers a problem with your liver, he will immediately order a regimen for you. This may include medication such as corticosteroids to reduce inflammation, a diet that’s restricted in protein, fat, and alcohol, and rest. Some liver diseases, such as viral hepatitis, can be highly contagious, so your doctor may recommend that your family members receive immune globulins against hepatitis.

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Description and Possible Medical Problems

The triglyceride level is nothing more than the amount of fat that is found in the bloodstream. A test to determine your triglyceride level will be included as part of a cholesterol test; triglycerides alone pose very little risk to your health. I feel the value should be 150 or less. Currently, there is a lot of controversy in the medical establishment over whether an elevated triglyceride level alone increases the risk of heart disease. Even though I believe that for good health the triglyceride level should be at 150 or less, an elevated triglyceride level will be treated only if it is extremely high, in excess of 800 milligrams/100cc, which is an indication of a pancreatic problem or advancing arteriosclerosis. Elevated triglycerides are often caused by heredity, but, like the HDL and LDL cholesterol levels, more often than not they’re a result of a high-fat diet, uncontrolled diabetes, and heavy smoking—particularly in women.

Treatment

The primary treatment for a high triglyceride level is medication, but again, only if the level is above 800. Your doctor will also prescribe a low-fat diet and moderate exercise program for you to follow. However, an underlying condition, such as diabetes, must also be treated in order to bring the triglycerides down to a normal level. I’ve found that in some rare cases a triglyceride level above 200 is caused by taking a medication such as Accutane, which is used to treat acne. In this case, discontinuing the medication will lower the triglyceride level to its previous state.

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Since, like many Americans, you may have been fighting excess body weight for most of your life, you may be heartened to discover that weight loss is a common part of the aging process. However, this weight loss begins when people reach their mid to late 60s, and it usually amounts to only a few pounds a year, if that. Even though your scale says you weigh less, any pounds that are lost due to the aging process are mostly lean body mass or muscle mass, not fat. This leaves most people with less strength than they had just a few years before. Since the process is usually slow, the weight loss usually goes unnoticed except for when they are weighed in at their annual checkup or observe a change in their physical stature.

The time you and your doctor should become concerned about weight loss, however, is when both your weight and your general health rapidly deteriorate over a short period of time. If you have lost 10% of your weight over a period of a month or two, I usually become quite concerned, and the younger my patient, the more concerned I become.

If a person who is quite overweight loses a couple of pounds without trying, the loss might not initially seem serious, but this too can be the sign of a medical problem.

As with the case of malaise, weight loss can occur because of either the normal physiological changes of aging or a more serious illness.

That’s why a complete medical history and physical exam with the necessary diagnostic tests are extremely important in any instance of unexplained weight loss. Thyroid problems may cause you to feel overheated, while cancer or a hidden infection may be responsible for a fever or night sweats. If you are coughing or feel short of breath, you may have emphysema ot lung cancer. There is also the possibility that if weight loss is accompanied by a cough, swollen glands, a fever, and/or a general feeling of malaise, you might have been exposed to the HIV virus, which can lead to the development of AIDS.

If you have tecently lost weight without trying, either a few pounds or 10 or more, you should ask yourself the following questions:

1. Over how long a time has the weight loss occurred?

2. Have I also experienced a change in my appetite or bowel habits?

3. Do I suffer from heat intolerance, nervousness, or heart palpitations?

4. Do I have night sweats, occasional fevers, or newly enlarged glands?

5. Am I coughing a lot lately? Do I suffer from shortness of breath?

6. Do I have a prior history of a serious illness?

7. Do I regularly use alcohol or tobacco?

8. Have I ever had an unsafe sexual encounter, shared a hypodermic needle, or had a blood transfusions?

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Laboratory/Diagnostic Procedures

High-risk groups. Fasting plasma glucose for the markedly obese, persons with a family history of diabetes, or women with a history of gestational diabetes.

Syphillis test VDRL or RPR for prostitutes, persons who engage in sex with multiple partners in areas in which syphilis is prevalent, or have contacts with persons with active syphilis.

Urinalysis for bacteriuria for persons with diabetes.

Chlamydial testing for persons who attend clinics for sexually transmitted diseases, attend other high-risk health care facilities (e.g., adolescent and family planning clinics), or have other risk factors for chlamydial infection (e.g., multiple sexual partners or a sexual partner with multiple sexual contacts).

Gonorrhea culture for prostitutes, persons who have multiple sexual partners or a sexual partner who has multiple contacts, sexual contacts of persons with culture-proven gonorrhea, or persons who have a history of repeated episodes of gonorrhea.

Counseling and testing for HIV for persons seeking treatment for sexually transmitted diseases; homosexual and bisexual men; past or present intravenous drug users; persons with a history of prostitution or multiple sexual contact; women whose past or present sexual partners were HIV-infected, bisexual or IV drug users; persons with long-term residence or birth in an area with a high prevalence of HIV infection; or persons who had a blood transfusion between 1978 and 1985.

Tuberculin skin test (PPD) for household members of persons with tuberculosis or others at risk for close contact with the disease (e.g., staff of tuberculosis clinics, shelters for the homeless, nursing homes, substance abuse treatment clinics, dialysis units, correctional institutions); recent immigrants or refugees from countries in which tuberculosis is common (e.g., Asia, Africa, Central and South America, Pacific Islands); migrant workers; residents of nursing homes, correctional institutions, or homeless shelters; or persons with certain underlying medical disorders (e.g., HIV infection).

Electrocardiogram for men with two or more cardiac risk factors (high blood cholesterol, hypertension, cigarette smoking, diabetes mellitus, family history of coronary artery disease); people who would endanger public safety were they to experience a sudden cardiac event (e.g., commercial airline pilots); or sedentary or high-risk males planning to begin a vigorous exercise program.

Hearing test for persons frequently exposed to excessive noise.

Fecal occult blood sigmoidoscopy for persons aged 50 and older who have first-degree relatives with colorectal cancer; a personal history of endometrial, ovarian, or breast cancer; or a previous diagnosis of inflammatory bowel disease, adenomatous polyps, or colorectal cancer.

Fecal occult blood colonoscopy for persons who have a family history of familial polyposis coli or cancer-family syndrome.

Bone mineral content for perimenopausal women who have an increased risk for osteoporosis (e.g., Caucasian race, bilateral ovary removal before menopause, slender build) and for whom estrogen replacement therapy is not recommended.

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Tetanus-diphtheria (TD) booster.

High-risk groups. Hepatitis B vaccine for homosexually active men, intravenous drug users, recipients of some blood products, or people in health-related jobs who are frequently exposed to blood or blood products.

Pneumococcal vaccine for persons who have medical conditions that increase the risk of pneumococcal infection (e.g., chronic cardiac or pulmonary disease, sickle-cell disease, nephrotic syndrome, Hodgkin’s disease, asplenia, diabetes mellitus, alcoholism, cirrhosis, multiple myeloma, renal disease, conditions associated with immunosuppression).

Influenza vaccine for residents of chronic care facilities and persons suffering from chronic cardiopulmonary disorders, metabolic diseases (including diabetes mellitus), hemoglobinopathies, immunosuppression, or renal dysfunction.

This list of preventive measures is not exhaustive. It reflects only those topics reviewed by the U.S. Preventive Services Task Force. Your doctor may wish to add other preventive measures on a routine basis, after considering your medical history and other individual circumstances. Examples of conditions not specifically examined by the Task Force include:

Chronic obstructive pulmonary disease.

Hepatobility disease.

Bladder cancer.

Endometrial disease.

Travel-related illness.

Prescription drug abuse.

Occupational illness and injuries.

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