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The ultrasound did detect "hepatic steatosis" which are little fat droplets within the liver.  This is a sign of inflammation and is very common (almost half of all adults in the United States).  Over time the inflammation can damage the liver.  There is no medication treatment for this, but it can improve with weight loss and abstinence from alcohol.

Your Hemoglobin A1C - diabetes monitoring test – was above the goal of 8.0%.  If you'd like to meet with a dietician sometimes small changes in your diet can have big benefits to your health.

Your HDL - good cholesterol - is borderline low, it can improve with increasing physical activity.

Your hemoglobin was low, normal is 13.5 to 17.9.  It should be rechecked in 1 month.

Your vitamin B12 level was on the low side of normal.  Normal is 213 to 816.  You may wish to take a multivitamin every day or every other day to bring this up.

Folate normal

iron studies - no evidence of deficiency

Blood count is normal.

Liver and kidney tests are normal.

Your blood liver tests and kidney tests are normal.  Your blood count (red blood cells, white blood cells, and platelets) was normal, as well.

LDL cholesterol (the 'bad cholesterol') is looking good at ***.  It is an improvement from last time when it was ***.  To keep this down, I recommend you 
continue your cholesterol-lowering medication and eat a diet rich in non-starchy vegetables, nuts, beans, and oats and low in processed and red meat.

*** LDL cholesterol (the 'bad cholesterol') is borderline elevated.  To bring this down, I recommend you eat a diet rich in non-starchy vegetables, nuts, beans, and oats and low in processed and red meat.

LDL cholesterol (the 'bad cholesterol') is elevated at ***.  I don't recommend you take a medication for this, but it is higher than last year (it was *** 1 year ago).
To bring this down, I recommend you eat a diet rich in non-starchy vegetables, nuts, beans, and oats and low in processed and red meat.

LDL cholesterol (the 'bad cholesterol') is looking good at 85.  To keep this down, I recommend you continue the atorvastatin and eat a diet rich in non-starchy vegetables, nuts, beans, and oats and low in processed and red meat.

I would recommend a healthy diet rich in fruits, vegetables, lean meats and low in processed foods. Try to get 30-60 minutes of exercise 4 to 5 days per week as 
tolerated. Work on reaching and maintaining a healthy weight.

Your stool test - fecal immunochemical test - was a screening test for colon cancer.  It was negative.  You should repeat this test yearly to keep up to date on cancer screening.

Your liver enzyme ***AST*** is borderline high. It can be increased with too much Tylenol (acetaminophen), herbal medicines, alcohol drinking, hepatitis (liver infection), statin (cholesterol lowering medicine), or hepatic steatosis (fatty liver). If you are drinking alcohol, then you should stop.  I would like to recheck liver enzyme in 1 month.  If the test is not coming down, then I will request an ultrasound (imaging test) of your liver.

Liver tests usually increases when a patient takes more than the recommended dose of Tylenol, take herbal medicines, drink alcohol, have a liver infection, or inflammation of the liver called 'hepatic steatosis' or fatty liver.  Since the test was elevated, we advise you to avoid alcohol.

Liver tests usually increase when a patient takes more than the recommended dose of Tylenol, take herbal medicines, drink alcohol, have a liver infection, or inflammation of the liver called 'hepatic steatosis' or fatty liver.  Since the test was elevated, we always advise the patient to avoid alcohol.

Your liver tests were in the normal range so it looks like there's no problem with the ***.

Your chloride (body chemistry test) is slightly elevated but not concerning.

Creatinine - the kidney function test - is slightly elevated at ***. Do not take NSAIDS like ibuprofen, naproxen, Aleve, Advil etc. Stay hydrated.  We will recheck your kidney function in 1 month, if it is still high then I will refer you to nephrologist.

Calcium level is borderline high.  If you are taking any calcium supplement then stop taking it.  We will recheck in 1 month.

Hemoglobin A1c (monitoring test for diabetes) is elevated at ***.  The  goal is less than 7.0.  The last time we checked it was ***, so last week's value was an improvement.  

The urine microalbumin (monitoring test for kidney damage related to diabetes) was normal.  To prevent damage to the kidneys it is best to get good control of blood pressure and diabetes.

The urine microalbumin (monitoring test for kidney damage related to diabetes) was normal.  To prevent damage to the kidneys it is best to get good control of blood pressure and diabetes.

Your blood count (red blood cells, white blood cells, and platelets) was normal.

We should repeat lab testing in 3 months to keep an eye on blood sugars.

Your Hemoglobin A1c (screening test for diabetes) was normal.

Your PSA (screening test for prostate disease) was slightly elevated.  Normal is less than or equal to 4.0.  Since it is mildly elevated, I recommend consulting urology.

Your Hemoglobin A1c (screening test for diabetes) was normal.

Your blood count (red blood cells, white blood cells, and platelets) was normal.



Your HDL (good) cholesterol is slightly low and your triglycerides (a type of fat in the blood) is quite elevated.  The rest of your lipid panel is in the normal range. The triglycerides are in a range to consider starting a cholesterol-lowering medication.  If you are not ready to start a medication, I would recommend working on a health diet and weight loss.  Please let us know if you are interested in starting a medication. If a medication is started, we should obtain a lipid panel, ALT (liver test) in 3 months. 

Your urinalysis is normal but it does show that you have an increased amount of protein in your urine.  This can occur due to high blood pressure. Your kidney function tests are looking normal. 

Continue your current blood pressure medications and try to work towards blood pressures < 140/90.

Your glucose (blood sugar) was slightly elevated, but not concerning.

I would recommend a healthy diet rich in fruits, vegetables, lean meats and low in processed foods. Try to get 30-60 minutes of exercise 4 to 5 days per week as 
tolerated. Work on reaching and maintaining a healthy weight.

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To Whom it may concern:

I am a *** at *** caring for ***, DOB: *. 

*** is a patient who receives services from ***. She/He has chronic back pain with a recent exacerbation of the pain. 

I recommend, in addition to following treatment recommendations, that she/he have some limitations in her activity for the next 2 weeks.  Specifically, she/he would benefit from reduced bending and crouching.  She/He would benefit from limiting prolonged standing and walking.  Finally, she/he would benefit from lifting no more than 15 pounds at a time while she/he is recovering from this acute episode.

Please feel free to contact me if any further information is necessary.