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Temp Log
The symptoms of a low body
temperature are classic for low thyroid function and they often get better
with thyroid medicine. Body temperatures are normally lower in the
morning, higher in the afternoon, and lower again in the evening. So if
the temperatures are low during the day when they're supposed to be at
their highest, that's better evidence that there's a problem. Temperature
patterns are also important and illuminating. How patients feel can be
affected not only by how high or low their temperatures are but also on
how steady their temps are. This is especially important during T3
therapy. One temperature reading a day is not enough to see how widely the
temperature is fluctuating, but more than three a day can be too time
consuming.
T3 uptake
This test measures the amount of thyroxine-binding globulin (TBG)
in the patient's serum. When TBG is increased,
T3 uptake is decreased,
and vice versa. T3
Uptake does not measure the level of
T3 or
T4 in
serum.
Increased
T3
uptake (decreased TBG) in euthyroid patients is seen in chronic liver
disease, protein-losing states, and with use of the following drugs:
androgens, barbiturates, bishydroxycourmarin, chlorpropamide,
corticosteroids, danazol,
d-thyroxine, penicillin, phenylbutazone, valproic acid, and androgens.
It is also seen in hyperthyroidism.
Decreased
T3
uptake (increased TBG) may occur due to the effects of exogenous estrogens
(including oral contraceptives), pregnancy, acute hepatitis, and in
genetically-determined elevations of TBG. Drugs producing increased TBG
include clofibrate, lithium, methimazole, phenothiazines, and
propylthiouracil. Decreased T3
uptake may occur in hypothyroidism
T4
This is a measurement of the total thyroxine in the serum,
including both the physiologically active (free) form, and the inactive form
bound to thyroxine-binding globulin (TBG). It is
increased
in hyperthyroidism and in euthyroid states characterized by increased TBG (See "T3
uptake," above, and "FTI," below). Occasionally, hyperthyroidism will not be
manifested by elevation of T4
(free or total), but only by elevation of
T3 (triiodothyronine).
Therefore, if thyrotoxicosis is clinically suspect, and
T4
and FTI are normal, the test "T3-RIA"
is recommended (this is not the same test as "T3
uptake," which has nothing to do with the amount of
T3 in the patient's
serum). T4
is decreased in
hypothyroidism and in euthyroid states characterized by decreased TBG. A
separate test for "T4"
is available, but it is not usually necessary for the diagnosis of functional
thyroid disorders.
T7 (FTI)
This is a convenient parameter with
mathematically accounts for the reciprocal effects of
T4
and T3
uptake to give a single figure which correlates with free
T4.
Therefore, increased FTI is
seen in hyperthyroidism, and decreased
FTI is seen in hypothyroidism. Early cases of hyperthyroidism may be expressed
only by decreased thyroid stimulation hormone (TSH) with normal FTI. Early cases
of hypothyroidism may be expressed only by increased TSH with normal FTI.
Currently, the method of choice for screening for both hyper- and hypothyroidism
is serum TSH only. Modern methodologies ("ultrasensitive TSH") allow accurate
determination of the very low concentrations of TSH at the phyisological cutoff
between the normal and hyperthyroid states
TSH
TSH has been recognized as an
exquisitely sensitive indicator of thyroid status. TSH assays (second or third
generation) have therefore been widely adopted as the front-line thyroid
function test. In ambulatory patients with intact hypothalamic and pituitary
function, a normal TSH result excludes hypo- or hyperthyroidism; whereas
elevated and suppressed TSH results are diagnostic of hypo- and hyperthroidism,
respectively. Abnormal TSH results are generally confirmed with a complementary
determination of thyroid hormone levels.
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Lipid Panel |
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This profile requires you to be
fasting 12-14 hours. No appointment necessary.
Components of a Lipid Profile
Total Cholesterol
Cholesterol is a necessary substance in your body from your first day of life. Experts recommend a cholesterol level below 200 for good health. Between 200 and 239 is borderline and above 240 is dangerous. When associated with at least two risk factors such as high blood pressure, diabetes, previous heart disease or stroke, excess weight and being a smoker, it increases the incidence of having coronary artery disease and heart attacks.
HDL (Good
Cholesterol)
High density lipoproteins (HDL) are proteins coated "packages" that carry fat and cholesterol through the body. The function of HDL is to remove cholesterol from the blood by transporting it to the liver where it will be prepared for excretion through the bile. HDL has a protective effect on the deposit of fat in the wall of blood vessels. Increasing its level in the blood will reduce the risk of cardiovascular disease. The use of polyunsaturated, monounsaturated fats (Olive Oil), and physical exercise may increase the level of HDL.
Triglycerides
Triglycerides are a type of fatty substance which must be measured together with your cholesterol for a complete picture of your circulating blood fats. Blood triglycerides tend to be elevated in people who have high cholesterol levels, in people
with diabetes or chronic kidney disease, and in those who are obese. The relationship between triglycerides and coronary artery disease is still controversial. Some studies suggest that high blood triglycerides might increase the risk
of coronary artery disease. If your blood level of triglycerides is elevated you
should consult your doctor for dietary changes and weight loss and exercise program or for the use of medication which may be necessary in some cases.
LDL
(Bad
Cholesterol)
Low density lipoproteins (LDL) transport one half to two thirds of all blood cholesterol to various body tissues. A certain amount of LDL cholesterol (up to 130) is normal. But when the level increases, LDL promotes plaque development on the walls of the coronary arteries, slowing the flow of blood and sometimes blocking the artery entirely. Levels of 130-160 are considered borderline high and levels of 160 or higher are definitely abnormal and should be reduced with rigorous diet, other lifestyle changes, and/or with drug therapy.
Controversies are now surfacing on the danger of having LDL blood levels which are too low. The relation to some type of cancers and other diseases have been noticed with LDL levels reduced below 90 and closer to 50. Therefore is unclear today how safe is to lower your LDL blood level. A safer level seems to be between 90-130 and should
be associated with an increase in the HDL levels.
VLDL (Very Low Density Lipoprotein)
VLDL (Very Low Density Lipoprotein) is a fraction of Triglycerides circulating in your blood stream. Not as important as the LDL, this blood fats follows the levels of your Triglycerides.
Tryglycerides levels may be elevated either for the presence of high fats in your food which when absorbed in your intestine is transformed as Chylomicrons and give a milky appearance to the liquid part of your blood ( serum ) or for the presence of Very Low Density Lipoproteins (VLDL) which is the part of Triglycerides produced by your body and not ingested with food.
Cholesterol/HDL Ratio.
The HDL in the blood is believed to serve two
functions: 1) it coats the inside of the artery wall and provide a kind of protective layer of grease to prevent fat deposits from building up and 2) it serves as scavenger by actually helping dissolve fatty deposits when they occur. The basic rule of balance for your blood is to have a relatively high amount of HDL in your body in relation to your total amount of cholesterol. This is called the
Cholesterol/HDL Ratio.
The ratio in men should always be less than 5.0, and
preferably less than 4.5. For women, the ratio should be lower and always under 4.0 and preferably under 3.5. In other words the man's HDL should always represent at least 20% of the total cholesterol count (and preferably should be 25% or greater). For a woman the HDL cholesterol should make up
at least 25% (or preferably 30%) of the total cholesterol. The Cholesterol/HDL Ratio is probably the best predictor of future coronary disease. Active people with low levels of body
fat tend to show the best cholesterol balance (ratio) in their blood.
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Urinalysis
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Specific Gravity
The specific gravity of urine depends on the gravity and number of
molecules dissolved in solution of the urine sample. The normal urinary
specific gravity may range from 1.002 to 1.030. Most of the molecules
dissolved in the urine are made of Sodium Chloride and Urea. Urine is
usually More concentrated in the morning which, is a normal phenomenon.
Abnormally diluted urine may be present in kidney disease whereas very
concentrated urine with high specific gravity may be present in diabetes,
vomiting, diarrhea, and fever.
Leukocytes
Leukocytes are one of the white (Leuko) cells (Cytes) present in blood
stream which defend the body from bacterial invasion. When present in the
urine may suggest the presence of an underlying mild urinary tract
infection. A repeated presence of leukocytes indicate the needs for further
testing such as cultures or blood test.
Nitrates
The presence of nitrates in the urine is due to the conversion of
nitrates in food by the action of the bacteria. Therefore, a positive
nitrate test is a good indicator for the presence of a significant amount of
bacteria in urine. This may be associated with a urinary tract infection of
a bladder or urethral the tube which connects the bladder to the outside)
infection. Significant bacteriuria is estimated to affect 1%-2% of young
girls,5%-10% of pregnant women and is also associated with diabetes,
hypertension, herniation of the urinary bladder, Prostate problems and the
use of a catheter for drawing certain anatomic abnormalities.
Ph
Normally freshly voided urine is acid. Therefore, the PH which is a
measure of acidity may range from 4.0-7.0. People who eat high protein diets
produce a more acid urine than those that consume mostly fruits and
vegetables. Increased urinary acidity (lower PH) may also be present in
diabetes, fever, pulmonary emphysema, diarrhea and dehydration. Alkaline PH
(Higher PH) may also be noted in chronic inflammation of the urinary
bladder, acute or chronic kidney failure, or for intoxication of salicylate
( such as aspirin) or other drugs.
Proteins
The presence of proteins in the urine is called "Proteinuria" and is an
important sign of renal disease. Proteinuria can be due to an increased
permeability of the walls of the filtering components of the kidneys (The
glomerulus). Proteins may be present in a number of kidney diseases. However
a small amount of proteins, mostly albumin, may appear in the urine in
response to excessive muscular exertion, exposure to colds, or with extra
ingestion of proteins with food. In some people the presence of proteins in
the urine may occur upon arising from a sitting position. This is called "
Orthostatic Proteinuria". Proteinuria may also be present in acute
inflammation of the kidneys as acute nephritis, or in the presence of
malignant hypertension, heart failure and diabetes.
Ketones
Ketones are called "Ketone bodies" and include acetone, diacetic acid and
beta hydrobutyric acid and and appear in normal urine of patients on a
carbohydrate-deficent diet. When the body can not find sufficient sugar for
its metabolism it turns to its fat stores for energy which in turn are
reduced to ketone bodies. Ketone bodies appear in urine before they increase
significantly in blood and this is called "Ketonuria". The presence of
ketones in the urine may occur in uncontrolled diabetes and hyperthyroidism.
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