My visit with Dr. Westman, Blood Test Results and Teeth
 

As at least one person remembered, I had an appointment with Dr. Westman back in late November or early December. My weight loss has semi-stalled. I’ve tried a lot of different things but no lasting joy. I need help. He asked for two things before my follow up. First, that I go get a bunch of blood tests. Second, that I visit the dentist. The former makes sense and I’ll post the results below. The latter not so much. We went over the reasons for stalled weight loss and his list was generally like everyone else’s, i.e. Carb Creep, etc. Then we went over some of the things that could be causing general inflammation. He asked, any recent scars, aches, pains….. and I said that I had an intermittent tooth ache under an old root canal. He said that could be an infection and to get it checked out.

Well I hate going to the dentist. Hate it. I enjoy procrastinating almost as much as I hate going to the dentist. Needless to say, I very much enjoy procrastinating on making an appointment to go to the dentist. But I made one and I went. The first thing I found out is that the last time I went to the dentist was in 2009. Almost six years ago. Back then I had two cavities over one year. This time I only had one cavity and no infections but here is the surprising part. First the hygienist and then the dentist were simply amazed at the bone structure under my teeth. They said they found it truly hard to believe it was so good even though it has been six years since my last cleaning. I do floss a lot.

The hygienist and I have known each other a long time. Our sons played youth soccer and HS football together. When I walked in and she recognized me she said, “You’ve lost a lot of weight. Was it intentional? (Yes!) What did you do?” I held back at first. I always do. I’ve gotten used to the “ATKINS! THAT WORKS? Well I hope you keep it off…..” reaction and said “You won’t believe it….”, “You’ll say I cheated….”, “I’ve been doing it for 2-1/2 years now…” and finally I told her. She did not know what to say. No criticisms of the diet. No atta boys. She just didn’t process it.

So what did she attribute the bone structure to? Flossing. She said I must be flossing really, really well. What do I think? I do not agree. Keep the carbs out of my mouth and I’d bet tooth decay goes away. The Google finds half a hundred links to this. Here is one from our forum: forum.lowcarber.org/showthread.php?t=417146

Here are the blood test results. The sample was taken at 9am after fasting since noon the day before. Technically it was fasting. I call it "not eating" because I'm not hungry.

If you're trying to figure things out here, this is the pattern I'm trying to lay out:

First is the Type of Test in "*XXX*"'s. I'll post the exact CPT codes tomorrow.

Under the test type is the "Observational Value" a.k.a. the name of the result.

The first number to the right of that is the numerical result, the second is the low limit, the third is the high limit and I added two more things, a percentage between high and low and last and "H" or "L" if it's outside of 10% to 90% of the high and low. Simple? I hope so. I'll be happy to answer any questions and try to upload pictures of the results for clarity.

Blood Tests 1/22/2015

*CBC* Value __ Ref. Range __
HGN 15.6 __ 13.5 - 18 __ 47%
HCT 47.7 __ 40 - 54 __ 55%
MCV 94 __ 80 - 94 __ 100% H
MCH 30.7 __ 26 - 33 __ 67%
MCHC 32.7 __ 31 - 36 __ 34%
RBC 5.08 __ 4.6 - 6.2 __ 30%
RDW 13.4 __ 11 - 16 __ 48%
PLT 226 __ 140 - 440 __ 29%
MPV 6.6 __ 6.9 - 10.4 __ -9% L
WBC 5.4 __ 4.5 - 11 __ 14%
GRAN # 3.5 __ 1.4 - 6.5 __ 41%
GRAN % 62.5 __ 37 - 75 __ 67%
LYMPH# 1.8 __ 1.2 - 3.4 __ 27%
LYMPH % 33.8 __ 20 - 45 __ 55%
MONO# 0.1 __ 0.1 - 0.6 __ 0% L
MONO% 3.7 __ 1 - 13 __ 23%

*Comprehensive Metabolic Panel*
Value __ Ref. Range __
Glucose, Serum 85 __ 65 - 99 __ 59%
BUN 13 __ 6 - 24 __ 39%
Creatinine, Serum 0.97 __ 0.76 - 1.27 __ 41%
eGFR If NonAfrican Am 92 __ 59 - __
eGFR If African Am 106 __ 59 - __
BUN/Creatinine Ratio 13 __ 9 - 20 __ 36%
Sodium, Serum 143 __ 134 - 144 __ 90%
Potassium, Serum 4.1 __ 3.5 - 5.2 __ 35%
Chloride, Serum 101 __ 97 - 108 __ 36%
Carbon Dioxide, Total 24 __ 19 - 29 __ 50%
Calcium, Serum 8.9 __ 8.7 - 10.2 __ 13%
Phosphorus, Serum 3.4 __ 2.5 - 4.5 __ 45%
Protein, Total, Serum 6.4 __ 6 - 8.5 __ 16%
Albumin, Serum 4.2 __ 3.5 - 5.5 __ 35%
Globulin, Total 2.2 __ 1.5 - 4.5 __ 23%
A/G ratio 1.9 __ 1.1 - 2.5 __ 57%
Bilirubin, Total 0.7 __ 0 - 1.2 __ 58%
Alkaline Phosphatase, S 75 __ 39 - 117 __ 46%
AST (SGOT) 16 __ 0 - 40 __ 40%
ALT (SGPT) 21 __ 0 - 44 __ 48%

*Lipid Panel w/ reflex to Direct LDL/A*
Value __ Ref. Range __
Cholesterol, Total 263 __ 100 - 199 __ 165% H
Triglycerides 84 __ 0 - 149 __ 56%
HDL Cholesterol 47 __ 39 - __
VLDL Cholesterol Cal 17 __ 5 - 40 __ 34%
LDL Cholesterol Calc 199 __ 0 - 99 __ 201% H
T Chol/HDL Ratio 5.6 __ 0 - 5 __ 112% H

*Pro Time*
Value __ Ref. Range __
INR 2.7 __ 2 - 3 __ 70%

*T3 Uptake*
Value __ Ref. Range __
T3 Uptake 35 __ 24 - 39 __ 73%

*Thyroid Stimulating Hormone*
Value __ Ref. Range __
TSH 3.67 __ 0.45 - 4.5 __ 80%

*T3 Free*
Value __ Ref. Range __
Triiodothyronine, Free, Serum 2.6 __ 2 - 4.4 __ 25%

*T3, Reverse*
Value __ Ref. Range __
Reverse T3, Serum 18.3 __ 9.2 - 24.1 __ 61%

*T4, FREE*
Value __ Ref. Range __
T4, Free(Direct) 1.44 __ 0.82 - 1.77 __ 65%



PS - I do not think I was supposed to get the *Pro Time* test per Dr. Westman. I think my Doctor's lab made an incorrect assumption as they know I'm on blood thinners.

Separate thread on Cholesterol #'s: http://forum.lowcarber.org/showthread.php?t=465153

Okay so the *CBC* and the *Comprehensive Metabolic Panel* are big nothing burgers. From the *CBC* I find my MPV is low which is not surprising as I'm on blood thinners. I also find that I do not have Mono, which is good if I die in an accident tomorrow I won't embarrass my wife during the autopsy. From the *Comprehensive Metabolic Panel* I see my Sodium is on the high side (meh) and Calcium is on the low side. Calcium being low surprises me given that I have anywhere from two to eight slices of cheese a day.

Can someone make sense of the thyroid numbers? Did I get everything one needs to evaluate the thyroid? I got rT3. Anything else?


*T3 Uptake*
Value __ Ref. Range __
T3 Uptake 35 __ 24 - 39 __ 73%

*Thyroid Stimulating Hormone*
Value __ Ref. Range __
TSH 3.67 __ 0.45 - 4.5 __ 80%

*T3 Free*
Value __ Ref. Range __
Triiodothyronine, Free, Serum 2.6 __ 2 - 4.4 __ 25%

*T3, Reverse*
Value __ Ref. Range __
Reverse T3, Serum 18.3 __ 9.2 - 24.1 __ 61%

*T4, FREE*
Value __ Ref. Range __
T4, Free(Direct) 1.44 __ 0.82 - 1.77 __ 65%

Will you have a follow up with Dr Westman where he discusses the results and how they might relate to your weight loss?

Very cool about your teeth and jaw!

Ya, I'll make that appointment tomorrow. It took like four or five months to wait for my first visit. I think I remember JEY telling us that the follow ups happen much quicker.

In my first visit he threatened to put me on a calorie restricted diet after a 1000cal macadamia nut and cream cheese three day fat fast. I don't think I'll like that. I give it a try but I'll probably quit it after a few weeks. I made my appointment when I was 231. Lately I've been bouncing just over 217. I could live with 217 better than being hungry, I think. But again, I'll give it a shot.

Yes, you get the follow-ups much quicker, they are shorter (15-20 min. Vs an hour for the first) but he takes as long as a patient needs. There is more time set aside for follow-ups, many see him monthly.

I can't help with Thyroid results, but will make a comment on your calculations of % along the range of values. Seems logical for those of us who like working with numbers, but completely pointless according to my oncologist. A range of normal is exactly that...it is perfectly normal to be anywhere within that range. My WBC count is always near the top end of ”normal"...that is "my" normal, not an indication of some hidden infection. For regular blood tests, there is nothing to be learned from where in the range you are. Apparently there is controversy over the thyroid tests, and some disagree that the normal range adequately picks up early problems, but not so with most.
Though I vaguely remember some doctor writing that he prefers to see AST and ALT near the mid-lower end of the range (less fatty liver?) and you have great numbers there too.