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Patient-prepared document · Kamla Sharma, 63F · Reviewed adversarially by Codex CLI · Not a clinical recommendation · Requires doctor second-opinion before action.
Lab Report Analysis — Kamla
Sharma
Date of tests: 15 November 2025
Lab: Tata 1mg, Ranchi
Age: 61F | Patient ID: RNC8777
Compared against: 01 May 2025 (previous test)
CRITICAL FINDINGS (Need
Medical Action)
1. Subclinical Hypothyroidism
- TSH: 7.275 uIU/mL (normal: 0.55–4.78)
- Free T3: 2.67 (normal) | Free T4: 1.20 (normal)
- Pattern = High TSH + Normal hormones = Subclinical
Hypothyroidism
- Trend: WORSENING — was 4.368 in May 2025
- Possible downstream effects (not all confirmed in her case):
fatigue, weight gain, cardiac risk, may worsen pre-diabetes. Note: her
lipid panel is currently good, so no dyslipidemia attribution.
- Action: Endocrinologist consult, evaluate levothyroxine
2. Pre-Diabetes
- HbA1c: 6.2% (normal <5.6; pre-diabetic range:
5.7–6.4)
- Fasting Blood Sugar: 103 mg/dL (normal 70–99)
- Trend: WORSENING — FBS was 96, HbA1c was 6.1 in May
2025
- Kidney not yet affected (microalbumin clean) — reversible window
still open
- Action: Dietary intervention now; physician/diabetologist
consult
3. Elevated
Homocysteine (Cardiac + Nerve Risk)
- Homocysteine: 18.66 umol/L (normal 3.7–13.9; high
risk: >15)
- Trend: IMPROVING — was 33.64 in May 2025, but still
in danger zone
- Most likely driver: B12 deficiency (well-established mechanism).
Hypothyroidism can contribute (less established, smaller effect). Folate
status was normal, ruling out folate-driven cause.
- Action: B12 supplementation, recheck in 3 months
4. Low Vitamin B12
- B12: 170 pg/mL (normal: 211–911)
- Trend: Improving — was 149 in May 2025
- Directly causes elevated homocysteine + nerve conduction issues
- Action: Methylcobalamin 1500 mcg/day (confirm dose with doctor)
5. Low HDL Cholesterol
- HDL: 34 mg/dL (women need ≥50 mg/dL)
- LDL (60) and total cholesterol (118) are excellent — HDL is the
specific gap
- Action: Aerobic exercise, omega-3, reduce refined carbs
6. Elevated Lipoprotein(a)
- Lp(a): 42.90 mg/dL (normal <30)
- Trend: WORSENING — was 29.80 in May 2025
- Genetically elevated, largely unmodifiable — manage all other
cardiac risk factors aggressively
7. Elevated IgE
(Allergy/Immune)
- IgE Total: 299 IU/mL (normal <158) — nearly
double normal
- Trend: WORSENING — was 257 in May 2025
- Could indicate allergic disease, intestinal parasites, or immune
dysregulation
- Action: Stool examination for ova/parasites FIRST (cheap, common
cause in eastern India). Specific allergy panel only if O&P negative
AND clinical allergic symptoms present.
8. Elevated CRP (Systemic
Inflammation)
- CRP Quantitative: 5.30 mg/L (normal <3.3)
- hs-CRP is low (0.87) — no active cardiovascular inflammation
- Source: UNCLEAR. Possible contributors include hypothyroidism,
allergy/IgE elevation, dental/gut foci, occult infection, or joint
inflammation. Cannot be determined from lab alone.
- Action: Treat identifiable root causes; clinical evaluation for
source if persists
WATCH LIST
| Marker |
Value |
Normal |
Status |
| Serum Iron |
43 µg/dL |
50–170 |
Low |
| Transferrin Saturation |
15.98% |
16–50% |
Borderline low |
| RDW-CV |
14.9% |
11.5–14 |
Elevated (mixed cell size) |
| Calcium |
8.3 mg/dL |
8.7–10.4 |
Below normal |
| Uric Acid |
6.3 mg/dL |
2.7–6.1 |
Mildly elevated |
| Lipase |
66 U/L |
12–53 |
Mildly elevated |
| ESR |
20 mm/hr |
0–20 |
Upper limit |
| BUN/Creatinine Ratio |
23 |
12–20 |
Mildly high |
WHAT’S GOOD
| Marker |
Value |
Note |
| Vitamin D |
40.2 ng/mL |
Major improvement from 17.2 (deficient) |
| eGFR |
89 mL/min |
Good kidney function |
| Microalbumin |
<3 mg/L |
Kidneys not yet affected by pre-diabetes |
| Liver (AST/ALT/GGT/ALP) |
All normal |
Healthy liver |
| Rheumatoid Factor |
<3.5 |
Negative — but does NOT rule out RA. Anti-CCP needed for full
assessment. |
| hs-CRP |
0.87 |
Low cardiovascular inflammation risk |
| Folic Acid (B9) |
12.47 |
Normal |
| Urine |
Clean |
No infection, no blood, no protein |
| Total Cholesterol |
118 |
Excellent |
| Triglycerides |
124 |
Normal |
| LDL |
60 |
Excellent |
CARDIOVASCULAR RISK PROFILE
| Risk Factor |
Value |
Status |
| Homocysteine |
18.66 umol/L |
HIGH — improving |
| Lp(a) |
42.90 mg/dL |
HIGH — worsening |
| HDL |
34 mg/dL |
LOW — risk factor |
| LDL |
60 mg/dL |
Good |
| Total Cholesterol |
118 mg/dL |
Good |
| hs-CRP |
0.87 mg/L |
Low cardiovascular risk |
| Subclinical Hypothyroid |
TSH 7.275 |
Indirect cardiac risk contributor |
Overall: Multiple individual risk factors are
present (low HDL, elevated Lp(a), elevated homocysteine, subclinical
hypothyroid). However, an actual cardiovascular risk
classification cannot be made from lab values alone — it
requires BP, smoking status, family history of premature CVD, and an
ASCVD risk calculation. The lab picture warrants vigilance and
aggressive modifiable-risk reduction, but I cannot give her a formal
risk category here.
Priority Specialist Visits
- Endocrinologist — TSH 7.275 (subclinical hypothyroid)
- Physician/Diabetologist — HbA1c 6.2, FBS 103 (pre-diabetes)
- Allergy panel — IgE 299 (rule out parasites first)
- Iron workup — low serum iron, confirm before supplementing
- DEXA scan — calcium below normal at 61F