Essential Health Checks for Weight Loss and Medication Management

Q: Essential Health Checks for Weight Loss and Medication Management

Hello： The next step should involve a detailed physical examination and medical history inquiry to assess the current condition and subsequent management recommendations. <br>It is advised that you visit a cardiology or family medicine outpatient clinic for an in-person evaluatio

What tests should be performed?

Hello, doctor.
I am 165 cm tall and weigh 129 kg (I was nearly 150 kg before and have lost weight for about 2 months).
I am taking antihypertensive and antidiabetic medications: Shumai Kang enteric-coated tablets 5/20 mg (1 tablet), Tenormin 100 mg (half a tablet), Sodium Chloride 1.5 mg (half a tablet, previously 1 tablet, doctor agreed to reduce it), and half a tablet of Puda.
For my blood sugar, I take Kuruwa tablets (1 tablet in the morning and 1 tablet in the evening) and Forxiga 10 mg/tab (1 tablet in the morning).
I am currently continuing to lose weight, but after losing weight, I have noticed that I feel unwell; sometimes I experience pain near my chest close to the armpit, and sometimes my hands feel numb.
I check my blood sugar every three months; last month on the 21st, my fasting blood sugar was 103, and my HbA1c was 6.2.
This month on the 19th, my fasting blood sugar was 101.
I measure my blood pressure every morning and evening; before taking medication, it is usually in the 110s, and in the evening, it is around the 100s (sometimes in the 90s).
My heart rate is generally between 60 and 70, but my diastolic pressure is usually in the 50s to 60s.
I have had an echocardiogram, EEG, and chest and neck X-rays, all of which were normal.
My primary care physician said that my blood pressure and blood sugar are well controlled, and I should continue to lose weight.
However, in the past few days, I have been experiencing a feeling of pressure in my temples in the afternoon, and I feel fatigued and weak during the day.
I would like to ask the doctor: 1.
What additional tests should I undergo? 2.
Could this be related to my medications? Thank you.

Azu, 30~39 year old female. Ask Date: 2016/11/25

Dr. Gao Qingyun reply Family Medicine

Hello: The next step should involve a detailed physical examination and medical history inquiry to assess the current condition and subsequent management recommendations.
It is advised that you visit a cardiology or family medicine outpatient clinic for an in-person evaluation by a specialist.
Thank you.
Wishing you safety and health.
Sincerely, Dr.
Kao Ching-Yun, Director of Family Medicine, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2016/11/25

More Info

When it comes to weight loss and medication management, especially for individuals with obesity and related health conditions, it is crucial to have a comprehensive understanding of the necessary health checks and the implications of medication. Based on your current situation, here are some essential health checks and considerations:

Essential Health Checks
1. Blood Pressure Monitoring: Given your history of hypertension, regular monitoring is essential. You should continue to check your blood pressure daily, as you are currently doing. It’s important to keep track of both systolic and diastolic readings, as well as your heart rate. If you notice any significant changes, such as consistently low readings (e.g., below 90/60 mmHg), consult your healthcare provider.

2. Blood Glucose Levels: Since you are on medication for blood sugar control, regular monitoring of fasting blood glucose and HbA1c is crucial. Your recent readings (fasting glucose of 101-103 mg/dL and HbA1c of 6.2%) indicate that your blood sugar levels are relatively well-controlled, but continuous monitoring is necessary, especially as you lose weight.

3. Lipid Profile: Given the association between obesity and dyslipidemia, it is advisable to have your lipid levels checked regularly. This includes total cholesterol, LDL, HDL, and triglycerides. These levels can help assess your cardiovascular risk.

4. Electrocardiogram (ECG): If you experience chest pain or discomfort, especially near the armpit, an ECG can help rule out any underlying cardiac issues. This is particularly important since you are on blood pressure medication.

5. Thyroid Function Tests: Fatigue and unusual sensations in the head could be indicative of thyroid dysfunction. A simple blood test to check your thyroid hormone levels (TSH, T3, and T4) can help rule out this condition.

6. Complete Blood Count (CBC): This test can help identify any underlying issues such as anemia or infection, which could contribute to your feelings of fatigue.

7. Kidney Function Tests: Since you are on multiple medications, it’s important to monitor your kidney function through tests like serum creatinine and electrolytes, especially if you are experiencing any unusual symptoms.

Medication Considerations
Your current medication regimen includes antihypertensives and antidiabetic medications. It’s essential to consider the following:
- Medication Side Effects: Some medications can cause side effects that may contribute to your symptoms. For instance, certain blood pressure medications can lead to fatigue or dizziness. Discuss with your physician whether any of your medications could be contributing to your symptoms, especially the fatigue and head pressure.

- Dosage Adjustments: As you lose weight, the dosages of your medications may need to be adjusted. Weight loss can improve blood pressure and blood sugar levels, potentially allowing for lower doses of your current medications. Regular follow-ups with your healthcare provider are essential to evaluate the need for adjustments.

- Nutritional Support: As you continue your weight loss journey, consider consulting a registered dietitian. They can help you create a balanced meal plan that supports your weight loss goals while ensuring you get the necessary nutrients, especially since you have a history of dietary restrictions.

Conclusion
In summary, it is vital to maintain regular health checks, particularly for blood pressure, blood glucose, and lipid levels, while also considering the potential side effects of your medications. If you experience any new or worsening symptoms, do not hesitate to reach out to your healthcare provider for further evaluation. Your ongoing commitment to weight loss and health management is commendable, and with the right support and monitoring, you can achieve your health goals safely.

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