Post-Health Checkup Concerns: Test Results and Next Steps

Post-Health Checkup Issues

In mid-October, I underwent a comprehensive health check-up with the following results: 1.
Urinalysis - Ketones (positive reaction), other results normal - the physician advised that no treatment is necessary.
2.
Blood test - White blood cell count 3700, which is low - the physician indicated that my immune system is somewhat compromised but no treatment is needed; increased physical activity may help improve this.
3.
Cholesterol level 215, which is high.
The other two parameters, triglycerides at 117 and HDL cholesterol at 35, are normal.
4.
Abdominal ultrasound showed fatty liver; Hepatitis B test results were normal.
My height is 170 cm and weight is 72 kg.
The physician advised that no treatment is necessary and that increased exercise may help improve my condition.

I have another question: The Hepatitis B test was normal, but there are no antibodies present, even though I received three doses of the vaccine seven years ago at Chi Mei Hospital.
Six months later, a test at the municipal hospital showed that I had antibodies.
Why might the antibodies have disappeared? Is there a possibility of testing error, or should I receive a booster vaccine?

Jue Sheng, 40~49 year old female. Ask Date: 2003/11/04

Dr. Lin Mingxing reply Family Medicine

The Department of Family Medicine at Tainan Hospital, Ministry of Health and Welfare, responded that the positive result for ketones in the urine test is not particularly significant unless there is a specific clinical focus on differential diagnoses such as ketoacidosis.
Additionally, a lower white blood cell count may indicate reduced immunity, and the disappearance of antibodies after hepatitis B vaccination could be related.
It is advisable to retest for antibodies; if they are confirmed to be absent, consideration should be given to administering the vaccine again.

Reply Date: 2003/11/04

More Info

After undergoing a comprehensive health check-up, it’s understandable to have concerns regarding your test results and what they may imply for your health. Let's break down your findings and address your questions systematically.

1. Urine Test - Ketones Positive: The presence of ketones in urine can indicate that your body is using fat for energy instead of carbohydrates, which can occur during fasting, prolonged exercise, or in cases of uncontrolled diabetes. Since your doctor mentioned that no treatment is necessary, it may be worth discussing dietary habits with a nutritionist to ensure you are consuming a balanced diet that meets your energy needs.

2. Blood Test - Low White Blood Cell Count (WBC): A WBC count of 3700 is indeed on the lower side of the normal range. While your doctor suggested that this does not require treatment and can be improved with increased physical activity, it’s essential to monitor your health closely. A low WBC count can make you more susceptible to infections, so maintaining a healthy lifestyle and possibly discussing this with a hematologist may be beneficial.

3. Cholesterol Levels: Your total cholesterol level of 215 is slightly elevated, especially considering that HDL (the "good" cholesterol) is low at 35. Low HDL can increase the risk of heart disease. It’s advisable to focus on lifestyle changes, such as incorporating more physical activity, eating a heart-healthy diet rich in fruits, vegetables, whole grains, and healthy fats, and possibly consulting with a dietitian for personalized advice.

4. Abdominal Ultrasound - Fatty Liver: The diagnosis of fatty liver indicates that there is excess fat in your liver cells. This condition is often associated with obesity, diabetes, and high cholesterol levels. Lifestyle modifications, including weight loss, regular exercise, and a balanced diet, are critical in managing this condition. Regular follow-ups with your healthcare provider are recommended to monitor liver health.

5. Hepatitis B Vaccination and Antibody Levels: It’s concerning that you have no detectable antibodies for Hepatitis B despite having received the complete vaccination series seven years ago. There are a few possibilities here:
- Testing Error: Laboratory errors can occur, and it may be worth repeating the antibody test to confirm the results.

- Immune Response: Some individuals may not develop adequate immunity after vaccination, which can happen in a small percentage of the population. If this is the case, a booster shot may be recommended.

- Natural Decline: Antibody levels can decline over time, but typically, vaccinated individuals should still have some level of immunity.
Given these factors, it would be prudent to discuss with your healthcare provider whether a repeat antibody test is warranted or if a booster vaccination is necessary.
In summary, while your doctor has indicated that many of these issues do not require immediate treatment, proactive management through lifestyle changes and regular monitoring is essential. If you have further concerns, especially regarding the Hepatitis B vaccination, do not hesitate to seek clarification from your healthcare provider. They can provide tailored advice based on your health history and current test results.

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