I have recently had a complete blood panel done in which the CA 19.9 Serum test has shown elevated levels (67.89 U/mL) against normal of (< 37.00 U/mL). Along with this I also have an elevated level of 3.20 ng/mL in CEA Serum test as against a reference range of < 3.00 ng/mL. Alongside these I have a lower level of Free T4 (0.82 ng/dL) against reference range (0.89 - 1.76 ng/dL) while my Triglyceride levels are higher than earlier. At the same time my HDL cholesterol level has decreased and my LDL cholesterol level has increased.All other tests are normal and in between reference ranges. I am active barring occasional bouts of disturbed sleep. All organs are fine. I did have a issue with bowels where I started going to the washroom two hours after lunch as well which has been resolved by consumption of 1 tsp soaked fenugreek on empty stomach. I am also consuming the following medication for diabetes and blood pressure: Amaryl 1mgNebicard 2.5mgAmlogard 2.5mgBio-D3 PlusAntoxidUnienzymeTherefore please advise the reason for the elevated levels and what is the antidote as I am suffering from uncontrolled High Boold Pressure as well as High Sugar levels.
Person's Gender: Male
Person's Age: 52
Greetings Krishan.Why were these investigations done?Dr. Arun
Good Afternoon Doctor.
These are routine investigations that I carry out on my own every 6 months due to irritable bowel symptom about a year ago as well as reason for sudden unexplained increase in BP and diabetes. The tests have also revealed that Vitamin D failure is not under control. The Vitamin D, 25 Hydroxy test showed a level of 59.4 nmol/L.
Good afternoon Krishan,CA 19.9 and CEA are tumor markers. They may rise in benign conditions too and in the absence of any significant symptoms, they rise would not be pointer to anything serious.These are not considered as a diagnostic investigations. Though a CT scan of abdomen and high resolution CT scan of the lungs may be considered by your doctor. For the abnormalities in the lipid profile (high triglyceride, low HDL etc), following many be advised;
1) Dietary fiber; Soluble fiber is present in foods such as beans, oats, barley, and fruits and vegetables. This decreases absorption of cholesterol and lipids.
2) Phytosterols; Phytosterols are present in small amounts in nuts, seeds, and vegetable oils. Numerous studies have shown that phytosterols lower LDL-Cholesterols. There are many products on the market that contain phytosterols for total- and LDL-C lowering. These products are orange juice, yogurt, margarine spreads, salad dressings, breads, cereals, milk, and granola bars. Phytosterols also are available in soft-gel pills.
3) Soy protein is the major component of soybeans and decreases triglycerides and cholesterol.
4) if one is over weight, just weight loss also reduces the cholesterol and triglyceride levels.
5) Physical activity; regular aerobic exercise is effective in reducing blood lipids and proven by many studies.
6) Alcohol; if one takes, limit it to 20-30 ml per day.
Following dietary pattern may be helpful;
1) Red meat in low frequency and amounts
2) Minimally processed seasonally fresh foods
3) Less than five eggs per week
4) An abundance of plant foods; fruits, vegetables, potatoes, breads, grains, beans, nuts, and seeds
5) Olive oil as the principal source of dietary fat
6) Fresh fruits as the typical daily dessert.
A low TSH would warrant free T3 and free T4 with a thyroid scan. This may denote hyperthyroidism.
The vitamin D dose of 800-1,000 IU per day for 6-12 weeks would be able to treat the deficiency.
Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
MBBS, MS (General Surgery), Fellowship in Sports Medicine
Good Evening Doctor,
I already had a CT scan as well as a barium x-ray test done and both of them were clean.
Kindly advise on the same.
Hello Krishan,Since your CT scan and barium series is normal; there is likely to be nothing worrisome. Your doctor should repeat the CEA and CA 19.9 at the interval of three months for follow up. These should come down to normal.It is privilege assisting you.
I had a series of tests done in February as well - almost six months before this most recent blood panel.
The CEA levels at the time were 3.61 ng/ml (against reference range of upto 3.4 for non-smokers) and CA 19-9 levels were 59.60 u/ml (against reference range of 0 - 37.00 ng/ml).
This series was carried out at a different lab.
Kindly help me with this.
Kishan,If both the tumor markers are rising, you would need PET scan to rule out any hidden tumor just for the caution. This may not be anything significant but we would work on the extra cautionary side.
Good Morning Doctor.
Before proceeding with the PET scan, I have a small cyst in my kidney. Could these marker values be affected by the same?
Kidney cyst is most likely to be non cancerous and is not likely to be the factor for elevating the tumor markers.
Good Morning Doctor,
I have been advised the following substitutions in medicines:
1. In place of Amlogard 2.5 mg, I have been prescribed ESLO 2.5 mg
2. In place of Amaryl 1mg, I have been suggested Amaryl M.
3. I have also been recommended that if blood pressure is frequently above 130 SBP or 80DBP, then Nebicard 2.5 mg to be replaced with CARDIVAS.
Apart from these the latest results from new tests conducted are as below:
1. FRUCTOSAMINE 327 umol/L (against range of 202 - 282)
2. Vitamin D, 125 DIHYDROXY 43.69 pmol/L ( against range of 39 - 193)
3. Immunoglobulin profile IgG 1197 mg/dL (range of 700 - 1600)
4. Immunoglobulin profile IgM 44 mg/dL (range of 40 - 230)
5. Immunoglobulin profile IgA 622 mg/dL (range of 70 - 400)