How to Know If You Have Hepatitis C

Hepatitis C is classified among the most dangerous viral infections that have a special propensity to affect liver cells. 

After initial infection, the virus invades hepatic tissue and remains silent, while slowly destroying the parenchymal cells of the liver gland. Ironically, most cases of HCV infection are silent and are only instantaneously discovered on routine medical examinations or years after initial infection due to significant alteration in the liver function as a result of virus mediated destruction.

Hepatitis C is considered as life threatening virus and is transmitted by the use of contaminated needles (illicit drug abuse) or accidental needle stick injuries in the hospital setting.

How to Know If You Have Hepatitis C

Since hepatitis infection is mostly asymptomatic, at least in the early course of infection, most people tend to live a normal, symptom-free life. Test for hepatitis C is not generally performed by healthcare providers until the patient is certain of the exposure to a viral source.

There are certain risk factors that are often implicated in the pathogenesis of hepatitis C. If you have one or more of the following risk factors, you should ask your healthcare provider to perform a viral test: 

• Your birth year is between 1945-1965. 
• You have received a blood transfusion from an unaccredited source or from a donor who is an HCV positive. 
• Exposure to contaminated syringes or needles during illicit drug use. 
• If you have received blood/ plasma for a blood related disorder or condition especially before 1987. 
• If you are a recipient of an organ transplant especially before July 1992. 
• You have a history of kidney dialysis in the past. 
• You are an HIV positive patient. 
• If your mother was infected with HCV at the time of your birth. 

If you have any of the risk factors listed above, make sure to speak to your primary care provider to ascertain if you are infected. Doctors usually perform serological test to ascertain if you have an infection and may also perform a liver biopsy taking a tissue sample from your liver to see if the virus has affected the liver tissue significantly.

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Knowing HbA1c Test

Diabetics know all about blood sugar checks. Many diabetics have to check their blood sugar several times daily, especially Type 1 diabetics. 

In recent years, a test has been introduced that can check the average of blood sugar levels over a few weeks or even months. The Hemoglobin A1c or HbA1c Test looks for glycated hemoglobin. This is produced when hemoglobin in the red blood cells pick up the glucose in the blood (glycated). The glucose hangs around for a while so when doctors measure this test, they can get a bigger picture of how you are doing with your diabetes treatment.

The HbA1c is also referred to as the "A1c" and if the numbers with this test is higher than before, your treatment may need to be adjusted and you are at higher risk of long-term complications. Read on for more information about this test.

What Is HbA1c Test？

An HbA1c test helps doctors see how well diabetes treatment plans are working for their patients. Doctors can also use it as a screening exam to check for diabetes. You may have also heard it called by the names: hemoglobin A1c, A1c or glycohemoglobin A1c.

The doctor can look at this test and see what your blood sugar levels have average over the last few months. This is because hemoglobin in red blood cells pick up glucose and it tends to stay within the hemoglobin cells for a while. The higher the blood sugar/glucose level, the more glucose the hemoglobin absorbs. When this happens, the HbA1c reads high and the doctor will know that the blood sugar levels have been high over the last few months.

The doctor will need to re-evaluate the treatment plan and possibly send you to a diabetic educator. This is done to prevent complications from high blood sugars over a long period of time. These include: 

• Eye damage/disease 
• Heart disease 
• Stroke 
• Damage to nerves 
• Damage to small blood vessels 

When & How Often Should You Take HbA1c Test?

When you are first diagnosed with diabetes, the doctor will initially run your first HbA1c Test to see where you are at. The American Diabetes Association recommends, "If glucose levels are stable, then HbA1c testing can be done twice yearly." If your blood sugar levels are not stable it is recommended for your doctor to run the test quarterly until your levels stabilize.

Using this test can help your doctor see if your current treatment plan is working or not. When the doctor works with the HbA1c numbers, research shows that the risk of long-term complications is drastically reduced.

What Is a Normal Reading for HbA1c Test?

The normal reading for an HbA1c test is between 4 and 5.6. Here is the breakdown of the ranges used to diagnose and monitor diabetes: 

• 4 to 5.6 – Healthy, no diabetes and minimal risk for getting diabetes 
• 5.7 to 6.4 – Pre-diabetes/high risk for future diabetes 
• 6.5 or higher – Diagnosis of diabetes and higher numbers mean your diabetes needs careful monitoring 

What Are the Limitation of HbA1c Test?

The HbA1c cannot help monitor daily blood sugar levels since they are an average of a few months. This also means that the test cannot monitor the fluctuations during the day and the differences from night to morning and vice-versa.

There are some health conditions that can show false elevated HbA1c levels and this must be taken into consideration. These include kidney disease, alcoholism, high triglycerides in the blood. If you suffer from sickle cell, thalassemia or have blood loss your A1c may show lower numbers.

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7 Reasons You're Tired All the Time

We all tend to blame fatigue on a too-busy lifestyle. And much of the time we're right. But if you feel tired all the time, don't blow it off. Give yourself about 2 to 3 weeks to make some lifestyle changes: Get more sleep, trim your social calendar, eat more wholesome foods, drink more fluids, take a multivitamin, and cut back on caffeine and alcohol. "If you're still feeling the symptoms of fatigue after those changes, then you need professional help," says Sandra Adamson Fryhofer, MD, an internal medicine doctor in Atlanta. Excess exhaustion could be the sign of a more serious medical condition that can be treated.

Feeling tired always

Here are the 7 most common problems you need to know about.

Anemia

The fatigue caused by anemia is the result of a lack of red blood cells, which bring oxygen from your lungs to your tissues and cells. You may feel weak and short of breath. Anemia may be caused by an iron or vitamin deficiency, blood loss, internal bleeding, or a chronic disease such as rheumatoid arthritis, cancer, or kidney failure. Women of childbearing age are especially susceptible to iron-deficiency anemia because of blood loss during menstruation and the body's need for extra iron during pregnancy and breastfeeding, explains Laurence Corash, MD, adjunct professor of laboratory medicine at the University of California, San Francisco.

Genetic inherited Anemia

The Symptoms: Fatigue is a major one. Others include extreme weakness, difficulty sleeping, lack of concentration, rapid heartbeat, chest pains, and headache. Simple exercise, such as climbing the stairs or walking short distances, can cause fatigue.

The Tests: A thorough evaluation for anemia includes a physical exam and blood tests, including a Full blood count (FBC), to check the levels of your red blood cells. It's also standard to check the stool for blood loss.

Thyroid Disease

When your thyroid hormones are out of whack, even everyday activities will wipe you out. The thyroid gland, about the size of the knot on a man's tie, is found in the front of the neck and produces hormones that control your metabolism. Too much thyroid hormone (hyperthyroidism), and metabolism speeds up. Too little (hypothyroidism), and metabolism slows down.

Thyroid hormone controls your metabolism

The Symptoms: Hyperthyroidism causes muscle fatigue and weakness, which you may notice first in the thighs. Exercises such as riding a bike or climbing stairs become more difficult. Other symptoms include unexplained weight loss, feeling warm all the time, increased heart rate, shorter and less frequent menstrual flows, and increased thirst. Hyperthyroidism is most commonly diagnosed in women in their 20s and 30s, but it can occur in older women and men too. Hypothyroidism causes fatigue, an inability to concentrate, and muscle soreness, even with minor activity. Other symptoms include weight gain due to water retention, feeling cold all the time (even in warmer weather), heavier and more frequent menstrual flows, and constipation. Hypothyroidism is most common in women over age 50; in fact, as many as 10% of women past 50 will have at least mild hypothyroidism.

The Tests: Thyroid disease can be detected with a blood test. Your doctor may order for Thyroid Function test. 

Thyroid Function Test

Diabetes

More than a million people are diagnosed with type 2 diabetes every year, but many more may not even know they have it. Sugar, also called glucose, is the fuel that keeps your body going. And that means trouble for people with type 2 diabetes who can't use glucose properly, causing it to build up in the blood. Without enough energy to keep the body running smoothly, people with diabetes often notice fatigue as one of the first warning signs, says Christopher D. Saudek, MD, professor of medicine and program director for the General Clinical Research Center at the Johns Hopkins University School of Medicine.

Diabetes lead to fatigue

The Symptoms: Aside from exhaustion, other signs include excessive thirst, frequent urination, hunger, weight loss, irritability, yeast infections, and blurred vision.

The Tests: There are two major tests for diabetes. The fasting plasma glucose test, which is more common, measures your blood glucose level after fasting for 8 hours. With the oral glucose tolerance test (OGTT), blood is drawn twice: just before drinking a glucose syrup, then 2 hours later.

Depression

More than "the blues," depression is a major illness that affects the way we sleep, eat, and feel about ourselves and others. Without treatment, the symptoms of depression may last for weeks, months, or even years. 

Feel Depressed

The Symptoms: We don't all experience depression in the same way. But commonly, depression can cause decreased energy, changes in sleeping and eating patterns, problems with memory and concentration, and feelings of hopelessness, worthlessness, and negativity. 

The Tests: There's no blood test for depression, but your doctor may be able to identify it by asking you a series of questions. If you experience five or more of these symptoms below for more than 2 weeks, or if they interfere with your life, see your doctor or mental health professional: fatigue or loss of energy; sleeping too little or too much; a persistent sad, anxious, or "empty" mood; reduced appetite and weight loss; increased appetite and weight gain; loss of interest or pleasure in activities once enjoyed; restlessness or irritability; persistent physical symptoms that don't respond to treatment, such as headaches, chronic pain, or constipation and other digestive disorders; difficulty concentrating, remembering, or making decisions; feeling guilty, hopeless, or worthless thoughts of death or suicide. 

Rheumatoid Arthritis

This autoimmune disease is not always easy to diagnose early, but there are some subtle clues to look for. RA happens when your immune system turns against itself and attacks healthy joint tissue, sometimes resulting in irreversible damage to bone and cartilage.

Unexplained Pain? Check for Rheumatoid Arthritis

The Symptoms: Many symptoms (such as fatigue, low energy, loss of appetite, and joint pain) are shared by other health conditions, including other forms of arthritis such as fibromyalgia and lupus. Anemia and thyroid disorders, which also cause fatigue, are even more common in people with RA, according to John Klippel, MD, president and CEO of the Atlanta-based Arthritis Foundation. Rheumatologists look for at least four of the following criteria in diagnosing RA: morning stiffness in and around the joints lasting at least 1 hour before maximum improvement; at least three joint areas with simultaneous soft tissue swelling or fluid; at least one joint area swollen in a wrist, knuckle, or the middle joint of a finger; simultaneous involvement of the same joint areas on both sides of the body; lumps of tissue under the skin; and bone erosion in the wrist or hand joints, detected by x-ray.

The Tests: A thorough physical exam by a rheumatologist can provide some of the most valuable evidence of the disease, but there is also a test for the presence of rheumatoid factor, an antibody found in the blood. About 80% of people with RA test positive for this antibody, but the test is not conclusive.

Chronic Fatigue

This baffling condition causes a strong fatigue that comes on quickly. People who suffer from CFS feel too tired to carry on with their normal activities and are easily exhausted with little exertion.

No mood in anything

The Symptoms: Other signs include headache, muscle and joint pain, weakness, tender lymph nodes, and an inability to concentrate. Chronic fatigue syndrome remains puzzling, because it has no known cause.

The Tests: There is none. Your doctor must rule out other conditions with similar symptoms, such as lupus and multiple sclerosis, before making the diagnosis.

Sleep Apnea

You could have this sleep-disrupting problem if you wake up feeling tired no matter how much rest you think you got. Sleep apnea is a disorder characterized by brief interruptions of breathing during sleep. In the most common type, obstructive sleep apnea, your upper airway actually closes or collapses for a few seconds, which, in turn, alerts your brain to wake you up to begin breathing again. Someone with obstructive sleep apnea may stop breathing dozens or even hundreds of times a night, says Roseanne S. Barker, MD, former medical director of the Baptist Sleep Institute in Knoxville, TN.

The Symptoms: Sleep apnea is often signaled by snoring and is generally followed by tiredness the next day. Because sleep apnea can lead to heart disease, high blood pressure, and stroke, it's important to be tested.

The Tests: This involves an overnight stay at a sleep clinic, where you'll undergo a polysomnogram, which is a painless test that will monitor your sleep patterns, breathing changes, and brain activity.

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Colon Cancer Screening

Getting regular checkups and colon cancer screening is the best way to prevent colorectal cancer. Finding and removing colon polyps helps prevent colon cancer. In addition, colon cancer screening helps find cancer early, making a cure more likely.

Colon Cancer Screening for People at High Risk

• People with the following risks should begin colon screening before age 50. 
• History of inflammatory bowel disease (Crohn’s disease or ulcerative colitis) 
• Close relatives who have had colorectal disease or polyps before age 60 
• Family history of familial adenomatous polyposis or hereditary non-polyposis colon cancer 

Specific recommendations for high-risk people are as follows:

People with history of multiple or large polyps 

• Colonoscopy at the time of initial polyp diagnosis 
• If 1-2 small adenonatous polyps with low grade abnormality, repeat in 5 years. 
• If 3-10 adenomatous polyps or 1 adenomoatous polyp greater than 1 centimeter, repeat colonoscopy within three years after polyp removal 
• With certain types of polyps or with high grade abnormality, repeat colonoscopy within three years 
• If normal, repeat again in five years 
• If more than 10 adenomatous polyps, repeat in less than 3 years 
• If polyps are permanently attached and not on a stem and are removed in portions, repeat colonoscopy in 2-6 months to verify complete polyp removal 

Large colon polyp seen under colonoscopy

People who have had surgery for colorectal cancer 

Colonoscopy within one year after surgery; if normal, repeat in three years; if still normal, repeat in five years. 

People with a family history 

• Colonoscopy at age 40 or 10 years before the age that the immediate family member was diagnosed with cancer, whichever is earlier; if normal, repeat every five years. 

Family history can be repeating

People with a family history of familial adenomatous polyposis 

• At age 10 to 12, annual flexible sigmoidoscopy. 
• If positive genetic test, colon removal should be considered because of very high risk of colorectal cancer. 
• People with a family history of hereditary nonpolyposis colon cancer 
• Colonoscopy every one to two years, starting at age 20 to 25 or 10 years before age that immediate family member had cancer, whichever is earlier 
• Genetic testing offered to first-degree family members 

It is advisable to do a colonoscopy every 5 years after you reach 50's 

People with inflammatory bowel disease

• Colonoscopy every one to two years, starting eight years after the start of pancolitis (involvement or the entire colon) or 12-15 years after the start of left-sided colitis

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Fecal Occult Blood Test

When doctors test for fecal occult blood they are testing for the presence of microscopic or invisible blood in the stool, or feces. Fecal occult blood can be a sign of a problem in your digestive system, such as a growth, or polyp, or cancer in the colon or rectum. If microscopic blood is detected, it is important for your doctor to determine the source of bleeding to properly diagnose and treat the problem.

What Causes Blood to Appear in Stool?

Blood may appear in the stool because of one or more of the following conditions: 

• Benign (noncancerous) or malignant (cancerous) growths or polyps of the colon 
• Hemorrhoids (swollen blood vessels near the anus and lower rectum that can rupture causing bleeding) 
• Anal fissures (splits or cracks in the lining of the anal opening) 
• Intestinal infections that cause inflammation 
• Ulcers 
• Ulcerative colitis 
• Crohn's disease 
• Diverticular disease, caused by outpouchings of the colon wall 
• Abnormalities of the blood vessels in the large intestine 
• Meckel’s diverticulum, usually seen in children and young adults 

Gastrointestinal bleeding may be microscopic (occult blood), or may be easily seen as red blood, or black tar-like bowel movements, called melena.

Food Restriction Before The Test

Because certain foods can alter the test results, a special diet is often recommended for 48 to 72 hours before the test.

The following foods should not be eaten 48 to 72 hours before taking the test: 

• Beets 
• Broccoli 
• Cantaloupe 
• Carrots 
• Cauliflower 
• Cucumbers 
• Grapefruit 
• Horseradish 
• Mushrooms 
• Radishes 
• Red meat (especially meat that is cooked rare) 
• Turnips 
• Vitamin C-enriched foods or beverages 

Why Do We Need To Do The Test

To allow for the early detection and prevention of colorectal cancer, the fecal occult blood test is recommended yearly for everyone starting at age 50. This annual test may be recommended along with a flexible sigmoidoscopy and barium enema every five years to check for colorectal polyps or cancer. An alternative is a colonoscopy every 5-10 years.

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Simple Teaching: Uric Acid

What is Uric Acid?

Before you start taking actions to lower uric acid levels naturally, it's important to understand what uric acid is, where it comes from, why high levels can lead to gout, and why you need to reduce high uric acid levels in the blood.

So, first things first: What is uric acid?

• Uric acid is a by-product of the chemical breakdown of compounds called purines that exist in our bodies' cells and in our food. Purines are very important to us because they provide energy and protein, among other important components. During those processes, uric acid is produced in the bloodstream.
• Uric acid is good for us because it acts as an antioxidant and helps look after the internal linings of our blood vessels. It's our kidneys' job to process the uric acid produced and excrete waste out of our bodies through our urine, or also a little through our stools.

Foods that contain high levels of purine

What Causes High Uric Acid in Blood?

While the kidneys usually maintain uric acid at healthy levels, there are times when they are unable to do this. In turn, what results is that excess uric acid is retained in, and circulates in, the blood.

Two of the main causes for high uric acid levels in blood are:

• The kidneys aren't working to their full potential. They are unable to process and expel sufficient uric acid quickly enough, or
• There is too much uric acid being produced by the metabolizing purines for healthy kidneys to process.

Reduced Kidney Function

Whatever is the case, the result is high uric acid in the blood.

What is the Result of High Uric Acid Levels in the Body?

• Hyperuricemia: High uric acid levels in the blood is a condition known as hyperuricemia. Over time, this can lead to the production of uric acid crystals. Technically speaking, these are crystals of monosodium urate, which can settle in the joints, tendons and surrounding tissue.

• The body reacts defensively. The crystals are needle-like in shape and are looked upon as foreign objects by the body's natural defenses. In turn, the body's natural anti-inflammatory processes working against these crystals are what actually cause gout symptoms such as redness, swelling, heat, inflammation, stiffness, and very great pain.

Uric acid crystals observed under microscope

These are the symptoms of a gout attack. In other words, high uric acid can lead to gout, which is why it's important to decrease uric acid levels in the body.

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Simple Teaching: What Are Palpitations?

Palpitations are feelings that your heart is skipping a beat, fluttering, or beating too hard or too fast. You may have these feelings in your chest, throat, or neck. They can occur during activity or even when you're sitting still or lying down.

Overview

Many things can trigger palpitations, including: 

• Strong emotions 
• Vigorous physical activity 
• Medicines such as diet pills and decongestants 
• Caffeine, alcohol, nicotine, and illegal drugs 
• Certain medical conditions, such as thyroid disease or anemia

Strong emotions such as anger can trigger palpitations

These factors can make the heart beat faster or stronger than usual, or they can cause premature (extra) heartbeats. In these situations, the heart is still working normally. Thus, these palpitations usually are harmless.

Some palpitations are symptoms of arrhythmias. Arrhythmias are problems with the rate or rhythm of the heartbeat. Some arrhythmias are signs of heart conditions, such as heart attack, heart failure, heart valve disease, or heart muscle disease. However, less than half of the people who have palpitations have arrhythmias.

Electrocardiogram can be use to trace an arrhythmias

You can take steps to reduce or prevent palpitations. Try to avoid things that trigger them (such as stress and stimulants) and treat related medical conditions.

Outlook

Palpitations are very common. They usually aren't serious or harmful, but they can be bothersome. If you have them, your doctor can decide whether you need treatment or ongoing care.

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What Are Blood Tests?

Blood tests help doctors check for certain diseases and conditions. They also help check the function of your organs and show how well treatments are working.

Specifically, blood tests can help doctors: 

• Evaluate how well organs—such as the kidneys, liver, thyroid, and heart—are working 
• Diagnose diseases and conditions such as cancer, HIV/AIDS, diabetes, anemia, and coronary heart disease 
• Find out whether you have risk factors for heart disease 
• Check whether medicines you're taking are working 
• Assess how well your blood is clotting 

Overview

1. Blood tests are very common. When you have routine checkups, your doctor may recommend blood tests to see how your body is working.
2. Many blood tests don't require any special preparations. For some, you may need to fast (not eat any food) for 8 to 12 hours before the test. Your doctor will let you know how to prepare for blood tests.
3. During a blood test, a small sample of blood is taken from your body. It's usually drawn from a vein in your arm using a needle. A finger prick also might be used.
4. The procedure usually is quick and easy, although it may cause some short-term discomfort. Most people don't have serious reactions to having blood drawn.
5. Laboratory (lab) workers draw the blood and analyze it. They use either whole blood to count blood cells, or they separate the blood cells from the fluid that contains them. This fluid is called plasma or serum.
6. The fluid is used to measure different substances in the blood. The results can help detect health problems in early stages, when treatments or lifestyle changes may work best.
7. Doctors can't diagnose many diseases and medical problems with blood tests alone. Your doctor may consider other factors to confirm a diagnosis. These factors can include your signs and symptoms, your medical history, your vital signs (blood pressure, breathing, pulse, and temperature), and results from other tests and procedures.

Outlook

Blood tests have few risks. Most complications are minor and go away shortly after the tests are done.

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