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Clinic Appointment in July 2021: Abnormal Blood Results and Weight Gain

In July 2021, my fasting sugar level was borderline, liver enzymes were mildly elevated, and I had put on 3.5 kg in weight.

On the same day as my scheduled gastroenterology appointment on July 6, 2021, I had some “routine” blood investigations – full blood count, fasting blood sugar, lipid profile, renal function test, liver function test, and urine analysis.


I had no symptoms around that time and was feeling fine.


So when I learned about some abnormalities in the blood tests, I was gobsmacked. In truth, they were not terribly abnormal; I just didn’t expect anything other than figures within the normal range.

Borderline Fasting Blood Sugar

My fasting blood sugar level was 5.6 mmol/L, or 100 mg/dL. The laboratory’s reference range was as follows:

Normal<5.6 mmol/L
Prediabetes5.6–6.9 mmol/L
Diabetes≥7.0 mmol/L

The previous fasting blood sugar test I had was performed on April 17, 2020. On that day, my fasting blood sugar was 5.1 mmol/L, i.e. normal.

Liver Function Test

The liver function test showed an elevated ALT and raised GGT.

July 6, 2021April 17, 2020Reference Range
ALT 43240–40
GGT195320–50
Comparison of ALT and GGT between July 6, 2021 and the previous levels, measured on April 17, 2020.

The other biochemical parameters on the liver function test were normal.

My full blood count, ESR and CRP were within normal limits. So were my lipid profile and urine analysis. Other than a mildly raised uric acid level (440 µmol/L; reference range: 142–416), my renal function test was also normal.

Weight Gain


Other than the raised fasting blood sugar, ALT and GGT, there was one more surprise for me at the hospital: weight gain of 3.5 kg, or nearly 5% of my body weight (!), between January 2021 and July 6, 2021 (6 months).

My weight had increased from 70.6 kg (on January 19, 2021) to 74.1 kg (July 6, 2021), i.e. a weight gain of 3.5 kg over 6 months.


My gastroenterologist hypothesized that fatty liver was the cause of the raised liver enzymes, possibly due to excess carbohydrates in my diet.
His hypothesis would be supported by the weight gain, which he seemed to believe was mainly in the form of abdominal adipose tissue despite my repeated assertions that I had been exercising a lot and my Strava record was superb.

Putting on weight came out of left field. I had not been monitoring my weight at home – I prefer to only use the industrial-looking digital weight scale at the hospital for validity – and, besides, my clothes didn’t feel any tighter and I didn’t notice any significant change in my facial features, e.g. my cheeks didn’t look any rounder.

Admittedly, the borderline fasting sugar level seemed to suggest some loss of  insulin sensitivity, and, thanks to my weight gain, it was hard to discount the fact I had moved closer to being classified as abdominally obese. Abdominal obesity is a risk factor for insulin resistance.

Ulcerative Colitis: Did I Really Have a Relapse in January 2021?

On the same clinic appointment, my gastroenterologist expressed his reservation about my self-diagnosis of a relapse of my ulcerative colitis in January 2021. According to him, if it were a relapse, I would have experienced bloody diarrhea – I did not notice any blood in my stools. Nevertheless, since I had increased my dose of Salofalk back to 1 gram t.d.s, he was reluctant to lower the dose again.

On July 6, 2021, my C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) –inflammatory markers of disease activity – were both normal.

Conclusion

To my mind, I had a few medical problems that might or might not have been related:

  1. Raised liver enzymes
  2. Borderline fasting sugar level
  3. Weight gain

I shall address each of these problems in separate articles.

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