Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.
Hi I'm Dr. Phil
Can I ask your first name?
Nice to meet you
what were the tests?
and what did they show?
were they elevated?
Yes, can't give details yet, don't have them
okay what did they recommend next?
ultrasound of the liver?
Yes, Ultrasound on 8th April
what medicine do you take if any?
Here we go, until 2 days ago Byetta 10 units x 2 daily, now stopped.
ok. anything else?
Plus Humalog mix 25 40 and 30 unit daily, Metformin 1000mg x 2 daily,Telmisartin 40 mg., Asprin 0.75mgNebivolol 2.5mg daily,
Acenocoumarol 3mg daily (in place of Warfrin) finally Simvastin 40mg
ok I think there is likely 2 things going on
1)the simvastatin commonly causes liver problems
2)with diabetes, many folks develop fatty liver
this is where the liver stores fat and shouldn't
this causes liver elevation in the blood tests
The treatment is weight loss and there is some evidence that vitamin E 400 units per day can help
the ultrasound is the next step to prove this. I agree with it 100%
any more questions for me?
Did I do excellent work for you Mike?
you there Mike?
I did say your help was excellent and am following up with my GP and Liver Specialist in next few days.