Health Assessment and Diagnosis

This article discusses the importance of health assessment and diagnosis in healthcare. It covers topics such as nutritional analysis, functional diagnosis, and treatment options. The article also provides insights into the patient's condition and suggests possible interventions.

Running head: HEALTH ASSESSMENT AND DIAGNOSIS
HEALTH ASSESSMENT AND DIAGNOSIS
Name of the Student
Name of the University
Author Note

1HEALTH ASSESSMENT AND DIAGNOSIS
Introduction
In the context of health care assessment of the health condition is an important factor and
the assessment should be done on the basis of the head to toe diagnosis. Based on this factor the
assessment of James, a 50 year old patient with increasing amount of cold, fatigue, anxiety and
mouth ulcers should be done with utmost priority. In the following section the nutritional
analysis and the functional diagnosis would be discussed. Along with the above mentioned
factors the physical attributes and the examination results would be discussed as well.
Nutritional Analysis
As per James’ dietary intake it can be seen that the person eats Uncle Tobies muesli bar
at breakfast, in mid morning he eats 2-3 sweet biscuits, at lunch he intakes sandwich containing
ham, cheese, tomato and brown bread. At mid afternoon he intakes milk coffee and 4 sweet
biscuits. Other than these his dietary chart mostly comprised of red meat and processed food
along with dairy, alcohol and ice cream. Hence, on the basis of his dietary intake it can be stated
that his nutritional uptake mostly consisting of carbohydrate and sugar content. On the other
hand it can be seen that his diet does not have enough of vegetables so that it can be stated that
his vitamin uptake especially vitamin B complex lacking the proper amount (Kuzmanović et al.,
2016). Hence, the diet of James is not adequately filling up the requirement of his body. Thus the
insufficient vitamin B in the body especially the lack of B9 can be stated as the as the actual
deficiency of the body as James showed the prone to fatigue and mouth ulcers which are the
symptoms of the deficiency of vitamin B9 or the folic acid (Spinas et al., 2015). On the other
hand the excess processed food and fruit intake also deposited cholesterol to his body thus the

2HEALTH ASSESSMENT AND DIAGNOSIS
hypertension occurred which would lead to the anxiety and stress build up in the body. Hence,
the factor of the nutritional balance is not adequate in case of James. Other than this it can be
stated that James has a keen attraction to the sweet biscuits and the red meat should be lessened
in order to prevent his adverse physical conditions. It has been seen that Uncle Toby’s Muesli
bar contains 18.7 g carbohydrate and 5.8 g sugar per serving and the Arnott’s selection sweet
biscuits contain 5.7 g sugar. Hence, it can be seen that the sugar and carbohydrate are the
primary intake of James as he eats these products on daily basis. On the other hand it can also be
seen that his energy level in the morning is average whereas in afternoon it goes low and in the
evening it grows higher which can be related to his food habit. As the sugar and carbohydrate
content of his breakfast and the red meat content of his supper is high thus the energy levels of
these periods of the day is higher than afternoon (Ponikowski et al., 2016).
Summary
On the basis of the communication with the patient and the diagnostic analysis it has been
seen that the patient in a severe condition of stress and also fatigue and lethargy. He also could
be able sleep properly and wakes up at most nights at 2 to 4 am. His energy level is average in
morning and low in the afternoon. It can be stated that James is found to be in a condition of
emotional trauma as he could not find his job satisfactory enough and also could not be able to
socially attach with people also with his family (De Castella, Platow, Tamir & Gross, 2018). It
can also be seen that his vital signs and also the body factors are not stable as his musculoskeletal
system, immune system and reproductive system cannot work properly in various situations. It
can be seen that the person cannot be able to stress free in the week days however, in the
weekend he seems better on the basis of his energy and the body system functions. It can be

3HEALTH ASSESSMENT AND DIAGNOSIS
related to his sedentary life style, low amount of sleep and inadequate dietary nutrition uptake.
His family history also relates to his condition as well as his father died by the attack of stroke
and also his mother has type 2 diabetes mellitus. James’ weight gaining and the warning of
doctor to take statin medication to address the condition of the cholesterol rise in his body is also
a great concern as he leads a sedentary life style and also do not eat proper nutritional needs of
body. Hence, it can be seen his bicarbonate level of the body is higher than desirable functional
range as found 33 mEq/L. Triglyceride level found to be higher than the conventional range that
is 3.5 mMol/L it also caused by his excessive fat uptake. On the other hand the blood glucose
level is also high (5.7 mMol/L) as his carbohydrate uptake is higher than usual. Thus it can be
stated that his condition is to be changed by implementing self-management training. On the
other hand his vital signs highlighted that he has a high blood pressure (142/90), low pulse rate
(70 bpm), regular respiratory rate (14 rpm) and a condition of tension found on the cervical
lymph node as it has been found in a raised condition and soft and movable as well (Bergey,
Filipe, Conrad & Singh, 2018). Other than these his neutrophil level in blood is low (38 percent)
and it refers to the factor of the allergic infections of his body. His stressed condition can be
found on his skin colour, eye condition, nails, hair and scalp along with tongue and mouth as
these are pale and also seen to be mal nutrition consumed. Other than this his weight can be seen
in the regular range however, as it is in the higher range thus it can be stated as risky for the
person. On this assessment of the patient it can be stated that the patient is in a condition of mal
nutrition and also in higher rate of stress which affected his life style as well as his condition of
living. On this context it can be found that his fat consumption rate is high and thus his bilirubin
is higher than the desirable range in his body that is 22 μMol/L. Hence, it can be stated that he
needed to be treated with proper observation and the medication for the energy and the

4HEALTH ASSESSMENT AND DIAGNOSIS
nutritional uptake. Thus it can also be stated that the vital sign development with the life style
changing should be considered as a factor of the treatment of this patient as well. On this context
it can also be stated that the aspect of curing the patient should be considering his life style and
the condition of the diet. The motivation would also play a crucial role in terms of the
development of the positive mental thought process which would also impact on the hormonal
function of the body. His condition can also be referred as the factor of the negative actions of
the stress and also other physiological conditions as well (Funder et al., 2016).
Critical Analysis
Based on the pathological assessment of the patient it can be seen his blood count and the
hemoglobin and the mean corpuscular volume found to be in normal range along with some
hormones which are also secreting in the normal range. However, the Transferrin hormone found
to be in a very low concentration in the body which can be stated as the condition referring to the
hymolitic anemia that is the transferring of the iron content in the body is not happening in the
regular amount. Hence, it can be stated that the condition of the body should be supplemented
with the medication of the iron and also the activation of the Transferrin hormone (Gao, Monian,
Quadri, Ramasamy & Jiang, 2015). On the other hand the white blood cell counts also in the
lower level from the adequate amount in the body. This can be referred as the factor of the
immune system of the body which cannot support the body and thus the occurrence of the cold
of James’ is frequent. Thus it can be stated that the requirement of the antioxidant of the body
should be considered with a priority basis as the immune system of the body is affected in this
stage. On this basis it can be stated that the factor of the medication and the diet should be done
on the basis of the controlling of the needs of the body to sustain against the foreign infections

5HEALTH ASSESSMENT AND DIAGNOSIS
and also the raising of the energy of the body. The iron deficiency can be referred as the cause of
the energy deficiency and also the factor of the condition which affects his condition of living.
The factor of the tongue ulcer and the pale skin condition along with the energy can be treated
with the supplement of vitamin B complex and also the vitamin C in the process of the
medication along with the process of the proper diet (Carr et al., 2017). On the other hand the
condition of the patient can be addressed by the process of the helping the patient with his self-
management. The factor of the vitamin supplementation along with the process of the proper
assessment of the patient in regular interval would be helpful in the process of the mental state
management of the patient which also is a crucial factor for the patient’s health in this case
(Kitayama & Park, 2017). Other than all these the factors of the bicarbonate amount, urea
amount and other protein amounts are found to be in higher range and lower range respectively
which also affect the gastric and the libido function of the patient. On the other hand the weight
gaining should be controlled as well. Hence, it can be stated that the factor of the need of the
exercise and the proper diet would be required in a prioritized way to address all these issues.
Thus the pathological tests would be done in regular intervals in order to assess the condition of
the changes of the body and on the basis of the diagnosis the proper treatment process would be
addressed.
Functional diagnosis and Discussion
On the basis the assessment it can be stated that the basic issues of James is the
inadequate nutritional uptake along with the condition of the body components such as the red
blood amount, white blood amount and the hormones along with the proteins are related for his
condition. Hence, on this condition it can be prescribed that the vitamin uptakes including the

6HEALTH ASSESSMENT AND DIAGNOSIS
vitamin C and vitamin B complex. On the other hand the proper diet including the vegetables
and the fresh fruits for the development of the antioxidant and the vitamin B complex in the body
(Kaplan, Rucklidge, Romijn & McLeod, 2015). On the other hand the intake of red meat should
be minimized as this causes the development of the urea in the body (Bergeron, Chiu, Williams,
King & Krauss, 2019). Thus it can be stated that the factor of the controlling of the protein in the
body should be considered as well as the bicarbonate for the improvement of the liver function of
the body. The iron intake of the body on the other hand should be controlled as the Transferrin
hormone is not adequately forming in the body. It can be stated that the over consumption of the
iron by up taking red meat caused the less formation or activation of the Transferrin hormone in
the body (Jhaveri, Deshpande, Pattni & Torchilin, 2018). Other than these the blood pressure of
the patient showed the value of 142/90 which can be stated as the red flag symptoms as it is a
severe concern in his health records. Hence, the fatigue resulted thus the patient should be
referred to the general physician for the better assessment and also proper treatment. It has also
been seen that James has a serious issue with his anxiety control and it is an emotional response
of the patient and should be marked as yellow flag symptom. On this context it can be stated that
he should be referred to psychiatric counsellor for better assessment of his condition and also
providing him proper treatment that can reduce the effect of the anxiety (Ramanayake &
Basnayake, 2018). On this context the LDL test, HDL test, creatinine phosphate and blood
albumin count test as the pathological tests would be referred for James in order to rule out any
kind of cardiac angiopathy successfully. On the other hand the factor of the weight control
should be considered for the control of the obesity, diabetes and also the factor of the mental
health of the body as the lethargic condition can arise from the obese condition and the
cholesterol development also affect the factor of the diabetes as it has been found that James has

7HEALTH ASSESSMENT AND DIAGNOSIS
a family history of diabetes. Thus the risk of the diabetes should be controlled. Other than all
these factors the empowerment and motivation should be provided to him as it would be helpful
in the self-management development and also proper diet following for the improved life style.
Daily morning regimen of at least one hour running and other stretching exercise would also help
him in refreshing his mind (American Diabetes Association, 2018). That would also be effective
in the proper hormonal development of the patient.
Thus it can be concluded that the primary concern of the patient would be the dietary
intake and the exercise for everyday as of controlling the factor of the physiological functions
working properly. Hence, it can be stated that the factor of the patient’s mental health and the
physiological functions should be considered and impacted by proper diet and empowerment
providence to the patient.

8HEALTH ASSESSMENT AND DIAGNOSIS
Referencing
American Diabetes Association. (2018). 4. Lifestyle management: standards of medical care in
diabetes—2018. Diabetes Care, 41(Supplement 1), S38-S50. Retrieved from
https://doi.org/10.2337/dc18-S004
Bergeron, N., Chiu, S., Williams, P. T., M King, S., & Krauss, R. M. (2019). Effects of red meat,
white meat, and nonmeat protein sources on atherogenic lipoprotein measures in the
context of low compared with high saturated fat intake: a randomized controlled trial.
The American journal of clinical nutrition. https://doi.org/10.1093/ajcn/nqz035
Carr, A. C., Rosengrave, P. C., Bayer, S., Chambers, S., Mehrtens, J., & Shaw, G. M. (2017).
Hypovitaminosis C and vitamin C deficiency in critically ill patients despite
recommended enteral and parenteral intakes. Critical Care, 21(1), 300. Retrieved from
https://doi.org/10.1186/s13054-017-1891-y
De Castella, K., Platow, M. J., Tamir, M., & Gross, J. J. (2018). Beliefs about emotion:
implications for avoidance-based emotion regulation and psychological health. Cognition
and Emotion, 32(4), 773-795. Retrieved from
https://doi.org/10.1080/02699931.2017.1353485
Funder, J. W., Carey, R. M., Mantero, F., Murad, M. H., Reincke, M., Shibata, H., ... & Young
Jr, W. F. (2016). The management of primary aldosteronism: case detection, diagnosis,
and treatment: an endocrine society clinical practice guideline. The Journal of Clinical

9HEALTH ASSESSMENT AND DIAGNOSIS
Endocrinology & Metabolism, 101(5), 1889-1916. Retrieved from
https://doi.org/10.1210/jc.2015-4061
Gao, M., Monian, P., Quadri, N., Ramasamy, R., & Jiang, X. (2015). Glutaminolysis and
transferrin regulate ferroptosis. Molecular cell, 59(2), 298-308. Retrieved from
https://doi.org/10.1016/j.molcel.2015.06.011
Jhaveri, A., Deshpande, P., Pattni, B., & Torchilin, V. (2018). Transferrin-targeted, resveratrol-
loaded liposomes for the treatment of glioblastoma. Journal of Controlled Release, 277,
89-101. Retrieved from https://dx.doi.org/10.1016%2Fj.jconrel.2018.03.006
Kaplan, B. J., Rucklidge, J. J., Romijn, A., & McLeod, K. (2015). The emerging field of
nutritional mental health: Inflammation, the microbiome, oxidative stress, and
mitochondrial function. Clinical Psychological Science, 3(6), 964-980. DOI:
10.1177/2167702614555413
Kitayama, S., & Park, J. (2017). Emotion and biological health: The socio-cultural moderation.
Current opinion in psychology, 17, 99-105. Retrieved from
https://dx.doi.org/10.1016%2Fj.copsyc.2017.06.016
Kuzmanović, D., Khan, M., Mehmeti, E., Nazir, R., Amaizah, N. R. R., & Stanković, D. M.
(2016). Determination of pyridoxine (vitamin B6) in pharmaceuticals and urine samples
using unmodified boron-doped diamond electrode. Diamond and Related Materials, 64,
184-189. Retrieved from http://dx.doi.org/10.1016/j.diamond.2016.02.018
Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G., Coats, A. J., ... & Jessup,
M. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic

10HEALTH ASSESSMENT AND DIAGNOSIS
heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart
failure of the European Society of Cardiology (ESC). Developed with the special
contribution of the Heart Failure Association (HFA) of the ESC. European journal of
heart failure, 18(8), 891-975. Retrieved from https://doi.org/10.1002/ejhf.592
Ramanayake, R. P. J. C., & Basnayake, B. M. T. K. (2018). Evaluation of red flags minimizes
missing serious diseases in primary care. Journal of family medicine and primary care,
7(2), 315. Retrieved from https://dx.doi.org/10.4103%2Fjfmpc.jfmpc_510_15
Spinas, E., Saggini, A., Kritas, S. K., Cerulli, G., Caraffa, A., Antinolfi, P., ... & Saggini, R.
(2015). Crosstalk between vitamin B and immunity. J. Biol. Regul. Homeost. Agents,
29(2), 283-288. Retrieved from
https://s3.amazonaws.com/academia.edu.documents/41848579/_JBRHA29-2.pdf?
response-content-disposition=inline%3B%20filename
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age=21

11HEALTH ASSESSMENT AND DIAGNOSIS
Appendices
Appendix 1
PHYSICAL EXAMINATION (General)
EXAM RESULTS
Pulse 70 bpm (60-100bpm)
Blood pressure 142/90. Red flag. High and need reference for GP.
Temperature 37.2. Normal
Respiratory
Rate
14 rpm (normal 14-20rpm)
Lymph nodes Cervical lymph nodes slightly raised bilaterally. Moderately tender, soft
and movable to touch.
Respiratory
exam
NAD
Cardiovascular
exam
NAD
PHYSICAL EXAMINATION (Nutritional/Functional)

12HEALTH ASSESSMENT AND DIAGNOSIS
EXAM RESULTS POSSIBLE NUTRITIONAL
DEFICIENCY
Face:  Looks pale
 Dark circles under
eyes
Fatigue, allergies, B12, folate, iron.
Eyes  Twitching eyelid
on R side
 Pale conjunctiva
Magnesium, Iron, folate, excess caffeine.
Nails:  White spots &
brittle (break
easily)
Zinc, B2, B3, B12
Hair & scalp  Dry hair and
thinning, with mild
dandruff
biotin, Zinc, EFA
Tongue & Mouth  Small ulcers on
edge of tongue on
both sides.
 Painful tip of
tongue
 Tonsils appear
slightly red
B2, B3, biotin, folate, C, B12, iron
ANTHROPOMETRICS
Height 180cm
Weight 79kg
BMI =kg/m2 = 79/3.24 =
24.38
Healthy range 20-25. This BMI still in
healthy range. It is fine.
Waist to hip ratio 1.1 >1.0 in men indicates Android Obesity &
risk of cardiovascular disease.
Sum of Skinfold
measurements (chest,
40mm

13HEALTH ASSESSMENT AND DIAGNOSIS
abdomen and thigh)
Mid-upper arm muscle
circumference (MAMC)
20
GENERAL PATHOLOGY
Tets Result Convention
al range
Conventional
Interpretatio
n
Functional
Range
Functional
Interpretation
RED BLOOD
COUNT
4.2 M: 4.3-6.2 x
1012/L
Low 4.2-4.9 x
1012/L
Within optimal
range, still fine.
HAEMOGLOBI
N
139 130-180g/L Normal 140-150g/L Below optimal
-Deficiency Fe,
B6, B9, B12, Cu,
Vit C need
-
Hypochlorhydria,
if iron deficiency
anaemia
with low serum
phosphorus and

14HEALTH ASSESSMENT AND DIAGNOSIS
high globulin
-B6 Anaemia
(with low: MCV,
MCH, normal
serum
iron/ferritin; look
for low AST
and/or
GGT also)
-Digestive
inflammation (if
low: globulin,
phosphorus,
increased BUN,
basophils and
ESR)
HAEMATOCRI
T (Packed cell
volume)
0.46 M: 0.40-0.54 Normal M: 0.40-
0.48
Normal
Mean
Corpuscular
98 80-98 fL Normal 90 Above optiomal
• Low B12,

15HEALTH ASSESSMENT AND DIAGNOSIS
Volume (MCV) folate
•Hypochlorhydra
(probable if BUN
increased, and/or
serum
phosphorous
decreased)
MCH (Mean
Corpuscular
Hemoglobin)
28 27.0-32.0 pg Normal 28-31.9 pg It is fine.
Red Cell
Distribution
Width
17% M: 11.8-
14.5%
High The mean Above optimal
• Iron, B12,
folate deficiency
• Pernicious
anaemia
• Thalassemia
Serum Iron 13 9.0-26.0
umol/L
Normal 9.0-18.0
umol/L
It is fine

16HEALTH ASSESSMENT AND DIAGNOSIS
Serum Ferritin 50 M: 33-236
ug/L
Normal
Percent
Transferrin
Saturation
20 10-51% Normal 20-35% It is fine
Transferrin: 2.38 170 to 370
mg/dl
Normal
Platelet count 145 150 – 450 x
10^9/L
Normal 155 – 385 Below optimal
• Heavy metals,
with low MCH,
LDH
• Oxidative stress
• High ETOH
(alcoholism)
• Excessive B3
supplementation
WHITE BLOOD
CELL COUNT
4.0 M: 3.7-9.5 x
10
Normal 5.0 – 7.5 x
10
Below optimal
• Pancreatic
insufficiency (as

17HEALTH ASSESSMENT AND DIAGNOSIS
9
/L
9
/L
phagocytic WBC
used to
break down food
and clear
residues)
• Raw food diet
(slightly below
optimal)
• Low B12,
folate, B6
• Zinc, protein
• Alcoholism
• Chronic
parasites
Lymphocytes 20% 14-46% Normal 24-44% Below optimal
• Oxidative stress
(if seen with total
cholesterol
suddenly
low, low
albumin,

18HEALTH ASSESSMENT AND DIAGNOSIS
platelets,
increased
globulin)
• B12, B6 and
folic acid
(anemia)
Neutrophils 38% 35-74% Low 40-60% Below optimal
• Chronic viral
infections
• B12, B6, folic
acid (anaemia)
• Multiple food
allergies
Monocytes 0.3 0.3 to 1 x
109/L
Normal
Eosinophils 10% 4-13% Normal <7% Above optimal
• Parasites (esp.
if also high
basophils,
monocytes)
• Food

19HEALTH ASSESSMENT AND DIAGNOSIS
environmental
allergy/sensitivit
y
• Hyperthyroid
• Adrenal
dysfunction
Erythrocyte
sedimentation
rate (ESR)
1 17-50 years:
1-10 mm in 1
hour
Normal Males
<5mm/hr
Above optimal
• Inflammation
• Active allergy
C-Reactive
Protein
1.2
mg/L
<5 mg/L. Normal Cardiac
risk
average:
1.0 – 3.0
He is fine with
1.2mg/L
Sodium 137 136-145
mEq/L
Normal
Potassium 4.8 3.6 and 5.2
millimoles
per liter
Normal
Chloride 102 96 and 106 Normal

20HEALTH ASSESSMENT AND DIAGNOSIS
Bicarbonate/CO2 33 23 and 29 High High CO2 in
blood may point
to:
•Lung diseases
like COPD or
chronic
obstructive
pulmonary
disease
•Dehydration
•Anorexia
•Adrenal gland
problems, such
as Cushing’s
syndrome or
Conn’s
syndrome.
Urea 4.5 3.0-8.0
mmol/L
Normal 3.57-5.71
mmol/L
Normal
Creatinine 98 M: 0.06-0.12 Normal 70.7 – 97.2 Above optimal

21HEALTH ASSESSMENT AND DIAGNOSIS
mmol/L (umol/L) • BPH (male)
• Prostatitis
(male)
• UTI
• Renal
insufficiency
• Dehydration
• Uncontrolled
diabetes
• Creatine
supplementation.
• Uterine
hypertrophy
(female)
• Uterine
inflammation
(female)
• Dehydration
T.Protein 79 62-80 g/L Normal 69-74 g/L Above optimal
• Dehydration

22HEALTH ASSESSMENT AND DIAGNOSIS
• Adrenal
hypofunction
• Liver disease
• Diabetes
• Rheumatoid
Arthritis
Albumin 45 32-45 g/L Normal 40 – 50 g/L Normal
ALP – alkaline
phosphatase
30 25-100 U/L Normal 70 – 100
U/L
Below optimal
• Low
Magnesium
• Low Phosphate
• Low Zinc (ALP
below 70 U/L;
also low: WBC
or RBC zinc
levels and
low/normal or
low WBC)
• Malnutrition
•

23HEALTH ASSESSMENT AND DIAGNOSIS
Hypothyroidism
• Very low
fat/low protein
diets
• Adrenal
hypofunction
• Drugs:
oestrogen or
oestrogen with
androgens
Bilirubin (total
bilirubin, direct
(unconjugated)
bilirubin,
indirect
(unconjugated
bilirubin)
22 5.1-17.0
umol/L
High 1.7 – 20.5
umol/L
Above optimal
Often associated
with biliary stasis
or insufficiency.
• With a mild
biliary tract
obstruction levels
will be raised
along with
ALP (>100) U/L
• Biliary Tract

24HEALTH ASSESSMENT AND DIAGNOSIS
obstruction (liver
dysfunction e.g.
alcohol damage)
–
also: high GGT,
ALT, ALP and
LDH.
• Biliary
obstruction/calcu
li – also: high
GGT (higher
than ALT),
normal or high
ALT, high ALP
(>140).
• RBC
haemolysis (high
unconjugated
bilirubin).
GGT – gamma
glutamyl
30 0-51 U/L Normal 10-30 U/L Normal

25HEALTH ASSESSMENT AND DIAGNOSIS
transferase
AST – Aspartate
aminotransferase
8 <40 U/L Normal 10 – 30
U/L
Below optimal
• B6 deficiency
• Protein
deficiency
• Malabsorption
ALT – Alanine
aminotransferase
8 4-36 U/L Normal 10 – 30
U/L
Below optimal
• B6 deficiency
• Fatty liver
(early)
• Liver
congestion
(early)
• Alcoholism
• Protein
deficiency
• Malabsorption
Thyroid
Stimulating
Hormone (TSH)
1.81 0.4-5.0
mIU/L
Normal 2.0-4.4
mIU/L
Below optimal
•
Hyperthyroidism

26HEALTH ASSESSMENT AND DIAGNOSIS
• Secondary
hypothyroidism
(ant.
Pituitary
hypofunction)
• Tertiary
hypothyroidism
(hypothalamus
hypofunction)
• Grave’s disease
• Thyroid tumour
• Thyroxine
excess
• Thyroiditis
(inflammed) e.g.
post partum
Fasting blood
glucose test
5.7
mmol/
L
3.0-
5.4mmol/L
High 4.44-
5.55mmol/
L
Above optimal
• Insulin
resistance
• IFG, IGT

27HEALTH ASSESSMENT AND DIAGNOSIS
• Syndrome X
(high trigs, total
cholesterol,
insulin & BP;
low HDL
• B1 (glucose
>5.55 mmol/L) =
increased B1
need (if HbA1c =
normal); also if
anion gap
increased and
LDH may be
decreased (due
to glucose role in
glycolyis)…
• Chronic
stress…
• Fatty liver
(early) [high
glucose

28HEALTH ASSESSMENT AND DIAGNOSIS
associated
with higher
blood fats,
cholesterol etc.)
• Obesity & poor
nutritional status
Cholesterol
(Total)
5.2
mmol/
L
<5.5mmol/L No other risk
factors
3.9-5.69 It is fine
Triglyceride
(fasting)
3.5
mmol/
L
< 2.0
mmol/L
High 0.79-1.24 Above optimal
• Syndrome X
• Fatty liver
• Insulin
resistance (pre-
diabetes)
• Atherosclerosis
(esp. with
oxidative stress,
high
homocysteine,
high LDL, low

29HEALTH ASSESSMENT AND DIAGNOSIS
HDL)
•
Hypothyroidism
• Adrenal cortical
dysfunction (if
Trigs and
cholesterol high
with
low potassium.
Catecholamines
from adrenals
can cause
release of fatty
acids.
Cholesterol etc.
can increase with
stress)
• Alcoholism
• Excess refined
carbs
LDL (fasting) 3.2 <2.5 High 1.55-3.10 Above optimal

30HEALTH ASSESSMENT AND DIAGNOSIS
mmol/
L
• High sat/trans
fats; High refined
diet (high trigs,
raised blood
glucose, low
HDL) –
syndrome x
• Atherosclerosis
(particularly if
high oxidative
stress, increased
homocysteine
and if familial
hyperlipidemia.
• Oxidative
stress..
• Fatty liver/early
liver congestion
(if high trigs, and
low HDL)
• Oestrogen
(medication);

31HEALTH ASSESSMENT AND DIAGNOSIS
OCP; androgens
HDL (fasting) 0.9
mmol/
L
≥ 1.0 mmol Low ≥ 1.42
mmol
Below optimal
•Hyperlipidaemia
and
atherosclerosis
• Diets high in
refined carbs
• Syndrome X
• Oxidative stress
• Heavy
metal/chemical
overload
• Fatty liver
(early liver
congestion)
• Hyperthyroid
• Lack of
exercise
• Obesity
• Some drugs

32HEALTH ASSESSMENT AND DIAGNOSIS