Kathryn (Moderator) - 10:01 AM:
Our chat on knowing your numbers is now open. You can submit questions at any time during our chat.
Dr. Nadim Ilbawi (NorthShore) - 10:02 AM:
Good morning everybody- welcome to our chat. I'm looking forward to answering your questions.
Laurie (Evanston, IL) - 10:03 AM:
Is BMI useful for determining health? I've heard other ways, like body fat percentage calculation are more accurate. Thoughts?
Dr. Nadim Ilbawi (NorthShore) - 10:04 AM:
Hi Laurie, Good question- BMI can be helpful but definitely has its limitations. Because muscle weighs more than fat, some very muscular individuals may have an elevated BMI but still have excellent health. That being said, higher BMIs (in the obese or morbidly obese range) have negative health associations.
Ann - 10:08 AM:
What is the best exericse or diet to be on in order to decrease your chol. My good is bad & bad is good. How do I reverse this. I am an active 63 year old woman.
Dr. Nadim Ilbawi (NorthShore) - 10:15 AM:
Hi Ann, This is a very good question that a lot of my patients ask. In general, high intensity exercise can be very beneficial to lowering your cholesterol. Because you are 63, your maximum heart rate is 157. Getting up to 80% of that (about 125 beats per minute) while you exercise can be helfpul. I have a feeling that with how you describe your lifestyle, you regularly achieve and maintain this heart rate. When it comes to diet, people often make a mistake of avoiding fat. There are healthy fats (avocados, almonds, olive oil, eggs,...) that can help lower your cholesterol. If consumed in moderation, this can actually help lower your cholesterol. You mention your good cholesterol (HDL) is low. Exercise and weight loss can help increase this number. However, to be honest, this is a very difficult number to move- oftentimes because there is a strong genetic component to this level. If you are doing all the above, at least having a low LDL (bad cholesterol) is very important.
Ali (Skokie, IL) - 10:15 AM:
My cholesterol is 220 and my HDL is so high that the lab highlights it as abnormal; is this ok to not be on a statin? What options might I have?
Dr. Nadim Ilbawi (NorthShore) - 10:17 AM:
Absolutely- this highlights the fact that your doctor should never focus on just the total cholesterol number itself (normal is reported as less than 200). The breakdown of the cholesterol type is much more important. If your HDL is that high, it actually removes a risk factor for heart disease and a statin would not be indicated for this alone.
Kat (Buffalo Grove, IL) - 10:18 AM:
What are some common causes for iron deficiency? What are some ways I can improve my numbers if they're low?
Dr. Nadim Ilbawi (NorthShore) - 10:22 AM:
In women of child bearing age, this can occur with heavy menses or a period that lasts many days. Some women do not get enough iron in their diets to help the body "catch up" from the blood loss and so they become iron deficient. In these cases, an iron supplement like ferrous sulfate taken 2-3 times a day can be helfpul. Please note, the iron supplement can cause constipation and stomach upset in some individuals. Depending on your age and sex, iron deficieny may be warrant further testing/work up.
Mary (Highland Park, IL) - 10:22 AM:
I am borderline diabetic and weight is always been an issue. I have had multipe yeast infections & UTIs - 1 every 3 months. Is there a relationship with yeast infections, UTI & diabetes/weight?
Dr. Nadim Ilbawi (NorthShore) - 10:27 AM:
Hi Mary, Unfortunately there is a correlation to diabetes (or borderline diabetes in your case) and an increase in yeast infections. This occurs because yeast use sugars. This is difficult to prevent but with continued efforts at weight loss and potentially (hopefully not) medication to lower your sugars, this may improve.
Joan (Evanston, IL) - 10:28 AM:
If cholesterol just over 200 and HDL is good, fasting sugar is 106-115, does the medication glucophage help to reverse insulin resistance? Or Is losing weight and diet improvement a better alternative?
Dr. Nadim Ilbawi (NorthShore) - 10:32 AM:
Excellent question- I am a big proponent of diet and exercise to prevent you from ever needing medication. Glucophage can help lower your weight and increase insulin sensitivity but if you can do this by losing weight and exercising, that would be my preference by far. The numbers you are sharing with me suggest you will be able to do this hopefully without having to start medication
Norma (Chicago, IL) - 10:36 AM:
Is exercise the one best way to lower cholesterol? What other ways are there?
Dr. Nadim Ilbawi (NorthShore) - 10:39 AM:
Hi Norma, Exercise is one way to do this but I would say diet changes are potentially more effective. Many believe that the role of exercise in lowering cholesterol is related to weight loss (higher weight associated with higher LDL). However, changes in your diet may have a greater impact. For example, lowering saturated fat intake seen in many animal products, can help lower your cholesterol. As I noted in an earlier post, increasing healthy fats like avocados and nuts can make a difference too if consumed in small portions. Finally, and very important, is lowering bad carbohdyrate intake. These are found in white bread, pasta, rice, sweets, sugary drinks, etc.
Emilia (Skokie, IL) - 10:40 AM:
I am 43; post-menopausal and overweight. What are some things I can focus on to improve my health/numbers?
Dr. Nadim Ilbawi (NorthShore) - 10:46 AM:
I talk to patients a lot about sustainability. Many people chose diets and exercise programs that are not sustainable for years and years to come. I recommend that you make lifestyle changes that you believe you can maintain. If you find yourself doing something in your diet choices or exercise habits that you can't see yourself doing in 10 years, cut back or make changes so that you can achieve good long term health. For some people that means working out 3 days a week instead of the recommend five. If I were to summarize and keep simple only two recommendations, I would say try to work out at home for 25 minutes (gyms are unrealistic for most) at least three times a week where you get your heart rate up high (for you a heart rate in the 140s would be ideal) and lower significantly the bad carbs in your diet (see previous post please but less white rice, white bread, pasta, sweets, sugary drinks).
Minna (Chicago, IL) - 10:47 AM:
When I get results back from blood work, is there anything very important on the list that I should be looking at, or should I just ignore it and assume my doctor will notify me if there's any reason for concern?
Dr. Nadim Ilbawi (NorthShore) - 10:52 AM:
NorthShore Connect is a great tool for our patients because it now allows you to see normal results (selected list contains over 300 labs at this time) within 24 hours. Your doctor will review your labs in detail and bring your attention to abnormal labs that need follow up. In some cases, you will see a lab resulted out of the "normal" range that your doctor did not comment on; that is likely because your doctor does not consider this result concerning. I would not recommend you use the internet to look up results as the searches tend to highlight bad possibilities only. I don't think it ever hurts to be proactive about your health. If you are concerned about an abnormal result, do not hesitate to ask your physician if the abnormal result concerns him/her.
Paul (Evanston, IL) - 10:52 AM:
What do vitamins A, B, C, and D correspond with in terms of health? I know vitamin D shows up in tests with calcium, but I am curious about how the others show up.
Dr. Nadim Ilbawi (NorthShore) - 10:59 AM:
These vitamins play multiple roles in many body functions. Of the ones you note, I will focus on vitamin D as this tends to be the only one we check in otherwise healthy individuals. If you have a mostly balanced diet, you should have no problem getting the other vitamins and in this country it is very rare to see deficiencies in A or C. Vitamin B12 deficiency can occur in specific populations with certain diets (eg Vegan), in a condition called pernicioius anemia (body cannot absorb vitamin b12) and in other cases . Vitamin b12 deficiency can show up in other routine labs your doctor will do so it is not routinely tested unless clinically indicated. Vitamin D deficiency is common for all of us living in Chicago because of our limited sun exposure. While it plays a role in mood, blood vessel health, calcium absorption/bone health and many oher functions, we have had limited evidence that supplementation makes a difference with clinical outcomes.
Pam (IL) - 10:59 AM:
I was told that my blood pressure is low, but I don't feel like I have any problems. Is this typical? Can I do anything to get my numbers back to normal?
Dr. Nadim Ilbawi (NorthShore) - 11:09 AM:
Pam, I'm sorry we got cut off as I was typing up my response to you. Below is my response: How low was your blood pressure? If your top blood pressure number (systolic) is over 90 and the bottom (diastolic) is over 60 then your blood pressure is normal. If you feel well then having a low blood pressure is great and will serve your heart health very well!
Kathryn (Moderator) - 11:10 AM:
This will be the end of our chat. Thank you for your questions. For more information on the numbers from your checkups, or to speak with a specialist like Dr. Ilbawi, you can contact the Department of Family Medicine.
Dr. Nadim Ilbawi (NorthShore) - 11:10 AM:
Thank you all for asking very relevant and important questions this morning. I appreciate the opportunity to have participated in this chat. Take care and have a good day. Nadim Ilbawi, MD