Conversation: The conversation between human and AI assistant.
[|Human|] My BP is high as I have started oberving for past 1 week, it was 140+ fasting and 158+ on 3 alternate days. Feeling drowsiness the entire day for past one month. My cholestrol level is 125, Serum Alkaline Phosphate both in lever and kedney is 377 (range 95-240), ESR is 45, B12 is 128 & Vit D is 10.69. Request suggestion
[|AI|]  Hello! Thank you for asking on Chat Doctor! Regarding your concerns I would recommend as follows: You should monitor frequently your BP values even for a couple of days and with your measured values to consult your doctor (GP or internist). If high BP values persist, then some secondary reasons of high BP should be sought first. Your cholesterol level is OK. You don't need any therapy for that. Alkaline phosphatase is abnormally high coupled with a high ESR. Some additional blood tests are necessary to define the cause. A possible inflammation should be excluded first. Vit D level is also abnormally low (moderate deficiency). Renal function tests, parathyroid evaluation, and electrolyte levels (including calcium) is necessary for the differential. Vit B12 deficiency is present, so a comprehensive check up should be worked out to identify the reason. Vegetarian diet, malabsorption, hyperthyroidism, megaloblastic anemia, any gastrointestinal, abdominal or elsewhere masses should be excluded first. For all the above reasons of investigation, I would recommend: (1) First a careful medical check up by an internist (physical examination) a medical history gathering.(2) Several blood tests, like complete blood count, PCR, liver and renal function tests, Thyroid and parathyroid hormone levels, serum electrolytes, ECG, Chest X-ray study, abdominal ultrasound, complete urine test, serum proteins evaluation, LDH, Gama GGT, Schilling test, eventual fibrogastroscopy and other optical studies (as needed). If suspicions are raised, additional tests may be required. Hope to have been helpful. Greetings!