Hello,
I’ve reviewed your history in detail. You have well-controlled
diabetes (
HbA1c 5.7%), mild subclinical hypothyroidism, and currently mild fatty
liver with a normal CT and no significant protein leak in urine (UACR 10). These are all good signs.
Your present complaints of nausea, loss of appetite, and mild weight loss are likely related to either fatty liver, medication side effects (particularly Serta or Petril), or gastritis/metformin-related gastric irritation.
My suggestions:
1. Continue your current diabetes and
thyroid medicines as advised.
2. Take Istamet after meals and not on an empty stomach.
3. Avoid oily, spicy foods and late-night heavy meals.
4. For nausea, you can take Tab. Domperidone 10 mg or Ondansetron 4 mg before food (as advised by your doctor).
5. Continue following your nephrologist’s advice — moderate protein intake and avoid painkillers (NSAIDs).
6. Monitor weight and appetite; if weight loss continues, repeat thyroid and
liver function tests after 4–6 weeks.
7. Ensure adequate hydration and small frequent meals.
8. If nausea persists despite above measures, consider reviewing antidepressant dose — sometimes Serta can affect appetite or cause nausea. Discuss this with your psychiatrist.
Overall, your reports are reassuring. Focus on balanced diet, proper sleep, and avoiding unnecessary medications.