Please help me dr plse I am in so much pain - #12391
Tightness in neck region Menstrual irregularities Low periods few drops Urinating burning Urge to pass..Lower abdomen..Lower backpain Weighloss due to loss of appetite..Nausea..severe Body ache..Fatigue Muscle pain..Hands stiffness early morning..In so much hot i dont like fan or ac I use to prefer without it feel so much cold or no sweating sometimes feel hot usually at night only..severe Headache..FT3 (Free Triiodothyronine 3) 2.35 pg/mL FT4 (Free Thyroxine 4) 0.98ng/dL TSH 3rd Generation 0.364..all labs reports showing same values but ranges are different I am in so pain with symptoms I knw that..Hb= 9.2 vit d= 3.34 Vit b12=101
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Hello dear See as per clinical history it seems thyrotoxicos or autoimmune thyroiditis I suggest you to please get following tests done and share result with endocrinologist for further evaluation Lft Anti tpo test Blood tests Imaging Thyroid USG Please donot take any medication without consulting the concerned physician Regards
The symptoms you’re describing, coupled with your lab results, suggest a need for comprehensive evaluation, as there may be multiple contributing factors. The muscle and body pain, fatigue, and cold intolerance coupled with headaches can be related to your thyroid function. Your thyroid levels—particularly TSH—appear on the lower end, suggesting a possible mild hyperthyroidism, though clinical correlation is important. That aligns with some of your temperature regulation issues, like feeling too cold at night and preferring warmth, though not exclusively. Your Hb (hemoglobin) level suggests anemia, which can contribute to fatigue and overall body aches. Poor vitamin D status coupled with low B12 levels can exacerbate muscle pain and fatigue. The burning sensation during urination, along with abdominal pain, could indicate a possible urinary tract infection that needs to be addressed. It’s paramount to manage your anemia; dietary adjustments and supplements. Increasing your vitamin B12 and D through diet (or supplements, ideally after consulting with a healthcare provider) is essential for improvement. Ensure adequate hydration, fiber intake, and balanced nutrition to help regulate menstrual irregularities. The persistent nausea and significant weight loss emphasize the need for a detailed gastrointestinal evaluation to rule out infections, inflammation, or any other malabsorption issues. Due to the complexity of your conditions, involving persistent pain, it’s important to have these red-flag symptoms evaluated promptly by a healthcare provider for immediate management to address potential underlying systemic issues and any need for urgent intervention, especially considering the severe body ache and other systemic symptoms.
Your symptoms and test reports suggest thyroid imbalance along with severe vitamin D and B12 deficiency, and low hemoglobin causing fatigue and pain. These combined issues can affect your periods, appetite, and body temperature regulation. Specialist consultation is advised (Endocrinologist and Physician).
Subclinical / Early Hypothyroidism or Autoimmune Thyroid Disorder (Hashimoto’s or evolving form) Severe Vitamin D & B12 Deficiency Iron-deficiency Anemia (Hb 9.2 g/dL) Menstrual irregularity likely secondary to hormonal and nutritional imbalance
Investigation: Anti-TPO antibody Anti-thyroglobulin antibody
RX 1) Tab. Uprise D3 60,000 IU 1 capsule weekly for 8 weeks, then once every 15 days after breakfast 2) Tab neurokind od 1 tab after meal once daily for 3 months 3) Orofer xt 1 tablet daily after lunch for 3 months. Your body is exhausted and inflamed from nutritional and hormonal imbalance. Correcting Vitamin D, B12, and Iron will make a huge difference within 2–3 weeks. Please don’t ignore or self-medicate thyroid hormones until antibody results confirm the diagnosis — these fluctuations are common in autoimmune thyroid disease.
Helo Ilma,
Rx D3 must - Once a week for 6 weeks Neurobion forte alternative days for 6 weeks Fefol - once daily ( better with lime juice) for 6 weeks
For thyroid, please consult a physician or an endocrinologist in person and take the medication if needed.
You will get well soon I trust this helps. Feel free to talk Thank you
Hi Dear Ilma, I can understand your concern totally With your symptoms it is more towards Subclinical Hyperthryoidsm /Anemia under evaluation /Vit D3 and B12 deficiency Kindly do an USG Neck CBC with peripheral smear ECG 2D ECHO Take Cap Vit D3 60KIU twice a week for 4 weeks CAP RENERVE PLUS 0-0-1 for 1 month TAB OROFER XT 1-0-1 for 1 month after food Kindly visit an Endocrinologist
Hello Ilma, I can understand how distressing it must be to experience so many symptoms at once. You have Severe Vit-D & Vit-B12 deficiency + Moderate anemia. You have borderline TSH as well, which requires further evaluation. Here is my advise for your betterment -
1. Get these tests done - Sr. Ferritin, Sr. Iron, TIBC, Anti-TPO & Anti-Tg antibodies, ESR, CRP, FBS, PPBS, LFT, RFT. Kindly review with these reports.
2. Start with this prescription - -Tab. Uprise-D3 60,000 IU once weekly × 2 months. Take with milk / after a fatty meal. -Tab. Methycobalamin 1500mcg at night × 3 months - Tab. Iron + Folic Acid once daily × 3 months. -Tab. Paracetamol 650 mg, take one tablet when moderate - severe pain occurs.
3. General Measures - Get sunlight exposure for 20mins/day. Include foods: eggs, milk, paneer, curd, non-veg (if diet allows). Iron-rich foods: jaggery, dates, pomegranate, spinach, beetroot. Vitamin D: sunlight, eggs, fish, fortified milk. B12: dairy products, eggs, non-veg, fortified cereals. Avoid: junk food, caffeine excess, late-night sleep. Gentle yoga or walks to improve circulation and pain.
4. When to Seek Urgent Help - Sudden palpitations, weight loss, tremors, check thyroid urgently. Severe weakness or dizziness-possible anemia worsening. Painful lymph nodes or swelling in neck.
Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Med
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