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Dr. Ravoof
Dr. Ravoof, Doctor
Category: Endocrinology
Satisfied Customers: 2444
Experience:  Experienced Physician in the field of Medicine and Surgery.
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Last 3 4 months I felt very tired grumpy found myself not tolerating

Customer Question

Last 3 4 months I felt very tired grumpy found myself not tolerating things that in past I used too ignore so went to gp to discuss about my health and done some blood test that all came back normal ( haemoglobin 125 haematocrit 0.38 ... Only monocytes count above range 0.9 ) and she told me is nothing wrong with me
Not satisfied with situation I search on website and decided to go private ( ask gp for referral letter to take extra blood test)
Cortisol 329 nmol/L
Ferritin 10 ug/L - low
TSH 1.33 my/L
Free T3 4.5 pmol/L
Free T4 16.98 pmol/L
FSH 15.3 u/L luteal. - high
LH 7.4 u/L luteal
Oestradiol 85 pmol/L luteal. -low
Progesterone 2.9 nmol/L. -low
Prolactin 360 mu/L
Vit D 39 nmol/L. - low
I am female 45 years old with monthly period , normal weight ( tall 1.73 with 69 kg) always with low blood pressure ( hand and feet cold all the time) pale complexion
When I drink water or tea always need to go to toilet almost straight away and only health problem I have is osteoarthritis both knee and start to feel pain on back and hip too recently
I took blood test between third and fourth week of period
Can you link all information I gave so to find out what is wrong with me
Many many thanks in advance
Submitted: 1 year ago.
Category: Endocrinology
Expert:  Shantal-Mod replied 1 year ago.
Hello,
I'm Shantal and I'm a moderator for this topic.
I've been working hard to find a Professional to assist you with your question, but sometimes finding the right Professional can take a little longer than expected.
I was checking to see if you had already found your answer or if you still need assistance from one of the Professionals.
Please let me know if you wish to continue waiting or if you would like for us to close your question?
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Shantal
Expert:  Dr. SH replied 1 year ago.
Thank you for your question.I see that your FSH is on the higher side and considering that you are 45 years of age I think that you may be nearing your menopause (having premenopause) which could be the reason why you are experiencing the symptoms that you are experiencing.So I think that hormone replacement therapy with estrogen and progestrone combination may help with your symptoms.I think that your symptoms are most likely hormonal.Let me know if you have more questions.Please rate me by clicking on one of the stars.Kind regards
Customer: replied 1 year ago.
I was prescribed 5 years ago HRT due to a very severe mastodynia non-cyclical and I refuse because of side effects. My gynaecologist that I gave birth my son 18 years ago advised to take a German pill called Femicur and phytosoya and I am feeling good I stop a year ago so probably wasn't good idea
Is any other tratament?
Is worth it too check hepcidin ( having ferittin so low)? I understood that haemoglobin lower then 130 and cell haemoglobin lower then 28 that I have = presence of IDA
Or check angiotensin?( I understood if is too little increased urine output so loss of sodium so low blood pressure
Or aldosterone? For the same reasons
Expert:  Dr. SH replied 1 year ago.
I personally think that you should resume what worked for you previously because there is no point in trying things that you have not tried or have not worked for you.
For a low ferritin I would recommend using ferrous sulfate (which is over-the-counter).
Low ferritin in itself, usually is not the cause of the symptoms that you are experiencing. It is the low hemoglobin associated with the low ferritin that causes the symptoms usually but there is no harm in taking ferrous sulfate as you already have a low ferritin level.
I would also recommend taking vitamin D supplements as well.
You certainly have iron deficiency but your overall hemoglobin is 13 so this does not fall into anemia but taking ferrous sulfate may still help with your symptoms.
I do not think that checking angiotensin or aldosterone would helpl.
Let me know if you have more questions.
Please rate me by clicking on one of the stars.
Kind regards
Customer: replied 1 year ago.
I suggest aldosterone because regulate salt and water and blood pressure( that is low 9/5 )and maybe this is one of reason I am tired.
I was almost 3 months in naproxen for pain on lower back and I thought I feel tired because of it but stopped in August and still tired
I am taking 400mg/day ferrous sulphate but I don't know for how long
It is known that is making worse osteoarthritis if is too much iron taken
And I take fultium D3 3200 UI for lack of vit D but again I don't for how long
After a month of iron my serum iron is 18 transfer level 2,5 transfer saturation 0.57 so should I take for 3 months or less or more ­čśĽ
Any advice of blood test to do for ( low blood pressure , excess of urine, tingling on fingers and toes (sometime blueish colour), waking up with numb legs or arms
Customer: replied 1 year ago.
Can you answer to the last SMS from 29/9/15
Thank you ­čśâ
Expert:  Dr. Ravoof replied 1 year ago.
Dear customer, What is your present blood pressure?
Customer: replied 1 year ago.
9/5
Expert:  Dr. Ravoof replied 1 year ago.
Dear customer, Do you mean 90/50 mm of Hg.
Customer: replied 1 year ago.
Yes I always had low blood pressure. I measured often because I check my husband's ( he is with high blood pressure taking simvastin perindopril and felodipine so when I check his I check mine too)
Expert:  Dr. Ravoof replied 1 year ago.
Dear customer, Did you have your fasting blood glucose level investigated? Thanks.
Customer: replied 1 year ago.
Yes I have is 4.9 mmol/L
Serum sodium level 139 mmol/L
serum potassium level 4.9 mmol/L
Serum creatinine level 70 umol/L
Serum total bilirubin level 4 umol/L
Serum alanine aminotransferase level 14 iu/L
Serum total cholesterol 4.9 mmol/L
Triglyceride level 0.6 mmol/L
Serum HDL cholesterol level 2.1
Serum LDL cholesterol level 2.7
Total protein 71g/L
Albumin 42 g/L
Globulin 28 g/L
Serum calcium 2.2 mmol/L
Adjusted calcium 2.2 mmol/L
Alkaline phosphatase 46 iu/L
Phosphate 1.14 mmol/L
Uric acid 260 umol/L
Haemoglobin 125 g/L
Total white blood count 8.6 10*9/L
Nucleated red blood cell count 0.0 10*9/L
Platelet count 351 10*9/L
Red blood cell count 4.49 10*12/L
Haematocrit 0.388
Mean cell volume 86.4 fL
Mean cell haemoglobin level 27.8 pg
Mean cell haemoglobin concentration 322 g/L
Hope test help
Kind regards
Expert:  Dr. Ravoof replied 1 year ago.
Dear customer, With these symptoms I would suggest that you consult your doctor about diabetes insipidus since a low blood pressure may occur in this condition along with excretion of an excessive amount of diluted urine. http://www.mayoclinic.org/diseases-conditions/diabetes-insipidus/basics/definition/con-20026841 Take care.
Customer: replied 1 year ago.
Thank you very much for your help
Expert:  Dr. Ravoof replied 1 year ago.
Dear customer, You are welcome. Please rate the answer with a positive rating. Thanks.
Customer: replied 1 year ago.
Reading the link you sent are to majors symptoms extreme lost of fluids and extreme thirst
I urinate often but I don't feel any thirst in fact I can stay all day not to drink any liquids and I don't have dry mouth , sunken eyes ( in the morning I have puffy eyes) , weigh loss, rapid heart beat, muscle pain
But I will ask my gp for investigation because I always restrict myself drinking fluids not to go all the time to the toilet
Expert:  Dr. Ravoof replied 1 year ago.

Dear customer,

 

You are correct, thirst is an important symptom and excessive thirst is seen particularly for ice cold water in this disorder. Hence at the most your doctor may recommend doing a urine test to look for dilute urine.

 

Take care.

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