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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8781
Experience:  Doctor of Medicine
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Serum BICARBONATE level of 17 mmol/l Tested 12months apart, still low. Could this be met

Resolved Question:

Serum BICARBONATE level of 17 mmol/l
Tested 12months apart, still low.
Could this be metabolic acidosis?

Combined with constant head aches, low leg pain, stiff back. Problems with hormones. (hypo symptoms of thyroid, gonad etc)

Should I see my GP about this?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. SH replied 3 years ago.

Dr. Shahzad MD :

Hi there. Thank you for your question. I will be helping you out with your queries

Dr. Shahzad MD :

Can you please let me know what kind of hormones have you been tested for?

Dr. Shahzad MD :

Have you been tested for cortisol levels?

Dr. Shahzad MD :

Do you have any other medical problems?

Dr. Shahzad MD :

Are you on any medications for anything?

Dr. Shahzad MD :

Please let me know.

Dr. Shahzad MD :

Also can you please let me know if you have had your vitamin D levels done.

Customer:

Vitamin D 83nmol/L
T4 12.9mmol
LH 2.0IU/L
Testosterone 14.5
Sanacthen test OK.

Customer:

Over winter I have symptoms of hypothyroidism, which during spring and summer improve

Customer:

T4 goes from 11.9 to 14.5 from winter to summer

Dr. Shahzad MD :

How is your TSH like?

Customer:

Testosterone again is low, 13.4 in winter and rises to 15.5 is summer

Customer:

TSH is 2.45-2.55 average (has been 5.2 when I felt really really bad)

Customer:

serum calcium is low reference 2.1mmol/L

Dr. Shahzad MD :

How is your libido and sex function?

Customer:

v.poor

Customer:

winter I have 0 libido and ED

Customer:

summer I have urge for sex about 1 every 4-6 weeks.

Customer:

Had sex last october and only just had sex last week.

Dr. Shahzad MD :

What was normal range for testosterone in the lab report with you?

Customer:

I have poor erection quality

Customer:

Umm.. let me look...

Customer:

testosterone 8.6 to 29

Customer:

blood pressure is 120/60 with wide pulse pressure

Customer:

Cials, Viagra etc do nothing. Head ache is massive. tried 1,2 and then 3 tablets. Nothing.

Customer:

Tried MUSE as well. Nothing.

Dr. Shahzad MD :

You mentioned headache, since how long are you having this headache?

Dr. Shahzad MD :

Also for how long are you having these other symptoms?

Customer:

All other symptoms of lethargy, tiredness, pain in muscles and loss of drive has been getting worse over the last 8 years.

Customer:

headaches are getting worse over the past month or so.

Dr. Shahzad MD :

Have you had any scans of your head like an MRI scan

Customer:

My CK levels are 188 (tested twice, about 1 month apart)

Customer:

No. Only DEXA scan of bones. -2.5 -> -2.9 spinal.
Nothing on my head.

Customer:

Endo initially thought of a pituitary problem, but cannot do anything as my hormone results are always low normal, never below.

Dr. Shahzad MD :

Have you had parathyroid hormone levels done?

Customer:

Yes. 4.1pmol/L (Range 1.1 to 4.2)

Dr. Shahzad MD :

How is your urea and creatinine like?

Dr. Shahzad MD :

in the normal range?

Dr. Shahzad MD :

What is the normal range of vitamin D of your lab report.

Customer:

Urea 6.2 (2.5 -> 7.8)

Customer:

Creatinine 92 (65 -> 105)

Customer:

So normal range

Customer:

Vit D range.... just says >50

Dr. Shahzad MD :

ok

Dr. Shahzad MD :

Your calcium is low and phosphate is high.

Customer:

I'm concerned I have low serum calcium (have had high phosphates, but have cut out a of of dairy)


Dr. Shahzad MD :

The vitamin D is also high and so is your parathyroid hormone i.e. in the upper limit of normal.

Dr. Shahzad MD :

I think that you are having vitamin D resistance in your body.

Customer:

The phosphate is now in OK range but Bicarbonate is always low

Dr. Shahzad MD :

Even with a high vitamin D level your calcium is low and most of your phosphate readings have been above the normal level.

Customer:

phosphate has been high 2.19 but is now down to 1.09

Customer:

This was 1 year apart

Customer:

My LDL and HDL are both just about range

Customer:

I also have just above range iron.

Dr. Shahzad MD :

I also think that a diagnosis of renal tubular acidosis shouldbe considered.

Dr. Shahzad MD :

This diagnosis is usually made by a nephrologist.

Dr. Shahzad MD :

This condition can cause calcium problems, osteoporosis along with acidosis and usually a low potassium.

Customer:

My potassium has always been unable to be measured? (always says storage changes)!

Should I request a referral from my GP?

Dr. Shahzad MD :

Yes

Dr. Shahzad MD :

You should request a referral.

Customer:

OK. Thank you

I have had a trial of T4, T3 and Testosterone but nothing seems to alter my general state. I have an initial benefit but then it goes.

Customer:

Thanks for your help. I will contact my GP.

Will the acidosis have an effect on erectile dysfunction. or cause a general non-function of hormones.

Customer:

Last question. Honest.

Dr. Shahzad MD :

Acidosis can cause

Dr. Shahzad MD :

sorry

Dr. Shahzad MD :

Acidosis can cause wide ranging effects.

Dr. Shahzad MD :

Got it right this time :)

Dr. Shahzad MD :

So yes its possible.

Customer:

OK so a nephrologist specialist.
Is this as part of a renal department?

Dr. Shahzad MD :

Yes exactly.

Dr. Shahzad MD :

There are two kinds of renal doctors.

Dr. Shahzad MD :

Nephrologists who do the medical part of kidney.

Dr. Shahzad MD :

Urologists who do the surgical part.

Dr. Shahzad MD :

At your age the osteoporosis that you are having is just not normal.

Dr. Shahzad MD :

You need to be investigated further surely.

Customer:

OK. Thanks. I will discuss with my GP and request a referral.
Thank you again.
Good bye.

Dr. Shahzad MD :

You are most welcome
Take care
Wish you all the best.
Please do rate me for my services before you leave by clicking on one of the smilies below. I hope I provided excellent services.
Tip/bonus is always appreciated.
Good bye :)

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