How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. SH Your Own Question

Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8765
Experience:  Doctor of Medicine
28323552
Type Your Medical Question Here...
Dr. SH is online now

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: 2 years ago.
Category: Medical
Expert:  Dr. SH replied 2 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 :)

Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8765
Experience: Doctor of Medicine
Dr. SH and 2 other Medical Specialists are ready to help you

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
< Previous | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
 
 
 

Meet The Experts:

 
 
 
  • Family Physician

    Family Physician

    Doctor

    Satisfied Customers:

    2418
    GP with over 27 years experience including emergency medicine
< Previous | Next >
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor

    Satisfied Customers:

    2418
    GP with over 27 years experience including emergency medicine
  • http://ww2.justanswer.com/uploads/DO/DoctorRich/2012-9-12_72454_Doctorweb.64x64.jpg Dr. Natasha's Avatar

    Dr. Natasha

    Doctor

    Satisfied Customers:

    7887
    American Board Certified in Emergency Medicine, Ivy League trained
  • http://ww2.justanswer.com/uploads/DR/DrK99/newpic2.64x64.jpg Dr. K.'s Avatar

    Dr. K.

    Board Certified MD

    Satisfied Customers:

    255
    Board certified with experience in primary care.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/JA/JACUSTOMERjtu60wne/2011-2-14_183449_passportphoto2.64x64.jpg docwithheart's Avatar

    docwithheart

    Board Certified Physician

    Satisfied Customers:

    0
    Board certified pediatrician, with special experience in general pediatrics, hospital pediatrics, and pediatric cardiology
  • http://ww2.justanswer.com/uploads/DR/drappapo/2013-8-16_22576_drdavid.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    224
    Treat children/young adults, former chief resident, multiple publications
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Board Certified Physician

    Satisfied Customers:

    12373
    20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
 
 
 

Related Medical Questions