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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 45941
Experience:  Board Certified Physician
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Hello Dr Shahzad, Further to our chat yesterday I had the

Resolved Question:

Hello Dr Shahzad,
Further to our chat yesterday I had the following tests done, as you suggested:

Calcium
Vitamin D
Phosphorus

The calcium came back at 8.8 mg/dL with a reference level of 8.5 - 10.1
The phosphorus came back at 3.6 mg/dL with a reference level of 2.5 - 4.9
The Vitamin D came back at 25.10 ng/mL with a reference level of greater than or equal to 30

I also had ESR done which came back a little high at 23 mm/hr with a reference level of 0-15

What would you determine from the results?

I have been taking 2000mg of Vitamin D everyday for 1 month

Thank you
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. David replied 3 years ago.

Dr. David :

This is Dr. David

Dr. David :

your ESR is high

Dr. David :

and your prior CK levels have been high.

Dr. David :

you should be seeing a rheumatologist

Dr. David :

and getting to check for autoimmune disorders where your body makes antibodies which can attack your own muscles.

Dr. David :

you need an ANA blood test which is an anti nuclear antibody blood test.

Dr. David :

are you willing to go and see a rheumatologist to get these test done?

Customer:

Hello - I have had an ANA test and the results were normal.

Customer:

I am in a country where medical care is not good, hence the reason I am on this website

Dr. David :

then you need to get a muscle fiber biopsy for evaluation.

Dr. David :

I see you had a muscle biopsy already

Dr. David :

and it was inconclusive

Customer:

This has already been done. The results are attached. I went through all of this with another doctor on here yesterday and he is the one who told me to get the tests done which I was emailing about today

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Dr. David :

why were you given zocor?

Dr. David :

was your cholesterol level high?

Dr. David :

do you have diabetes?

Customer:

No to both, it was a bad doctor in a bad country who mis-prescribed

Customer:

The biopsy results have been sent to you

Dr. David :

are you still having muscle pain?

Dr. David :

if you got that CK level drawn after exercise or heavy lifting or heavy labor, this can elevate your CK level.

Customer:

Yes sometimes, I am a pilot so I am also sitting a lot of the time and I get pain

Customer:

No I do not exercise that much

Customer:

The CK has been taken a number of times and not after exercise

Dr. David :

you could have a polymyositis muscle inflammation disorder going on.

Dr. David :

you might need to go on steroid therapy to help decrease inflammation in your body to help the pain.

Customer:

How did you determine that? The biopsy appeared to be normal

Customer:

How can we conclude 100%?

Dr. David :

it could have been just the area where you had the sample taken.

Dr. David :

nothing in medicine is 100%

Dr. David :

polymyositis diagnosis is often made by your clinical symptoms and elevation of CK levels.

Customer:

Did you see the ESR results? This was something that the doctor I chatted to on here yesterday suggested I did

Customer:

He also suggested Vitamin D which was a little low

Dr. David :

yes, they are high as well.

Customer:

So what would you suggest to do now?

Dr. David :

find a rheumatologist in your country.

Dr. David :

hopefully one trained in the USA.

Dr. David :

and see if you would benefit from steroid therapy.

Dr. David :

and keep taking the vitamin D.

Customer:

Thank you - one can continue a normal life with such a condition?

Customer:

And what usually causes such a condition?

Dr. David :

you are welcome

Dr. David :

we don't know why one person will get myositis and someone else won't

Dr. David :

steroids can help keep the muscle pain and inflammation calmer

Dr. David :

but there are side effects to steroids.

Dr. David :

so your doctor will have to balance these two issues.

Dr. David :

good luck to you

Dr. David :

let me know if you have questions.

Dr. David :

if done for now, please leave positive feedback below

Customer:

Thanks for your help

Dr. David :

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Dr. David :

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Dr. David :

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Dr. David :

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Dr. David :

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