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DrRussMD
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 63983
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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The question I have is about the diagnose of mitochondrial

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The question I have is about the diagnose of mitochondrial myopathy. I haven't had a diagnosis yet but from what I have read on the internet a metabolic myopathy fits my symptoms. Do mitochondrial diseases show on routine blood tests, ie. full blood count?
Submitted: 1 year ago.
Category: Medical
Expert:  DrRussMD replied 1 year ago.
Hello
There is almost to way you have a mitochondrial myopathy.
It is extremely rare.
It shows up in childhood.
What are your symptoms
What tests have you had
Customer: replied 1 year ago.

I have exercise intolerance, or to use my own description, my muscles seem to run out of energy with mild to moderate exertion. I can't hold a position against gravity for long. When my leg muscles are tired they shake uncontrollably, I can't grip things with my hands for long, the items slide through my fingers. I have pain in my muscles when they are tired, but this does pass at rest. I would say that there is a certain amount of weakness when I try to do certain things like climbing and descending ladders or steep steps. My nerve conduction tests were all clear, there were some abnormalities on the edge but I have not been told what they were and the muscle biopsy was only checked for polymyositis and inclusion body myositis both were negative. I'm seeing an urologist next week to see if my urine retention could be related to a muscle problem.

Expert:  DrRussMD replied 1 year ago.
So you actually test normal on strength testing and EMG
Customer: replied 1 year ago.

The person who did my email said there were some abnormalities but I never got to find out what they were. As for the strength tests yes my strength is almost normal.

Expert:  DrRussMD replied 1 year ago.
OK
Well you need to see what the interpretation section of that report says.
Let me ask you, if you exercise even a little, you have to rest correct?
Are you tired at other times?
Customer: replied 1 year ago.

Yes that is correct, though walking on flat surfaces doesn't tire me as quickly. My job tires me and when I stop working I can fall asleep quite readily in front of the television, is that the sort of tiredness you are referring to?

Expert:  DrRussMD replied 1 year ago.
I would say this is more likely myalgic encephamyalitis previously known as chronic fatigue.
This is a spectrum of illness, and typically does not show up on labs.
The muscle biopsy would show a mitochondrial myopathy, but I do not think you have that.
OK, so that is an initial answer….
Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.
Customer: replied 1 year ago.

Sorry I couldn't continue earlier, it was gone midnight and i'd got to be up at 6.30 am to go to work. I have had time to look into the symptoms of me/cfs and it does seem feasible but I have not had a virus that would have coincided with the start of these symptoms and my symptoms have been progressing for at least 20 years, starting with shaking legs when in certain positions like bending over to tie shoe laces a position that keeps me in one position for longer than a few seconds, then I have trouble standing up again. Static, isometric exercise is my biggest problem. Does this sound right for ME.

Expert:  DrRussMD replied 1 year ago.
A virus is irrelevant.
The idea that it comes from a virus is a myth at this point, and not proven.
It can still be ME.
In fact the problem with exercise is what we call pathonemonic....characteristic of the disease.
We are not here to diagnose you , however, so run this idea by your doctors. A rheumatologist would be the specialist in this area.
please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.
Customer: replied 1 year ago.

last thing, then I will rate, my original question, regardless as to whether I have a mitochondrial myopathy or not, does the disease show in routine blood tests such as red or white blood cells or liver function, etc.?

Expert:  DrRussMD replied 1 year ago.
No
It shows in no routine blood tests.
However, it will show , if there, in the muscle biopsy.
please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 63983
Experience: Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
DrRussMD and 3 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

So what does cause ME?

Expert:  DrRussMD replied 1 year ago.
Unknown but considered to be autoimmune
Customer: replied 1 year ago.

How long does it take for the muscle to grow back after a muscle biopsy?

Expert:  DrRussMD replied 1 year ago.
There is no significant damage to interfere with muscle function.Any damage will be minor and heal over 1 to 3 months in its entirely.But you will not notice that for the most part.Please click a positive rating: we are only paid by ja for hour time per positive rating and for bonuses, and it is the only way we can provide this service.Come back as needed.
Customer: replied 1 year ago.

After nearly 3 months I still have quite a substantial dent where I had my muscle biopsy and some pain, is this normal.

Expert:  DrRussMD replied 1 year ago.
hiI don't see a single positive rating on any of my answers.We are only paid by just answer per positive rating, and for bonuses.I have been paid nothing for my time and expertise at this point.Did you have problems with the rating system? If so , please let me know.Please click a positive rating on this post.Come back as needed.
Customer: replied 1 year ago.

Sorry. I gave you an 'excellant' rating on 19th September, so I don't understand why you have not been paid, the fee I was charged has come off my account. I am completely satisfied with your answers so far, though I am not convinced as yet that the problem is ME and shall continue to investigated possible conditions up until my next neurology hospital appointment in December. I have been on holiday since my question on 23rd September, this is my first opportunity to write again on my computer. Tell me what I have to do to send my rating.

Expert:  DrRussMD replied 1 year ago.
I do see an accept thanks.Yes, a dent can be a normal variation.I would suggest , of course, and exam. If you find me in medical I will be glad to look at a picture if it shows up.dt
Customer: replied 1 year ago.

i have taken a photo of my biopsy dent, how do i send it to you?

Expert:  DrRussMD replied 1 year ago.
Hi
Please start a new post in medical
Make sure it stays in the medical category.
"For Dr. Thomas only" in the title, and use a request lock.
You can attach the photo there.
In order to get paid for a new question, I will have to have a raging.
I don't think you can rate again here.
I will try to place an add services offer here, which you could accept and use this thread, if it works.
Customer: replied 1 year ago.

For Dr Thomas MD only

Expert:  DrRussMD replied 1 year ago.
OKI don't see anything that can be said to be abnormal.Has the surgeon looked at this?
Customer: replied 1 year ago.

No. I won't be seeing him again now, he has referred me on to one of his collegues at the same hospital. I just didn't know what to expect and if the missing muscle sample would be replaced by the body;whether it would grow back, or whether the dent would remain.

Expert:  DrRussMD replied 1 year ago.
I think everything will be find here.It will take 3 to 6 months to get back to normal.There might be a small dent in the skin from scarring....or not.
Customer: replied 1 year ago.

Thank you.

Expert:  DrRussMD replied 1 year ago.
AnytimeAny questionsFind me in the medical category as needed.I am here daily.Use a long request lock and "for Dr. Thomas only" in the title.Make sure it stays in medical. I am board certified in integrative medicine, internal medicine, trained in functional medicine and homeopathy, etc. I am here daily: use my request link as needed and “for Dr. Thomas” in the question title. Give that link to friends, family, associates, etc. Find me as needed for correct, safe and accurate answers.
Customer: replied 1 year ago.

When I have to stand for any length of time, especially after any exertion,(even the day after exertion) my legs shake and I feel like they won't hold me up against gravity, so I find myself leaning or standing in strange positions and holding on to nearby objects, or just moving around all the time or finding somewhere to sit. When it first started a few years back it was diagnosed as an orthostatic type tremor and was mostly in my right leg, but now it has progressed to this feeling of weakness and unsteadiness from the waist down. Can this be a symptom of ME?

Expert:  DrRussMD replied 1 year ago.
Hi
In fact, that is a cardinal symptom.
Extreme fatigue on the slightest exertion.
Or, even worse after actual exercise.
Customer: replied 1 year ago.

Sorry, I am trying to get things clear in my mind, I may ask the same question again in a different way. So here goes. I only need to contract my muscles for more than perhaps 10 minuets to get pain and discomfort that may not even bother me for 24 hrs or more - especially hip and thigh. For instance trying to keep myself upright, stopping body movement in a moving car, resting something on my lap to work on, sitting in some hard seated chairs, then I may have trouble using the muscles at all, not just shaking but actual inability to use the muscle - little strength. An example - while on holiday at the beginning of this month (short walks) my leg muscles were so tired by the 5th day that I could not step up on to the bus as I had the previous days - it was a little bit higher than the average stair. I did manage eventually but with much effor to the point of hurting my arms.The 6th day was quite an easy day and my muscles recovered somewhat but not completely. M.E. or not?

Expert:  DrRussMD replied 1 year ago.
I want to make sure that you understand that we do NOT diagnose on this site.Not only your symptoms, but your level of anxiety and concern, and this latest description as well are consistent with ME.I would suggest that anxiety reduction would help as well.
Customer: replied 1 year ago.

It is a big part of my life at the moment because it affects so many things that I try to do - particularly at work (a job that is very important to me and I don't want to let anyone down) and in hobbies. I have been trying to get a diagnosis for this problem for at least 18 months and I expect that my 'anxiety' is making it worse. But I can not allow myself to treat myself fairly with respect to rest, exercise , exceptance, without a diagnosis, until then I will consider myself as a fraud. I can't change things without knowing what is wrong, I could hurt myself more. I have no appointment with neurologist for another 6 or 7 weeks. I can make an appointment to see my GP. I have some very supportive friends especially at work, but my family, that I live with, are too old to understand anything except a proper diagnosis, I don't think they even know how I feel .If it is in my head (ie psychosomatic) then i will only get critiscism from them. Is there anywhere that I can find good information about this condition, I have purchased 2 books but they both talk about viruses, headaches, flu- like symptoms and not much about how the muscles are affected. My muscle fatigue is much more prominent than my general tiredness. I know you are not diagnosing and there is no way I would report any of this to any medic that I might consult away from the internet, but I thank you for all your information. And to be honest I have very few general symptoms of recognised anxiety, but I think I might be depressed.

Expert:  DrRussMD replied 1 year ago.
I suggest that you work with a doctor trained in functional medicine.
www.functionalmedicine.org.
These doctors recognized the entire spectrum of this disorder.
Customer: replied 1 year ago.

Sorry if this is not your department, and perhaps this is an odd question, but how can I tell if I have muscle atrophy or if it's cellulite in my inner thigh area. It's only one patch on both legs but more severe on the right.

Expert:  DrRussMD replied 1 year ago.
Exam from your doctor.
Customer: replied 1 year ago.

Thank you!

Expert:  DrRussMD replied 1 year ago.
anytime
Customer: replied 1 year ago.

Would I be right in thinking that if a person was to have muscle atrophy around joints then they could have joint problems, such as buckling or displacement or just plain pain?

Expert:  DrRussMD replied 1 year ago.
At some point that would be the case. Please find me in medical by request for further questions.
Customer: replied 1 year ago.

Are there any other reasons why a joint should buckle or 'stick' so that you can't move it?

Expert:  DrRussMD replied 1 year ago.
Many reasons, ligament damage, arthritis, etc.
Customer: replied 1 year ago.

that's a relief!

Expert:  DrRussMD replied 1 year ago.
Find me by request in medical.Use "for Dr. Thomas only" in the titleAnd a long request lock.
Customer: replied 1 year ago.

what's a request lock

Expert:  DrRussMD replied 1 year ago.
You use it when you request an expert.customer service can help you
Customer: replied 1 year ago.

Thank you!

Expert:  DrRussMD replied 1 year ago.
anytime
Customer: replied 1 year ago.

I have a problem with my calf muscles, this started in my right leg but is now troubling both legs. My calf muscles are tight and hurt when I'm walking. I try to stretch them prior to exercise if I have been sitting for any length of time but I think they have permanently shrunk (it has been getting worse for several years) and stretching makes no difference. The pain isn't always there but the tightness is. If I stretch regularly the right calf particularly, it makes my ankle unstable and then it will sometimes give way when I'm walking (not made me fall yet - it just buckles). What do you think is causing this and what can I do, because it is affecting my walking and working.

Expert:  DrRussMD replied 1 year ago.
HiAt this point you will need to find me by request in the medical category.Use a long request lock, and "for Dr. Thomas only" in the question title.

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