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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 59131
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Dr. Arun Phophalia is online now

I have an under active thyroid and I take Levothyroxine

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Hello Pearl,
JA: Have you seen a doctor about this yet? What medications are you taking?
Customer: I have an under active thyroid and I take Levothyroxine 100mg. I have regular blood test and every is fine but I get very hot and I mean hot, I feel really hot inside and I find sleeping without my Dustin fan impossible. Can you suggest anything please. Regards
JA: Is this a time sensitive issue? What type of specimen are they testing?
Customer: heather.
JA: Is there anything else the Doctor should know before I connect you? Rest assured that they'll be able to help you.
Customer: I suffer with back pain and I have had a CT scan, an MRI Scan and a Renal scan which showed I have a cyst on each kidney. The Dr said this is fine!

What are your age and gender?

Since when do you feel these episodes of feeling hot?

Customer: replied 11 days ago.
I take Omeprazole and Fluoxetine.
I have been in hospital and had injections in my spine to help my pain. The Specialist injected a total of 9.9mg of dexamethasone and 5ml 0.5% levobupivacaine. I had no complications. I have since been back to see the pain Special and he confirm to me that I had a cyst on each of my kidneys but said that was ok but just to make sure I had a renal scan which showed exactly that. My back pain is not cure but I think it is a little better.
Customer: replied 11 days ago.
Thank I will leave it for the moment.

Apologies for any intrusion of those automatic offers for phone calls. These are produced by the website automatically and outside of my control.

Just to reconfirm; you have back pain and episodes of feeling hot?

What are your age and gender?

Customer: replied 11 days ago.
82 but I am very fit normally and the doctors said they couldn’t believe my age, which I think was a compliment.
Customer: replied 11 days ago.
that is correct.

Thanks for the further information.

I am writing the answer for you and will get back to you in 5 minutes.

Unless you wish to speak in person, you can ignore the request for a phone call automatically generated by the website, not by me.

Thank you.

The following investigations would be required, for the confirmation of the diagnosis;

1) X-ray of the lower back

2) MRI of the spine

3) Nerve conduction velocity (NCV) study

4) Electromyography (EMG).

You may consult any of the following specialists (apart from your GP);

a) Orthopedist

b) Neurologist

c) Specialist in Physical medicine and rehabilitation.

The following measures would be helpful;

1) Backcare in the activities of daily living, which is an integral component of the treatment of back problems. Back education is one of the most important things which teaches the basic body mechanics, like correct posture for standing, standing at a desk or drawing board, sitting, brushing teeth, washing the face, pushing and pulling a weight, lifting a weight, getting in and out of bed, sleeping, getting into and sitting in a car. The training for these routine activities helps in preventing the spasm of the muscles. One needs to consult an occupational therapist or physical therapist which can educate about the proper and improper behaviors when the back is painful in case they have to sit, bend forward, lie down, walk, cough, or sneeze.

You need to practice postural hygiene by avoiding bending your back forward. If you have to pick anything from the floor you should bend your knees while keeping the back straight.

You should also avoid sitting for long periods as intradiscal pressure, that is the pressure inside the disc is maximum during sitting posture and that can aggravate your symptoms. If you have to sit, you must take regular breaks every 15 to 20 minutes even if for a couple of minutes. When sitting, try using a footstep to support your feet so that the thigh body angle remains 90 degrees or less than that for most of the time.

You should also use the full length of the chair when sitting in a chair so that your buttocks are in contact with the back support and the deep of your back is supported by a chair or a cushion placed between the deep of the back and the chair.

You should also consider strengthening the core and the back muscles that play an important role in supporting the vertebral column.

Two excellent exercises for strengthening core and back muscles are swimming and yoga, once you are significantly better and these can be done without the pain.

The following more need to be done:

a) Avoid activities that increase pain.

b) Rest intermittently

c) Avoid bending at 90 degrees

d) Pushing and pulling should be avoided until the pain subsides

f) Avoid prolonged sitting and standing

g) Avoid sitting or sleeping on the floor

2) Anti-inflammatory analgesics like ibuprofen, other analgesics, and muscle relaxants

3) Local analgesic gels or sprays/ointment

4) Hot fomentation

5) Electrotherapy like transcutaneous electrical nerve stimulation: done by the physical therapist. Other things are ice packs, heating pads, electrical stimulation, phonophoresis, iontophoresis, relaxation, and biofeedback.

6) Well-supervised physiotherapy: The exercises consist of abdominal bracing, modified sit-ups, double-knee-to-chest or low back stretches, seat lifts, mountain and sag exercises, knee-to-elbow exercises, hamstring stretches, extension exercises, and extension flexibility exercises. Swimming exercises (pool exercises) are best for back pain. Initial stretching and later strengthening exercises are taught.

7) Lumbosacral corset or support or back brace.

8) If obese or overweight, reduce weight for long-term benefits.

9) Epidural steroid shots

You may start these exercises;

1) Straight leg raising: Lie on the bed with your back and remain in a relaxed position. Slowly raise one of your legs upward and keep it as straight as possible. Count up to ten, and slowly bring down the leg. Do the same with the other leg. Repeat this exercise ten times.

2) Curl-ups; lie on the back with knees bent, fold arms across the chest, tilt the pelvis to flatten the back, and curl up lifting the head and shoulders from the bed/couch. Hold for ten seconds, then slowly lower to the starting position. As strength builds, aim to complete one set of ten curls. The exercise should be done twice a day (both sets).

This is a slide show for the exercises (you can pick up your own set, which suits you);

https://www.mayoclinic.org/healthy-lifestyle/adult-health/multimedia/back-pain/sls-20076265

https://southtees.nhs.uk/content/uploads/MICB4088-Spinal-Exercises.pdf

Natural products/herbs for resolving to feel hor are;

1) Evening primrose oil

2) South Pacific herb kava.

3) Valerian.

A healthy, balanced diet is advisable. Regular exercise is thought to be helpful. Avoid; hot and spicy foods, caffeinated beverages, smoking, and alcohol (if you do). Yoga, meditation, relaxation, or other stress-reducing techniques also are helpful. Other helpful agents for hot flashes are;

1) Soy isoflavones,

2) Black cohosh,

3) Red clover

4) Dong Quai,

I wish your symptoms resolve soon.

I would be happy to assist you further if you need any more information.
Thanks for using Just Answer.

Customer: replied 11 days ago.
Thank you so much for your help, I will read through all the information you have sent me, Is it possible to come back to you again. I have my Daughter’s birthday and it would be easier to message you when I am on my own. Regards, Heather.

You are very welcome, Heather.

Enjoy the party.

Take your time and I would be happy to answer your follow-up questions.

Customer: replied 11 days ago.
Thank you so much Dr Phophalia.

My pleasure.

Thank you.

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