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Edema in the legs. Pregnancy test negative. EKG and blood test normal. What could be causing edema?

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General & Family Physician
Practicing since : 2009
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I have had pitting edema in my legs for the last few weeks(I am only 23). I have been water pills for about a week now. The water pills aren't helping. Neither is keeping my feet up and drinking water. The doctor I go to ran an EKG and bloodwork and it all came back normal. Pregnancy test negative. Should I go to urgent care or what should I do??? What could be causing it? The swelling is not going down at all.
Posted Sat, 14 Jul 2012 in General Health
 
 
Answered by Dr. Aparna Kohli 23 minutes later
Hi,
Thanks for writing in.
I dont think you need to go to urgent care if pitting edema is the only symptom you have. Pitting edema usually occurs due to a problem in the heart, liver or in the kidneys. It can also be due to hypothyroidism, protein deficiency and venous insufficiency. Venous insufficiency and thrombophlebitis can be a cause particularly if you have swollen veins in your legs
So typically, you would need a battery of tests like an Echocardiogram, kidney function tests, liver function tests including a protein level, a TSH level and maybe a doppler ultrasound of the legs as well. I would like to know if all these tests have been done for you.
In some people, there is a condition called idiopathic edema These people have naturally leaky capillaries and no known cause can be identified. This condition typically worsens when the water pills are stopped. If all the above tests are normal, this is one condition we should be looking at.
Awaiting your reply.
Regards
Above answer was peer-reviewed by
 
Follow-up: Edema in the legs. Pregnancy test negative. EKG and blood test normal. What could be causing edema? 9 minutes later
I have had the EKG, TSH, etc... the one I haven't had is a doppler ultrasound of my legs. What would that tell us exactly? I'm still on the water pills... the condition hasn't worsened, but its not going away. Its driving me nuts and after running those couple of tests, my regular doctor gave me a prescription for water pills and potassium pills. I'm just wondering what to do now since those aren't working. Should I go get the ultrasound at the hospital? I may have to go through the ER for that... urgent care doesnt have an ultrasound machine and who knows how long it would take to get into my regular doctor to have her request an ultrasound.

Also, I was previously on Prozac and Lamictal and came off of those 2 medications a couple of months ago. My father wondered if it is Lamictal rash, without the rash symptom. I am currently on Klonopin, Sprintec and Ambien.
 
 
Answered by Dr. Aparna Kohli 13 minutes later
Hi,
Thanks for writing back.
The doppler ultrasound of the legs would tell us about the blood flow in the veins of your legs. Sometimes, when there is an inflammation or clot in the XXXXXXX veins of the legs, it can cause pitting edema. The doppler would help us rule out this clot.
The Sprintec could be contributing to the pitting edema as these hormones frequently cause water retention. For this, you should be looking at having <5 g of salt in a day and drinking atleast 5-6 litres of water in a day. You would need to stay away from processed food as that has a lot of salt in it.
You can get the ultrasound at the hospital.
Its unlikely that your symptoms are due to an allergy to Lamictal. Allergies usually do not present this way.
Let me know if I can address any more concerns.
Above answer was peer-reviewed by
 
Follow-up: Edema in the legs. Pregnancy test negative. EKG and blood test normal. What could be causing edema? 2 hours later
Ok. Is there anything I can do between now and whenever I can get an appointment for the ultrasound/to see my doctor again?

Soaking in hot water or cold water? Massage? Exercise or no exercise? I've been putting my feet up but it hasn't done much.
 
 
Answered by Dr. Aparna Kohli 8 hours later
Hi,
Thanks for writing back.
I would want you to continue exercising. A soak in warm water may help. Massaging in the upward direction should also help. Putting up your feet for a considerable amount of time (like 2-3 hours) and putting a stack of pillows under them should also help.
I would like to know if the swelling is lesser in the morning. If it is, we are just looking at some water retention here.
Regards
Above answer was peer-reviewed by
 
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