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Nausea, low ferritin, nerve weakness. Malfunctioning pancreas? Need blood test? Perimenopause?

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My wife was given 5 days of oral steroids, nasal steroids (around a month) and anti-allergic medicines to reduce her nasal polyps before a sinus surgery. She immediately started feeling nauseous. This was 5 months ago. Through these 5 months, she has had 7 dozes of various antibiotics (for H-pilori, post-nasal-surgery, others), and a megadose of Vitamin D injection + 3 sachets of Calcerol (Her Vitamin D level had fallen to 11, now OK) and also 3 shots of Vitamin B Complex injections.
We have got a CT Scan (Abdomen + Chest), Ultrasound (Abdomen), Endoscopy, Colonoscopy, X-ray complete spine, CT Brain (before sinus surgery) done. All clear. She lost 4 kgs, but then steadied out. She is 49, but not reached menopause yet.

Her nausea has progressively increased. Does not throw up. Appetite healthy, but VERY nauseous 24x7. Weight steady. Hb level steady at 11.5. Thyroid levels fine. Ferratin low. Surge of 'nerve weakness' in upper arms. Sensation along spine travelling up to nape of neck. CD/Colonoscopy detected non-specific thickening of colon walls near cicum and sigmoid.

Can her pancreas be malfunctioning. The net says that not all patients experience pain. But without CT and ultrasound detecting any inflammation, can there be a problem with the pancreas that is causing:
1. Acute nausea 24x7
2. Increase in nausea 1 hour after eating and while lying on the right side
3. Feeling of weakness - especially in arms
4. Fluctuating blood pressure and pulse rate
5. Hb level having come down from her regular 13-14 to 11.5?
6. Ferratin level had fallen to 7.4. Now little better at 10.4?
7. Has become extremely reactive to all drugs - including a simple para

If yes, will a blood test help figure this out? What tests? Does she need to give the blood sample on an empty stomach?
Can we include some other blood tests to figure out some other reasons that could possibly be causing her nausea? Hormones?


A gatroenterologist has done a a complete endoscopy and colonoscopy. We have also done a CT of the complete abdomen. It is all clear. So peptic ulcers may not be the problem.

She spaces out her food, eats very light food, and has lots of water.

The question that remains is whether an individual can have a malfunctioning pancreas when:
1. She has no enlarged pancreas
2. She has discomfort (tingling, glawing feeling) eminating from her amdomen, and travelling up along her back - but without pain
3. She had extreme 24 x7 nausea when given contrast fluid for CT, after being given peglec and sedatives for a colonoscopy procedure - but otherwise her acute nausea comes 5-6 times in 24 hours and lasts 30 minutes to one and a half hour and then subsides.
4. She has a general sense of fatigue, and acute bouts of weakness in her arms with ocassional XXXXXXX inside her arms. Stragely, these symptoms suddenly started a couple of months back.
5. Her nausea/discomfort becomes much less when she takes ajwain (caraway seeds), or a bit of food or a unienzyme tablet with her food. Rubbing Olisan on her tummy and back also helps.

Posted Tue, 8 May 2012 in Digestion and Bowels
Answered by Dr. Rakhi Tayal 22 hours later
Thanks for posting your query.
The collection of symptoms your wife is having are quite difficult to put together. I am sure this is creating a significant amount of anxiety and we will work on that here today.
I have to say that from what you have mentioned so far I do not feel that your wife has any type of life threatening problem like pancreatitis.
Everything you describe here sounds like most likely a benign type of viral syndrome. They can sometimes trigger a constellation of symptoms including fatigue, nausea, weakness, etc.
These types of viral syndromes can last for upto 4 to 6 weeks. I would advise that you support your body with good hydration, adequate sleep, a well-balanced diet and a moderate exercise regimen. Exercise is actually good for the immune system which is why I suggest it here. In addition you can supplement your diet with some Vitamin C - 1000 mg daily and consider drinking some immune boost type of tea such as Echinacea which is readily available at most supermarkets.

Another thing I think of with the symptoms you describe is a possible electrolyte imbalance. Sometimes a fluctuation in calcium, potassium or magnesium levels may lead to this kind of thing. This would be easy to treat with an over the counter multivitamin as well as a supplement of calcium with vitamin D. symptoms should respond within 7 to 10 days.

These can definitely be due to perimenopause also but all the organic causes must be ruled out before attributing it to perimenopause only.
Hope this answers your query. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Above answer was peer-reviewed by
Follow-up: Nausea, low ferritin, nerve weakness. Malfunctioning pancreas? Need blood test? Perimenopause? 48 hours later
Many thanks for your answer.
- We have checked her electrolyte balance - it is fine.
- Unfortunately, checking her B Complex levels now may not help because she has already taken 3 shots of Nurobeon mid last month
- Her low Vitamin D has been brought up to the lower end of normal range with one injection and 4 sachets of calcerol.
- She does try to exercise, but feels weak to manage it for more than a fewv minutes
- I am not too sure whether it is extreme weakness, or a dull upper body muscle pain and numbness she is unable to articulate. While on one hand she feels too weak to write and feels debilitated, she does go for short walks and her legs seem to be stead steady. Moreover, she feels weak more significantly in her arms, back and stomach
- As for her acute nausea, could this also be the same feeling of weakness in the abdomen/back die to reduced muscle tone?. If she had conventional nausea, would she have been able to force herself to eat like she does, and would she not have thrown up at least once in the last 5 months? Plus after Emeset 8 tablet would she not have always felt better - which at times she doesn't.

Your diagnosis that she may be suffereing from an long-term viral makes a lot of sense. 2 days before she started feeling bouts of acute weakness (since the 27th of August), she had a throat infection: A very painful throat, with lumps all over inside her throat - mostly red. She had 100.5 derees fever for just a day but the throad ache lasted a week. But 4 days after the infection came up, she started feeling very weak. Just before this, we had gone for a holiday and she had not compain of weakness. Incidentally she also had her megadose injection of Vitamin D around 2 days before her weakness started.

If she does have viral, it has now lasted 6 weeks and her weakness (or what she calls weakness) is progressively increasing.

Today, she is going to get her hormones and protein levels tested. Is there any test for viral? I am not aware of any.
Follow-up: Nausea, low ferritin, nerve weakness. Malfunctioning pancreas? Need blood test? Perimenopause? 4 hours later
In continuation to mt response above, another observation:
My wife had another XXXXXXX of Calerol today and soon after, her weakness started increasing. She tought back and realised, her weakness had peaked last Wednesday as well - that's when she had last week's dose of cencerol.

I checked on the net. Calcerol does have similar side effects:

Could this then be the problem?
Answered by Dr. Rakhi Tayal 2 hours later

Thanks for writing again.

The feeling of extreme weakness seems to be a viral syndrome which does not have any specific test available. She needs a neurologist assessment too to rule out any viral neuritis causing such a weakness.

Regarding the side effect of Calcerol, she can substitute it with a calcium with Vitamin D3 supplement for a few days like Corcium C after consulting with your physician.

Hope my answer is helpful. Write back if you have further queries.

Wishing your wife a trouble free speedy recovery.


Above answer was peer-reviewed by
Follow-up: Nausea, low ferritin, nerve weakness. Malfunctioning pancreas? Need blood test? Perimenopause? 3 hours later
You may find this helpful. No doctors have been able to tell us this:

Muscle and Bone Pain

This is a side effect of vitamin d that is not so easy to remedy and is actually a sign that you really NEED TO CONTINUE taking the vitamin d. If you experience Pain from Vitamin D this very likely means that your bones have become somewhat demineralized from having vitamin d deficiency for a very long time. When your bones are demineralized and you begin Vitamin D Therapy, this can cause calcium to begin to go back into the bones. When the calcium goes into the bones it drags fluids with it. This fluid can actually cause a small expansion of the 'collagen matrix' inside the bones and this expansion pushes out against the exterior covering of the bone which is very inflexible and has extensive nerve endings.

When this occurs, you can experience this as bone pain or even muscular pain. If you experience new or worsening pain from taking vitamin d, it is NOT Vitamin D Contraindication, a reason to be scared or to stop taking the vitamin d. If you continue with the Vitamin D Therapy, the pain should subside in several weeks. While uncomfortable, you will be better off in the long run if you manage the pain for this time and 'get through' to the other side.

Read more: WWW.WWWW.WW
Answered by Dr. Rakhi Tayal 2 hours later

Thank you for writing back.

The information shared by you was enlightening. This means that your wife needs to continue taking calcerol supplements in spite of the pains and weakness that she is feeling. She can take mild pain killers like paracetamol to counteract these symptoms.

Take care.

Above answer was peer-reviewed by
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