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Suffer fatigue, erectile issues, fuzzy head and burning armpits. Feeling tired. Suggest?

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Gastroenterologist
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Question
I have not been feeling well
Symptoms are: fatigue, erectile issues, fuzzy head, burning/itching armpits and groin and sometimes shooting down extremitites, very Grumpy,
I used to drink heavily
All test results in normal parameters except high HDL(54)+ LDL(173) and elevated ALT(66)
How do I determine if it is the Liver or Thyroid? Or what should be my next step? Tired of feeling terrible.
Tests Ordered:
CBC With Differential/Platelet; Comp. Metabolic Panel (14); FSH and LH; Hgb A1c with eAG Estimation; Lipid Panel; PSA Total (Reflex To Free); Testosterone,
Total, LC/MS; Thyroid Panel With TSH; Urinalysis, Routine;
General Comments:
Tests Results Flags Units Ref. Interval Lab
CBC With Differential/Platelet
WBC 8.1 N x10E3/uL 3.4-10.8 TA
RBC 4.67 N x10E6/uL 4.14-5.80 TA
Hemoglobin 14.9 N g/dL 12.6-17.7 TA
Hematocrit 44.7 N % 37.5-51.0 TA
MCV 96 N fL 79-97 TA
MCH 31.9 N pg 26.6-33.0 TA
MCHC 33.3 N g/dL 31.5-35.7 TA
RDW 14.0 N % 12.3-15.4 TA
Platelets 307 N x10E3/uL 155-379 TA
Neutrophils 54 N % 40-74 TA
Lymphs 33 N % 14-46 TA
Monocytes 10 N % 4-12 TA
Eos 2 N % 0-5 TA
Basos 1 N % 0-3 TA
Immature Cells N TA
Neutrophils (Absolute) 4.4 N x10E3/uL 1.4-7.0 TA
Lymphs (Absolute) 2.7 N x10E3/uL 0.7-3.1 TA
Monocytes(Absolute) 0.8 N x10E3/uL 0.1-0.9 TA
Eos (Absolute) 0.1 N x10E3/uL 0.0-0.4 TA
Baso (Absolute) 0.1 N x10E3/uL 0.0-0.2 TA
Immature Granulocytes 0 N % 0-2 TA
Immature Grans (Abs) 0.0 N x10E3/uL 0.0-0.1 TA
NRBC N TA
Hematology Comments: N TA
Comp. Metabolic Panel (14)
Glucose, Serum 81 N mg/dL 65-99 TA
BUN 12 N mg/dL 6-24 TA
Creatinine, Serum 1.15 N mg/dL 0.76-1.27 TA
eGFR If NonAfricn Am 76 N mL/min/1.73 >59 TA
eGFR If Africn Am 88 N mL/min/1.73 >59 TA
BUN/Creatinine Ratio 10 N 9-20 TA
Sodium, Serum 136 N mmol/L 134-144 TA
Page 1 / 3
Comp. Metabolic Panel (14)
Glucose, Serum 81 N mg/dL 65-99 TA
BUN 12 N mg/dL 6-24 TA
Creatinine, Serum 1.15 N mg/dL 0.76-1.27 TA
eGFR If NonAfricn Am 76 N mL/min/1.73 >59 TA
eGFR If Africn Am 88 N mL/min/1.73 >59 TA
BUN/Creatinine Ratio 10 N 9-20 TA
Sodium, Serum 136 N mmol/L 134-144 TA
Potassium, Serum 4.0 N mmol/L 3.5-5.2 TA
Chloride, Serum 101 N mmol/L 97-108 TA
Carbon Dioxide, Total 23 N mmol/L 19-28 TA
Calcium, Serum 9.6 N mg/dL 8.7-10.2 TA
Protein, Total, Serum 7.1 N g/dL 6.0-8.5 TA
Albumin, Serum 4.5 N g/dL 3.5-5.5 TA
Globulin, Total 2.6 N g/dL 1.5-4.5 TA
A/G Ratio 1.7 N 1.1-2.5 TA
Bilirubin, Total 0.5 N mg/dL 0.0-1.2 TA
Alkaline Phosphatase, S 66 N IU/L 44-102 TA
AST (SGOT) 26 N IU/L 0-40 TA
ALT (SGPT) 66 H IU/L 0-44 TA
FSH and LH
LH 5.3 N mIU/mL 1.7-8.6 TA
FSH 5.7 N mIU/mL 1.5-12.4 TA
Hgb A1c with eAG Estimation
Hemoglobin A1c 5.4 N % 4.8-5.6 TA
.
Increased risk for diabetes: 5.7 - 6.4
Diabetes: >6.4
Glycemic control for adults with diabetes: <7.0
Estim. Avg Glu (eAG) 108 N mg/dL TA
Lipid Panel
Cholesterol, Total 249 H mg/dL 100-199 TA
Triglycerides 108 N mg/dL 0-149 TA
HDL Cholesterol 54 N mg/dL >39 TA
According to ATP-III Guidelines, HDL-C >59 mg/dL is considered a
negative risk factor for CHD.
VLDL Cholesterol Cal 22 N mg/dL 5-40 TA
LDL Cholesterol Calc 173 H mg/dL 0-99 TA
Comment: N TA
PSA Total (Reflex To Free)
Prostate Specific Ag, Serum 1.0 N ng/mL 0.0-4.0 TA
Roche ECLIA methodology.
.
According to the American Urological Association, Serum PSA should
decrease and remain at undetectable levels after radical
prostatectomy. The AUA defines biochemical recurrence as an initial
PSA value 0.2 ng/mL or greater followed by a subsequent confirmatory
PSA value 0.2 ng/mL or greater.
Values obtained with different assay methods or kits cannot be used
interchangeably. Results cannot be interpreted as absolute evidence
of the presence or absence of malignant disease.
Reflex Criteria Comment N TA
The percent free PSA is performed on a reflex basis only when the
total PSA is between 4.0 and 10.0 ng/mL.
Testosterone, Total, LC/MS
Testosterone, Total, LC/MS 386.6 N ng/dL 348.0-1197.0 BN
Thyroid Panel With TSH
TSH 2.250 N uIU/mL 0.450-4.500 TA
Thyroxine (T4) 9.5 N ug/dL 4.5-12.0 TA
T3 Uptake 35 N % 24-39 TA
Free Thyroxine Index 3.3 N 1.2-4.9 TA
Page 2 / 3
These lab results are for information only. They are not intended for diagnosis or treatment. Please feel free to discuss your results with your health
care provider.
Testosterone, Total, LC/MS
Testosterone, Total, LC/MS 386.6 N ng/dL 348.0-1197.0 BN
Thyroid Panel With TSH
TSH 2.250 N uIU/mL 0.450-4.500 TA
Thyroxine (T4) 9.5 N ug/dL 4.5-12.0 TA
T3 Uptake 35 N % 24-39 TA
Free Thyroxine Index 3.3 N 1.2-4.9 TA
Urinalysis, Routine
Specific Gravity 1.011 N 1.005-1.030 TA
pH 7.5 N 5.0-7.5 TA
Urine-Color Yellow N Yellow TA
Appearance Clear N Clear TA
WBC Esterase Negative N Negative TA
Protein Negative N Negative/Trace TA
Glucose Negative N Negative TA
Glucose Reflex N TA
Ketones Negative N Negative TA
Occult Blood Negative N Negative TA
Bilirubin Negative N Negative TA
Urobilinogen,Semi-Qn 0.2 N mg/dL 0.0-1.9 TA
Nitrite, Urine Negative N Negative TA
Microscopic Examination Comment N TA
Posted Tue, 15 Oct 2013 in Digestion and Bowels
 
 
Answered by Dr. Amit Jain 10 hours later
Brief Answer:
Please see the details

Detailed Answer:
Hello! Thanks for putting your query in XXXXXXX I am a Gastroenterologist (DM).

I have gone through all the reports. All are within normal range except ALT, cholesterol levels,and LDL.

It suggest that elevated ALT may be due to reasons either alcohol or dyslipidemia

What you have to do:
1. Get an ultrasound abdomen especially for liver echotexture, portal vein diameter
2.Endoscopy examination to see for the changes of portal hypertesion
3. Few other tests to see for other cause of elevated ALT like Hepatitis B and C virus, Serum ceruloplasmin for XXXXXXX disease, XXXXXXX and SMA for autoimmune disease

This all may be due to liver only. So by these test it will be clear to what extent liver is disease.

I hope I have answered your query and this will help you. Please upload all the investigations as I mentioned then we will discuss further plan. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon.

Above answer was peer-reviewed by
 
Follow-up: Suffer fatigue, erectile issues, fuzzy head and burning armpits. Feeling tired. Suggest? 7 hours later
I have also had some other symptoms I failed to mention.
Muscle cramping(especially hamstrings)
Muscle pain(especially triceps)
Family history diabetes
Pain, pressure, and tenderness inside my ears
also on the neck below the ear lobes.
Some Tinnitus
Night sweats

I do not have insurance so I need to figure out how to do this cost effectively and prioritize what I should do first.

I also failed to mention I get lots of night erections during sleep just not when I want to.

Sorry I keep getting new thoughts on this.

What can I do homeopathically also what sort of diet and exercise should I employ as I have no insurance.

Thanks XXXXXXX
 
 
Answered by Dr. Amit Jain 3 hours later
Brief Answer:
Please see the details

Detailed Answer:
Hello! Muscle cramps and pain may be due to deficiency of zinc, vitamin and calcium. So may take some supplemnets to improve that

For ear you have to get your ear examined by ENT doctor (Ear, Nose and Throat)

I will advise to get and ultrasound abdomen first and tests for hepatitis B and Hepatitis C. Since these are very common and treatable causes of elevated ALT. Also ultrasound abdomen will tell the liver status and may decide whether to do endoscopy examination or not

For erection problem you should take lycopene which is a vitamin and an ayurvedic preparation like Vigomax Forte which I found very useful in my patients

You should take less fatty and high protein diet and do regular aerobic exercise at least 30 minutes per day

I hope I have answered your query. Wish you a good health.
Above answer was peer-reviewed by
 
Follow-up: Suffer fatigue, erectile issues, fuzzy head and burning armpits. Feeling tired. Suggest? 2 hours later
Is fatty liver disease a possibility
 
 
Answered by Dr. Amit Jain 6 minutes later
Brief Answer:
Yes fatty liver is a possibility

Detailed Answer:
Hello! Yes, Fatty liver is a possibility and as I explained earlier it may be either due to dyslipidemia or intake of ethanol
Above answer was peer-reviewed by
 
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