Brief Answer:
I feel there is more than one underlying cause

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. Your presentation does point towards a few conditions, but in my opinion it is more likely to be due to more than one underlying cause.

The flu-like symptoms and sore throat could be either due to an infection or related to an allergy (possibly related to the climate as climate change plays an important part). If at all you have observed these symptoms to appear during a particular season, or when you are outdoors, etc; then it is more likely to be a hypersensitivity reaction (allergy); if not then your symptoms could be due to an infection and will soon subside.

The hot flashes at your age in my opinion is most probably related to menopause, which I am assuming you are experiencing or have already attained. I would recommend a visit to your gynaecologist who will most certainly help you to cope with menopausal symptoms. One of the most commonly used treatment options include hormone replacement therapy (HRT). Please do consider speaking to your gynaecologist about this.

I would like to say that your sensitivity to cold could be related to a thyroid abnormality (most probably hypothyroidism) and would request you to undergo a simply blood investigation called a thyroid profile. This should help in providing us with more than enough information on confirming or ruling out this cause, and help us to initiate treatment for the same.

I hope you find my response both helpful and informative. Please do not hesitate to write back to me for any further clarifications, I am always here to help.

Best wishes.

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Brief Answer:
Menopausal symptoms for hot flashes for sure; others could be withdrawal

Detailed Answer:
Hello once again ma'am.

Yes, please do consider weather changes, exposure to specific substances like pollen, hay, etc.

You cannot expect menopausal symptoms in every individual who reaches menopause, sometimes the symptoms appear before menopause is even found and sometimes the symptoms can appear long after menopause has been attained. This all depends on the hormone levels, and so I still strongly suspect menopause to be the cause for the hot flashes.

Your thyroid profile does seem to be normal, and so a thyroid abnormality can be ruled out but there numerous other causes that can cause a sensitivity to cold and it can purely even just be a normal reaction to cold weather.

Yes your fibrosis score does seem high, and have you been diagnosed with any previous liver infections (e.g. hepatitis), your alcohol intake, etc.?

I do not think that doxepin withdrawal can cause the hot flashes as I still think it is related to your menopause, but cold sensitivity and flu-like symptoms can be due to the withdrawal (which should be done slowly and gradually, on instructions from a doctor).

Please do not hesitate to write back to me for any further clarifications, I am always here to help.

Best wishes.

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Brief Answer:
A few investigations; yes to liver specialist ma'am

Detailed Answer:
Hello once again ma'am, wishing you a good morning.

I think a consultation with a liver specialist would be in order, although not urgent, but it is best to follow up with a liver specialist from time to time due to your NAFLD. I did not understand what you meant by BPC? Please be so kind as to elaborate, thank you.

I am sure Dr. Bishnoi has provided you with a safe and stepwise reduction of the dosage, to avoid withdrawal symptoms.

You can go about a female hormone panel which measures hormones like FSH, LH progesterone, oestrogen, etc. Along with this get a comprehensive blood panel which will have parameters like eosinophils, ESR, etc; which will help confirm/rule out allergies and inflammation. If there is such an investigation at the clinic or hospital you are visiting, request for an elaborate allergen panel. This panel analyses all items edible and common surroundings to your immunity to find which ones can cause the flu-like symptoms.

I hope you find my response helpful. Please do not hesitate to write back to me anytime, I am always here to help.

Best wishes.

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Brief Answer:
The link you sent is directing me elsewhere; nothing medical

Detailed Answer:
Hi ma'am.

The link you sent, is directing me to another site and so I cannot really view anything medical. The site it is directing me to is 'playspan.com'.

Best wishes.

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