Question: Hello,
What may be the reason behind consistent general weakness and which specialist to consult with.
This is lasting for years (taking multivitamin supplements on prescription of GP on many occasions but in totality the weakness never goes away) and is persistent despite of normal eating with additional supplements like Horlicks etc. There is no loss of appetite. Visibly, there is no blood in stool (normal color, no black or dark colored). It feels like Lightheadedness while walking. Currently taking Vibrania D once daily and Gen D3 60K weekly and still no improvement.

I feel cold more than others and get shivering and winter diarrhea much often and need to put blanket to reduce shivering. There is no fever. At few occasions during winter season, went unconscious spontaneously without any other symptom.

Diagnosed with mild gastritis, LAX XXXXXXX and H Pylori. Treatment continuing for H Pylori with Meteronidazole triple therapy. This was diagnosed after having symptoms of severe chest discomfort/ heartburn which goes away after few burps in general, but in absence of burps or delayed release of burps, it results in great weakness along with associated very low BP (monitored value 90/60 on same day and low electrolytes :- Sodium 128mmol/L [135-155], Potassium 2.5 mmol/L [3.5-5.5], Chloride 102 mmol/L [98-107] after three days).

I have inguinal hernia too since about 5-7 years (not operated so far and using hernia belt since then and there is no pain like symptoms so far). Also diagnosed with prostatomegaly (prostate : 42.7cc, urinary bladder postvoid : 8cc) but this has no visible symptoms.

Few simple lever cysts also found and have no symptoms with this.

I have following test results (current and historic (marked)) available with me:
TSH (Thyroid Stimulating Hormone) :- 2.02 μIU/mL [0.35 - 4.94]
T3 :- 68 ng/dL [60-200]
T4 :- 7.8 ug/dL [4.5-12.0]
Haemoglobin :- 16.1 g/dL [13.5 - 18.0]
Neutrophils :- 77% [40 - 75]
Lymphocytes :- 18% [20 - 45]
ESR (Erythrocyte Sedimentation Rate) :- 2 mm/hr [0-20]
Immature Granulocytes (IG) :- 0.01x10^3 /uL [0.03]
MCHC :- 29.8 g/dL [31.5-34.5]
Red cell distribution width - SD(RDW-SD) :- 54.3 fL [39-46]
Red cell distribution width (RDW-CV) :- 14.7 % [11.6-14]
Platelet distribution width (PDW) :- 19 fL [9.6-15.2]
Mean Platelet Volume :- 13.1 fL [6.5-12.0]
Platelet count :- 125x10^3 /uL [150-400]
Platelet to large cell ratio :- 65.8% [19.7-42.4]
Plateletcrit (PCT) :- 0.16 % [0.19-0.39]
Total Iron Binding capacity :- 269 ug/dL [225-535 Male]

BUN :- 8.84 mg/dL [7.9-20]
Creatinine :- 0.8 mg% [0.6-1.1 Male]
Uric Acid :- 4.5 mg/dL [3.5-7.2 Male]
Calcium :- 9.52 mg/dL [8.8-10.6]

Urea (Serum/Urease-GLDH/UV) :- 14 mg/dL [15-45]
Alkaline Phosphatase (SAP) :- 154 U/L [56-119] on 24/11/2014
Alkaline Phosphatase :- 82.8 U/L [53-128] on 10/10/2014
HbA1C :- 4.7% [4.5-5.6]
BP :- 120/80
Cholesterol :- normal (Two-three years back triglyceride was higher, which is normal {58 mg% [25-200]} now)
LDL/HDL ratio :- 1.4 [1.5-3.5]
Vitamin D (25 hydroxy Vitamin D) :- 17.9 ng/mL [30-100] on 24/11/2014
25-OH Vitamin D :- 24.05 ng/ml [30-100] on 10/10/2014
Serum Sodium :- 141 mmol/L [135-145]
Serum Potassium :- 4.2 mmol/L [3.5-5.5]
Serum Chloride :- 101 mmol/L [95-110]
ECG :- Normal
Echocardiogram :- Normal
TMT :- Normal
BMI :- 18.7

Hi,

Thanks for advice.

As stated earlier too, I have inguinal hernia since about 5-7 years (not operated so far and using hernia belt since then and there is no pain like symptoms so far). Also diagnosed with prostatomegaly (prostate : 42.7cc, urinary bladder postvoid : 8cc) but this has no visible symptoms.

May I know which one need to be treated (operated surgically) first or can both be operated on same day during same session.

Hi,

Also, often it has been observed that during morning hours (6am to 9am) there is problem/ difficulty in breathing (shortness of breath), anxiety and weakness in leg (feels like if someone press it in order to have relief but no problem in standing/ walking) and also at the same time it has been monitored that blood pressure approaches 140/90 mmHg (never found crossing 140/90) and slowly it normalizes automatically within a couple of hours and blood pressure also comes down to about 120/80 (plus minus 5-7 for both) and remains in this range for whole day.

For ready reference, I am reiterating following from initial query:
Serum Sodium :- 141 mmol/L [135-145]
Serum Potassium :- 4.2 mmol/L [3.5-5.5]
Serum Chloride :- 101 mmol/L [95-110]
ECG :- Normal
Echocardiogram :- Normal
TMT :- Normal


What might be the probable reasons and how to proceed for diagnosis and identification of exact problem which is resulting in above symptoms. Also which specialist I should consult with for this?

Thank you. I am planning visit to suggested specialists.

Meanwhile little addition to already stated description as below.

During last blood pressure monitoring (at about 16:00 hours), it was observed that pulse is 106 while BP remain at 121/79. Didn't noticed it during morning hours. Will update with morning reading also after observation.

Does these symptoms have a relation with Psychological state too like in deep stress particularly depression or fear?