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Suggest Treatment For High Potassium Levels, Dry Mouth, Diarrhea And High BP
Question: I have been feeling ill for some time. Recently I have just felt so much worse. I have a history of episodes of high potassium at times the levels have been very high but when the bloods are repeated the levels are normal. My mouth is excessively dry and it feels as if one of my salivary glands is not producing saliva but one is. I have had very bad dirroreah for some time now. A strange taste in my mouth and what my dentist tells me is geographic tongue. My eyes are very dry too. I have pain in the left side just below the ribs at the front going through to my back and sometimes the muscles in my back where the pain is goes into spasm. The odd palpitation but I have high blood pressure so I suppose that is normal. I feel so very tired and some days I just cannot stay awake just spend the whole day struggling to stay awake. Just had a course of Vit D as my levels were a bit low (20) I have recently had an MRI that shows an adenoma in left adrenal gland and I have multiple benign lesions in the liver. Oh one other thing I crave sugary foods all the time and never seem to feel full I just want to eat and eat. My weight is stable even though I am overweight. I do not want to go to GP with all this unless there is a connection but really could do with some advise as to whether all this is connected in some way?
Brief Answer:
??Suspecting GIT abnormality, probably stomach ulcer?
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. I am so happy with queries like yours where patients provide all the information a doctor needs to work with in forming a diagnosis. In most cases we have to go back and forth with questions to the patient, which wastes a lot of the patients time (individual who is in need of medical attention).
I would like to address each of your symptoms separately and piece together possibilities that should be considered. If at all you have any doubts in the end, then please do write back to me and I shall try my best to explain things in a manner best understood by you.
+Dry mouth: There are various causes for a dry mouth like side effects of medications, chronic conditions (e.g. diabetes), dehydration, anaemia, smoking, nerve damage, etc.
But in my opinion dehydration and anaemia are the most likely causes in your case. Diarrhea results in excessive loss of fluids from the body which can result in dehydration.
The cause for the diarrhea needs to be investigated, and we shall get into that as well a little later into the query.
+Strange taste in mouth: Usually is common with dehydration, weight loss (ammonia taste in mouth). I would also put this symptom to be due to dehydration
+Geographical tongue: It has the most common cause listed as dehydration (another indication to confirm dehydration). Bad smell from the mouth can also be seen in such cases (please let me know if you experience this as well)
+Dry eyes: If at all there were some condition specifically causing your dry mouth, then it would not cause dryness of your eyes as well. But as your eyes and mouth are experiencing dryness, dehydration should be suspected
+Pain in left side below ribs in front: This presentation is similar to gastrointestinal tract (GIT) conditions like peptic ulcer disease, gastritis, intestinal abnormalities, etc.
+Pain radiating to back and some times back in spasm: Also commonly seen with GIT abnormalities, but more commonly associated to posteriorly lying stomach ulcers
+Exhaustion/lethargy: Very common with dehydration, anaemia and also vitamin D deficiency
+Sugar craving: Sign of poor nutrition (dehydration is also considered as poor nutrition)
Now to sum it up, do you see a link between all your symptoms? I certainly do. Your dehydration, diarrhoea and all others symptoms are most probably related to some GIT abnormality (most likely to be a stomach ulcer). So I would strongly recommend:
+Comprehensive blood panel (to include hemoglobin, ESR, etc.)
+Upper GI endoscopy
+Colonoscopy
I hope you find my response both helpful and informative ma'am. Please feel free to write back to me for any further clarifications, I would be more than happy to help.
Best wishes.
??Suspecting GIT abnormality, probably stomach ulcer?
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. I am so happy with queries like yours where patients provide all the information a doctor needs to work with in forming a diagnosis. In most cases we have to go back and forth with questions to the patient, which wastes a lot of the patients time (individual who is in need of medical attention).
I would like to address each of your symptoms separately and piece together possibilities that should be considered. If at all you have any doubts in the end, then please do write back to me and I shall try my best to explain things in a manner best understood by you.
+Dry mouth: There are various causes for a dry mouth like side effects of medications, chronic conditions (e.g. diabetes), dehydration, anaemia, smoking, nerve damage, etc.
But in my opinion dehydration and anaemia are the most likely causes in your case. Diarrhea results in excessive loss of fluids from the body which can result in dehydration.
The cause for the diarrhea needs to be investigated, and we shall get into that as well a little later into the query.
+Strange taste in mouth: Usually is common with dehydration, weight loss (ammonia taste in mouth). I would also put this symptom to be due to dehydration
+Geographical tongue: It has the most common cause listed as dehydration (another indication to confirm dehydration). Bad smell from the mouth can also be seen in such cases (please let me know if you experience this as well)
+Dry eyes: If at all there were some condition specifically causing your dry mouth, then it would not cause dryness of your eyes as well. But as your eyes and mouth are experiencing dryness, dehydration should be suspected
+Pain in left side below ribs in front: This presentation is similar to gastrointestinal tract (GIT) conditions like peptic ulcer disease, gastritis, intestinal abnormalities, etc.
+Pain radiating to back and some times back in spasm: Also commonly seen with GIT abnormalities, but more commonly associated to posteriorly lying stomach ulcers
+Exhaustion/lethargy: Very common with dehydration, anaemia and also vitamin D deficiency
+Sugar craving: Sign of poor nutrition (dehydration is also considered as poor nutrition)
Now to sum it up, do you see a link between all your symptoms? I certainly do. Your dehydration, diarrhoea and all others symptoms are most probably related to some GIT abnormality (most likely to be a stomach ulcer). So I would strongly recommend:
+Comprehensive blood panel (to include hemoglobin, ESR, etc.)
+Upper GI endoscopy
+Colonoscopy
I hope you find my response both helpful and informative ma'am. Please feel free to write back to me for any further clarifications, I would be more than happy to help.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for coming back to me. At first I considered dehydration so I ensured I drank plenty of water but it changed nothing. Even on days when I have no diarreah and am drinking plenty I still have a dry mouth. There is or appears to be no saliva being produced. I had a colonoscopy an ultrasound of abdomen a cat scan and MRI of abdomen and liver. The liver showed multiple benign tumours an adenoma in left adrenal gland. Bloods normal for blood sugar iron and liver function. Long history of high potassium at random times. Could the adrenal gland be responsible for any of this
Brief Answer:
Adrenal adenomas are mostly asymptomatic, but at times can be symptomatic
Detailed Answer:
Hello once again ma'am and thank you so much for your reply.
I am happy that you have successfully ruled out dehydration, this was indeed a good step forward.
I did not pay much attention to the adrenal adenoma at first because they rarely cause symptoms, but when they do it is usually to do with excessive steroid hormone production that can result in an array of symptoms. Let me list them for you:
+Weight gain
+Thinning of hair
+Acne
+Excessive hair growth in regions where there should be no hair growth in female
+Fatigue
+Depression, anxiety, etc.
+Headaches
+Bone loss (which can result in vitamin D deficiency and make the individual more prone to fractures)
+New or worsened blood pressure
+Disposition to developing diabetes in the future
+Heart palpitations
+Muscle cramps
+Pins and needles sensation (mostly in limbs)
+Excessive thirst
+Excessive urination
and a few others.
Do these symptoms match the presentation you are experiencing ma'am? Please also note that not all the symptoms need to be present, and if most of them are then it would be worth confirming or ruling out both these conditions. If so, then we need to confirm/rule out Cushing's and Conn's syndromes. This can be done by measuring cortisol, aldosterone and renin levels in your blood and urine. Please request your doctor for the same.
I hope I have explained things in a manner best understood by you. Please do not hesitate to write back to me for any further clarifications, I am always here to help.
Best wishes.
Adrenal adenomas are mostly asymptomatic, but at times can be symptomatic
Detailed Answer:
Hello once again ma'am and thank you so much for your reply.
I am happy that you have successfully ruled out dehydration, this was indeed a good step forward.
I did not pay much attention to the adrenal adenoma at first because they rarely cause symptoms, but when they do it is usually to do with excessive steroid hormone production that can result in an array of symptoms. Let me list them for you:
+Weight gain
+Thinning of hair
+Acne
+Excessive hair growth in regions where there should be no hair growth in female
+Fatigue
+Depression, anxiety, etc.
+Headaches
+Bone loss (which can result in vitamin D deficiency and make the individual more prone to fractures)
+New or worsened blood pressure
+Disposition to developing diabetes in the future
+Heart palpitations
+Muscle cramps
+Pins and needles sensation (mostly in limbs)
+Excessive thirst
+Excessive urination
and a few others.
Do these symptoms match the presentation you are experiencing ma'am? Please also note that not all the symptoms need to be present, and if most of them are then it would be worth confirming or ruling out both these conditions. If so, then we need to confirm/rule out Cushing's and Conn's syndromes. This can be done by measuring cortisol, aldosterone and renin levels in your blood and urine. Please request your doctor for the same.
I hope I have explained things in a manner best understood by you. Please do not hesitate to write back to me for any further clarifications, I am always here to help.
Best wishes.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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