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What Causes Weakness In Leg?

Posted on Wed, 3 Sep 2014

Question: I am a 76 year old male and a 7 year survivor of a left nephrectomy due to cancer. Beyond that, the surgery made me a diabetic. Take Paradin and 6 units of long acting insulin per day. No other illnesses. In the past month, I have found that my legs tire easily. I love to walk, so this is a problem. I get 9 hours of sleep a night without interruption. Is it only age when it came on so quickly.

Answered by Dr. Prakash H Muddegowda (2 hours later)

Brief Answer:
Possibly anemia.

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.

Looking at clinical history and present query, I can comment as follows:

1. Possibly low hemoglobin - that could be the main cause. Need to get an updated hemoglobin level estimation. If low, cause is very important at this age.
2. Reduced muscle strength, compared to previous years.
3. However, you need to look for any edema in legs, or altered sensation.
4. Deficiencies of Vitamins and minerals particularly, Vit B12 or calcium can induce weakness in muscles.

Try resistance training to build muscle strength. Improve nutrition with particular addition of eggs, red meat and fish.

I do not think, age is the only thing which has changed.

Any further queries, happy to help again.

Dr. Prakash HM

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Prakash H Muddegowda (25 hours later)

Thank you for your suggestion. I will get an Hb reading. I do not have any edema and I do resistance training on a daily basis and balance training also on a daily basis. I take a daily vit that includes Vit B. I am very careful with my diet given that I two conflicting issues - diabetes type 2 and only the one kidney. Have to watch both carbs and protein. Sometimes wonder if I get sufficient calories in a day, but my weight remains constant at 170 (5'11"), so I think I am doing okay. The surgery that traumatized my pancreas make my glucose readings rather unstable and, therefore, the Endocrinologist has me testing 6 times per day. Mid-afternoon is when I have to be most careful regarding hypoglycemia that comes on quickly - sudden unexpected drops. I will get the Hb tested and update you. Dr. Colladay (retired)

Answered by Dr. Prakash H Muddegowda (4 hours later)

Brief Answer:
Will wait for result.

Detailed Answer:
Hi Dr. Colladay,
Thanks for asking again.

Anemia could be the main cause. However, as you know there are multiple causes. If possible, get your serum calcium and potassium level checked.
Due to your rigorous diet, and reduced absorption due to age related atrophy changes in mucosa, some amount of deficiency in essential vitamins and minerals could be present.
Hope to identify a cause at the earliest for leg tiredness.
Do be careful about hypoglycemia, as it can increased risk of falls, along with CNS complications.

Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Prakash H Muddegowda (40 hours later)

Today, I got the results from the hospital lab that my CBC with differential is as it should be. Hb was 12.2. I have nothing more to add. If you have any additional comments, they would be welcome.

Answered by Dr. Prakash H Muddegowda (8 hours later)

Brief Answer:
Final - possibly peripheral vascular disease.

Detailed Answer:
Hi Dr. Colladay,
Thanks for replying.

Only one comment i can add further is a possibility of "peripheral vascular disease".

It is more common in the lower limb. It presents with pain or weakness with walking that is relieved with rest. Weakness or pain occurs distal to the partial obstruction. Superficial femoral or popliteal arteries are commonly affected.
Diabetes is one of the associated risk factor.
Evaluation with pulse, lower limb blood pressure, doppler or treadmill exercise testing could help in confirmation.

Hope it helps.
Any further clarifications, happy to help again.
Dr. Prakash HM

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Prakash H Muddegowda (14 hours later)

I have no pain and nothing that would indicate peripheral artery disease. I will seek further evaluation, however, on that possibility. The CBC will be repeated on Thursday along with electrolytes to see if there are any indicators there. Since I have the lone kidney, I will ask for a reading of my creatine, just to be on the safe side. Thank you for continuing to be there and responding.

Answered by Dr. Prakash H Muddegowda (8 hours later)

Brief Answer:
Hope the tests show significant findings.

Detailed Answer:
Hi Dr. Colladay,
Thanks for replying.

If it is not vascular (peripheral vascular disease, anemia) or neural (Vit B12 deficiency) or muscular (muscle weakness, electrolyte imbalance like calcium, sodium or potassium), then we might have to treat it as age related weakness.

As you are getting the tests done, hopefully we find something.

Hope to find a reason in your tests.
Any further clarifications, happy to help again.
Dr. Prakash HM

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Above answer was peer-reviewed by : Dr. Shanthi.E