Question: My mother (58+ Y) is under treatment for Hypothyroidism (Eltroxin 50 mcg), Hypertension (Olmezest 20 mg) & Osteoarthritis (stage-2) of knee joints (Gemcal D3). She was also diagnosed with mild anemia (Hb 10.7) & had been with 'Uprise XT' & 'Folvite' over past 4-months, which so far improved Hb to 11.2 only.

She was first diagnosed with Osteoarthritis of knee joints in early 2014 with a low Vit D level (14), after which she was put on the following medications -

1) 'DV 60 K' once a week for 8 weeks & then once a month for 10-months
2) 'Orcerin GM' BD for 6-weeks
3) 'Zedfit' powder
4) 'Shelcal CT'.

In 2015 her Vit D level improved to 51 & she was continued with monthly 'DV 60K' for next one year, after which it was stopped. She was also on 3-month course of 'Calcitonin Salmon' nasal spray, which had quite helped to manage the knee pain.

In 2016 her Vit D level was 55 although Xray had shown 'Osteoarthritis stage-2' of knee joints & therefore 'DV 60K' & 'Zedfit' were stopped. The doctor had asked to continue only 'Gemcal D3' (instead of Shelcal CT) & quadriceps drills, as she used to do before. However, she started experiencing lots of knee pain over past 6-months (specially winter) & also sometimes muscle cramp at night. She had taken 'Evion 400 mg' for a week, which had helped for muscle cramp but she had to stop due to gastritis problems.

Request your kind opinion whether we are on the right track & what should be the next steps for her. Few recent lab reports are as follows -

1) serum BUN - 14
2) serum creatinine - 0.8
3) TSH - 3.75
4) FBS - 97
5) Vit D - 43
6) serum calcium - 8.9

Thanks Doctor. Her B12 - 894, serum folate - 12, RBC folate - 883. So, can she continue with 'Gemcal' along with 'Uprise XT' (which contains 00 mg iron, 7.5 mcg B12, 1.5 mg folate & 1000 IU of Vit D) & 'Folvite' ? Or, should she resume 'Ecod Plus' along with 'Gemcal D3' ?