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Dr. Andrew Rynne

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Dizziness, strange feeling on chest, shoulders, arms and legs. Having acid reflux. What could be this?

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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 5697 Questions

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Posted on Tue, 19 Nov 2013 in Brain and Spine
Question: Hello,

It is about 20 days that I am experiencing some episodes of pre-syncope, i feel like i am fainting, very dizzy, strange feeling on my chest,shoulders arms and legs. Anyway, my heart seems to be ok, even if i have a mild mitral valve prolapse, but i want to check if everything is ok. I need to address even the slightest deficiency. Can you please help me with my blood tests? I was taking omeprazole 20 mg any other day for about one year. So i thought i could have some vitamin, mineral, deficiencies. I have acid reflux.
doctor
Answered by Dr. Sudhir Kumar 6 days later
Brief Answer:
My reply is below

Detailed Answer:
Thank you for posting your query.

I have gone through your symptoms and also the blood test reports. In that, all are normal except bilirubin, which is high. A high bilirubin indicates jaundice due to problems in the liver. So, this would need to be evaluated by a gastroenterologist or hepatologist.

In addition, I would suggest you to get the following blood tests done:

1. Hemoglobin,
2. Thyroid profile,
3. Vitamin D level,
4. Vitamin B12 level

I hope it helps.

Please get back if you require any further information.

Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad,
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudhir Kumar 3 days later
I checked all vitamin D, B12, hemoglobin, iron, magnesium, everything is fine. High bilirubin was a problem i have since my first blood test 20 years ago. I probably have XXXXXXX syndrome.
doctor
Answered by Dr. Sudhir Kumar 32 minutes later
Brief Answer:
Thank you for getting back.

Detailed Answer:
The chance of you having Gilbert's syndrome is less likely, as in Gilbert's syndrome, the indirect bilirubin is higher, whereas in your case, the direct bilirubin is higher.

Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar 13 hours later
Hello Dr.,

You are right, I gave it for granted it was the unconjugated bilirubin, because i have always that one high. But this time it seems to be different.

I have attached also CBC and other results. Can you please check? Could I have gallstones? Or an emolytic disease? What other test should I do?

Thanks for your time.

Regards
doctor
Answered by Dr. Sudhir Kumar 4 hours later
Brief Answer:
Thank you for getting back.

Detailed Answer:
I have gone through your other reports.
There is slight elevation of blood sugars, which may require diet control, and no medications are required.
Hemoglobin is normal, but MCV is low, which could happen with iron deficiency. But your iron level is normal, so, there is no need of any treatment for this.
Other reports are normal.
Regarding high bilirubin, gall stones are possible. You can do ultrasound scan of liver and gall bladder for confirmation. Hemolysis is unlikely, as there too, the unconjugated bilirubin is higher.

Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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