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Had fever, loose motion. Root canal treatment done. Feeling weak and fatigued. Blood test done. Any advice?

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Practicing since : 2001
Answered : 504 Questions
Medical History: Age 32, M, Weight 62KG

This is for a Neurologist in Bangalore.

Its a long history to read and I have also attached complete set of reports for the past two months.

1. Had fever in the 1st week of April
Took Calpol and Montec LC for 3 days.
Then took medicine Oflin O, Pantocid L and Enterogermina for 7 days and stopped after 7 days since loose motion started
2. Then loose motion started.
Took Amikacin injection for 5 days but lose motion did not stop completely. Also took I.V drips for 5 days since body was dehydrated. Stool culture report did not show bacterial growth.
Then doctor diagnosed and said it is Amoebic colitis and had Metrogyl Compound and VSL 3 for 10 days.
3. After taking these medicines lose motion stopped and became normal.
4. Immediately went for root canal treatment for 2 teeth and doctor gave Augmentin 525 and Zerodol P to eat for 5 days.
5. After root canal treatment body became very weak.
6. Revisited the doctor on 8th May and below were the test and report. Doctor also said oral thrush as developed and gave Candid mouth paint to be used for 5 days. Now oral thrush is not there after using Candid mouth paint.
Blood report: as on 9th May 2012
Platelet count : 1.30 Lakhs/cumm (reference range 1.5 – 4.5 Lakhs/cumm)
Serum SGOT : 64 U/L (Reference range 15-37 U/L)
Serum SGPT : 126 (Reference range 0-42 U/L)
Ultrasound report:
Liver: Normal in size and echotexture
No intra hepatic biliary/venous radicular dilatation.
No focal lesion seen
Impression: No obvious abnormality seen on this study. Normal size and echotexture of Liver and Spleen
No focal lesion in Liver parenchyma.

6. Went for complete set of Blood tests (LFT, Thyroid, Hepatitis B, C) and investigation again on May 24th 2012:
Below are the notable report details: (Also attaching complete set of reports)
Platelet count : 1.20 Lakhs/cumm (reference range 1.5 – 4.5 Lakhs/cumm)
Erythrocyte Sedimentation Rate: 24 mm/hr (Ref 0 – 9 mm/hr)
Serum/Plasma Glucose (Random): 163 mg/dl (Ref 70-150)
Serum SGOT : 34 U/L (Reference range 15-37 U/L)
Serum SGPT : 75 (Reference range 0-42 U/L)
Serum Alkaline Phosphate (ALP): 77 (Ref 108-306)
Gamma GT: 55 (Ref < 55)
Vitamin D: 5.05 ng/ml (Ref Deficiency < 20)
Bicarbonate: 22.0 (Ref 23-34)

7. Doctor said I have Vit D deficiency and prescribed inj Arachitol (3L) every week for 3 weeks. I have already taken 3 injections.

Current medications: Arcalion, Pantocid-DSR
8. My Head does not seem to be normal. I feel a lot of confusion and heavy headed. Cannot concentrate and sometime get headache as well. My doctor asked me to go for MRI on 6/15. Attached is the report.

9. Went for Vit D and Vit B12 tests today and there things seems to be normal now. Attached report.

My current problems:
Lot of weakness along with fatigue.
Head does not seems to be normal. State of confusion and heavy headed. Don’t know how to explain but its really disturbing.
Weakness in thigh and calf muscles.
Weakness is there for over 6 weeks now.

Doctor said, Liver impairment was drug induced. He said Vit D is the culprit hence am facing all those issues. But,
I would request you to throw some light on my situation. I am not well for the past 2 months. Is there something to worry about? Is there anything that I am missing or any test that I need to go for?
What are your thoughts? Any suggestions? (I am attaching complete reports for your study)
Please advise.
Posted Fri, 13 Jul 2012 in Brain and Spine
Answered by Dr. Shiva Kumar R 12 hours later
Hello and thank you for sending your question.

Your question is a good one and I will work on providing you with some information and recommendations regarding the symptoms you are experiencing.

From the details given to me and considering the profile of symptoms I feel you are suffering from post infective myalgia or post infective fatigue syndrome. usually many present with unexplained fatigue not related to exertion, headache or heaviness feeling in the head, Impaired memory or concentration, disturbed sleep, muscle and joint pains.

Regarding the Liver impairment I feel it is more related to the infection rather than the using medicines. Often Liver impairment is transient and recover by itself without any specific treatment. Ultrasound of the abdomen does not reveal any structural problems in the liver.

MRI of the brain shows non-specific changes and is not of a concern at this point of time. Vit D is low in you and can rarely cause excess fatigue and body ache. I feel there is no harm in taking Vit D supplements.

My recommendation would be for you to use simple pain killers like paracetamol or Aspirin for you headaches and body aches. Antidepressants like Escitalopram will help you to get rid of the fatigue and underlying depression. If symptoms persists see your Neurologist for a good physical examination and consultation. Blood tests like CPK, LDH, ESR, CRP and thyroid profile would be required to exclude thyroid disorders and myositis.

I want to reassure you that the symptoms does not signify any worry some type of disease or Neurological problem. This is certainly not something that is life-threatening.

I thank you again for submitting your question. I hope you have found my response to be helpful. If you have additional concerns I would be happy to discuss them with you.


Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.
Above answer was peer-reviewed by
Follow-up: Had fever, loose motion. Root canal treatment done. Feeling weak and fatigued. Blood test done. Any advice? 2 days later
Thanks Doctor.

I went to my doctor again and I have undergone few more tests including some muscle related CPK, LFT and antibodies. Some reports I should be getting tomorrow.

I would get in touch with you again as soon as I get reports.
Although, i still wanted to know about my head stability related issue. Vit D has become normal and I do not have any depression. As MRI does not indicate anything, what else do you think might be causing my head problems?

Answered by Dr. Shiva Kumar R 16 hours later

Thanks for the follow up query

Regarding heaviness of the head, other causes I can think are vertigo (problems in the inner ears) can present with heaviness of the head rather than true dizziness or vertigo. Rarely it can be seen in some one who is suffering from cervical spondylosis, Tension type headache and anxiety.

However I would like to assure you that all these are minor issues and most settle by themselves without any specific treatment. Only if you start getting headaches or dizzy feeling you may need medications to control and cure them.

Wishing you good health.

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist
Above answer was peer-reviewed by
Follow-up: Had fever, loose motion. Root canal treatment done. Feeling weak and fatigued. Blood test done. Any advice? 8 hours later
Thanks again doctor.
I did receive the reports today. I have attached them as well as XXXXXXX 23 report.
Notable points are that Liver enzymes have increased again.
AST = 58
ALT = 151
Platelet count = 1.1lac

My doctor has told that I have Non Alcoholic Fatty Liver disease. He said Vit D deficiency is still there in body. The blood vit D factor increased due to booster injections but it'll take time be properly absorbed in the body.

My heaviness in head is a bit reduced and weakness is also reduced if i compare from April.

My main symptoms are: Heaviness in head and weakness in calf muscles in legs. They are not always there but around 50% of the time.

My doctor has recommended me to change my lifestyle with regular exercises and healthy food. He said to wait and see for 1 month.

What is your opinion doctor? Do I need to visit a Hepatologist and go for Liver biopsy? I am really scared.

Answered by Dr. Shiva Kumar R 18 hours later

Thanks for the follow up query

As you feel your symptoms are better than before do continue on your doctor's advise for the liver problem. Healthy food and regular exercise will benefit for your heavy head and fatigue and tiredness in the calf muscles. I think its better to take an opinion from the Hepatologist for the liver problem to make sure nothing serious in the liver.

Wishing you good health.


Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.
Above answer was peer-reviewed by
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