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Had general malaise and flu symptoms. Sodium was low. Gamma GT was high. Had hashimotos thryoid. What do you recommend?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10445 Questions
I have had general malaise and flu like symptoms persisting. My Dr. did some electrolyte testing (but not a full panel) and my sodium was low at 132 mmol/L but potassium at top of normal range at 5 mmol/L. My red blood cell count was slightly low. My Gamma GT was higher than normal range. ALT and AST were not done. ALP was done and was normal. Do you see any pattern to these results and if I had further blood work what would you recommend it be?
I also had hashimotos thryoid. My meds are :
levothyroxine, 0.15 mg daily, celebrex 200 mg daily, tiazac 180 mg daily,
I have lived with my chronic conditions for years and have learned to self manage very well over all. At first I thought I was just in a prolonged flare of the Fibromyalgia, but feel it is severe enough and long lasting enough that maybe something new or in addition is going on
Posted Tue, 24 Sep 2013 in Medicines and Side Effects
Answered by Dr. Praveen Tayal 1 hour later
Brief Answer:
You can repeat test liver enzymes after 6 weeks

Detailed Answer:
Thanks for posting your query.
The symptoms that you are having could be related to an electrolyte imbalance. In addition to serum sodium and potassium,. it is best to get magnesium and calcium levels also evaluated.
GGT blood levels may be elevated due to liver disease, hepatitis, gallstones, diabetes, pancreatic disease, kidney failure, alcohol misuse, certain prescription drugs, certain herbs and supplements or taking very high amounts of supplements.
You can follow the trend over time of your liver enzymes. If there is a trend in a direction which continues to increase overtime then a investigation can be done regarding that. If this somehow does happen your doctor will do an ultrasound scan or perhaps a referral to a gastroenterologist.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: Had general malaise and flu symptoms. Sodium was low. Gamma GT was high. Had hashimotos thryoid. What do you recommend? 1 hour later
Dear Dr. Tayal,

Thank you very much for your prompt reply. I do have a few further questions.

Should I pursue the magnesium and calcium testing now or can it wait until liver enzymes are rechecked 6 wks. from now?

When I have the liver function retested what tests specifically do you recommend?

Thank you,
Answered by Dr. Praveen Tayal 22 hours later
Brief Answer:
Serum electrolytes should be evaluated now.

Detailed Answer:
Thanks for writing again.
It is best to get the serum calcium and magnesium levels done now as that will help in the proper treatment.
For the liver function tests, you will have to get all your enzymes evaluated including ALT, AST, GGT, ALP, etc.
Hope my answer is helpful.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.
Above answer was peer-reviewed by
Follow-up: Had general malaise and flu symptoms. Sodium was low. Gamma GT was high. Had hashimotos thryoid. What do you recommend? 39 hours later
Hello Dr. Tayal,

Thank you for your prompt and helpful answer above. I will follow up with my GP re the electrolyte and liver panel tests.

I would like to ask you some more questions on another topic. I am troubled by alternating chills and sweats. Sweating at night is a long standing problem. We keep our bedroom window slightly open all year long and I use minimal covers. But during this recent bout of malaise and increased body aches I am having short bouts of feeling very overheated (happens anytime, when just resting, etc) and I break a sweat. After a few minutes it slowly passes and I feel chilled. Re my temperature my normal baseline is about 96,6 -97.2 F over normal day. During this illness my temp is going from 97.7 to 99 F but I feel like it should be reading higher by how I feel. All this is happening while I am on penicillin for a suspected bacterial sinus infection. Although my sinus pressure symptoms have improved while on the penicillin these other seeming infection like symptoms persist. I am puzzled and discouraged and would appreciate your thoughts and advice.

Another symptom giving me trouble is that my throat feels swollen, dry and scratchy. I find I have to sip water while eating as food (such as toast crumbs) get stuck in the back of my throat.. I had a pill stick in my throat which has never happened before-I had not realized it was there but suddenly had a coughing fit while brushing my teeth one night and it flew out.

Finally I have a new pattern of body pain. In addition to the generalised aching I attribute to Fibromyalgia, I now have been having weeks of stiff painful big toe joints without swelling. Also my wrists and thumbs have hurt and been stiff. I have had some swelling of my wrists

I would very much appreciate any thoughts or advice. I realize I sound like an 'organ recital' and i certainly wish I didn't. I just want so much to feel better and resume my life which is made up of a loving husband, grown children, grandchildren, friends, my volunteering (which I have been unable to do), my garden, etc. Thank you forlistening and for your help.
Answered by Dr. Praveen Tayal 7 hours later
Brief Answer:
Can be due postmenopausal hormonal changes.

Detailed Answer:
The feeling of chills or hot flushes and bodyaches can be related to hormonal changes- postmenopausal changes. Consulting an endocrinologist will be helpful.
The pain in the great toe and wrists may be due to arthritis, gout, etc. A chronic infection like sinus infection can also cause such symptoms. You can start taking vitamin C supplements to build up your immunity.
Take care.
Above answer was peer-reviewed by
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