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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have low immunity, gastritis, pharyngitis, oral ulcer and hemorrhoids. Any treatment?

Answered by
Dr. Anil Grover


Practicing since :1981

Answered : 922 Questions

Posted on Mon, 24 Dec 2012 in General Health
Question: Dear Sir/Madam,

Chinese, male, single, 28 years old, 175cm, 53kg, work in corporate finance/investment banking so a lot of stress from work. Very skinny, and almost no fluctuation in weight all these years.

Diagnosed disease: chronic gastritis, chronic pharyngitis, hemorrhoids. When i was in my late tens I had a lab test of mycoplasma pneumoniae showing positive, but i was allergic to Azithromycin. No other disease diagnosed after comprehensive health check(including HIV, liver, kidney, heart, lungs). I've also tested for diabetes, but I think the doctor said only a set of very comprehensive test can rule out all forms of diabetes. I don't think I've done all of that.

Other conditions:
low immunity/prone to catching cold and fever. This year alone, I've had three times of cold/fever that needed to be taken care of by intravenous injection of antibiotics (levofloxacin and moxifloxacin hydrochloride) at the hospital. The doctor who reviewed my charts suspected that I am infected with mycoplasma pneumoniae but didn't suggest a lab test to confirm as he thought there was no particularly effective ways to treat it anyway.

Constipation: stool usually dry and on average once in 1.5-2 days

Frequent oral ulcer.

Constant feeling of low energy and drowsiness, even I sleep 7 hours a day. Sometimes it feels worse(feels feverish, light headache), I take the body temperature and it shows 36.8 to 37.0 Celsius. I also take my temperature when I feel great as a comparison, and during those (rare) times my temperature is below 36.5 Celsius. I usually tend to feel better at night, probably due to body temperature naturally falls at night.

Almost always skip breakfast. Partly due to my schedule: I usually sleep at 1:30 am and get up at 9:00 am. Also because I don't feel hungry in the morning, and sadly if I eat breakfast, I tend to get very, very sleepy in the morning, which I really don't understand.

Masturbation/sex: I never really believed in the theory of ejaculation bringing harm to the body, until I really tested it and found significant correlation: if I have sex/masturbate one day, 70% of the time I will feel significantly weaker the next day, sometimes fogged/swimming head sometimes experiencing lower back pain. I read the few articles about it, maybe it's the zinc loss, or maybe I think it's the spiritual tension of orgasm that's really energy consuming, instead of the loss of nutrients from semen? But even this is the explanation, how come others don't feel the same? I never ejaculate more than twice a day.

I think the conditions mentioned above are heavily affecting my life, but most doctors I see here cannot come up with any more than general advices like to exercise, relieve stress and eat healthy. By providing all the information above, I really hope to get more specific and feasible action plans from medical experts.

Thanks a lot for your help!
Answered by Dr. Anil Grover 6 hours later

While the space does not permit me to go to individual malady and your General Physician is the best person to deal with problems like constipation. I will advise you about an exercise which is simple to perform and relieves stress significantly. You add this to your daily routine. Please do not find excuse for not doing it for 15 minutes twice a day. You will see results in a weeks time. Please write back after two days if you do not feel any relief. Let me know, or we can start tackling your other problems conventional way (you can ask for refund also instead of writing to me). start doing yogic exercises which act as stress buster. You must remember stress is universal it is reaction to stress which matters and wrong reaction or aggressive reaction is the one which causes harm. I have taken this translation of original Sanskrit description of one of the yogic asana. It can be done without much effort 15 minutes in the morning and 15 minutes in the evening.
I quote:
How do you do Savasana?
1. Lie with your back, legs straight, and arms at your sides. Rest on your hands five
inches apart from your body with palms facing upward.
2. Rest on your feet drops open and closes your eyes.
3. Let your breath occur naturally, when breath is free mind also free. When the
breath is, allows moving naturally, the mind settles into itself.
4. Allow your body and mind to feel heavy on the ground.
5. From your feet soles to head-crown, consciously set free every body part, organ,
and cell.
5. Relax your face; make your eyes drop XXXXXXX into their sockets.
6. Welcome peace and silence into your mind, body, and soul.
To exit savasana:
1. First take a XXXXXXX breath followed by gentle movement from toes to head (head
be the last part) and awareness back to your body.
2. Then, slowly roll to your right side and rested there for few seconds, inhale and
comfortably move to seated position.
Hindrance or obstacles to the savasana
The most common obstacles to a Savasana practice are:

Nap (a brief sleep),
Mental agitation,

Although Savasana is the most difficult asana to perform, the focus is simple - relax everything (every body part and mind). If you get distracted or agitated, you can always undo, unwind, let go from the start
End of quote

The other symptom you described is because of reflux of stomach (Gastric) contents into your food pipe(esophagus). Apart from Pervacid which you are taking. Avoid lying down for at least after mean specially dinner. A short walk is recommended after lunch too.
Please continue taking precautions and medications as and when required for asthma, I hope that is not troubling you much. Find out what causes you allergy and try to avoid that. Finding out about allergen by special test is also another way should you feel that problem is something you can not handle.

If there is further query which you might have I will be most happy to answer. Good Luck.
With Best Wishes:
Dr Anil Grover
MBBS, MD (Medicine) DM(Cardiology)
Cardiologist and Internist
http:/ WWW.WWWW.WW
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Anil Grover 15 hours later

Thanks very much for your answer. I will try the Savasana. Just a few clarifications:
1. I tend to think the low immunity is due to some low grade infection, which may not be gone by just lifting pressure?
2. By "The other symptom yo described", do you mean the sleepiness after breakfast? I am a bit confused as I am not taking Prevacid. And I don't feel stomach acid at all.
3. I don't have asthma... and I don't have allergy... I was allergic to the antibiotics called Azithromycin in an intravenous injection.

And, while I try out Savasana, I cannot wait to hear your opinion about each one of the conditions I listed. I do not mind paying more to get more answers. I understand some of the conditions listed may be irrelavant, I just listed them out there for your reference in order for you to have a whole picture, in case some of these combined symptoms/conditions may indicate anything. For example, constipation, although seemingly simple, could possibly be caused by sth. not so obvious. That's why although I consult my general physician, I didn't stop there but put it in the description here.

Thanks a lot!
Answered by Dr. Anil Grover 21 minutes later
Thanks for writing back.
I will take each point.
1 You could be right. However depression either due to physical illness or too much of stress both do cause per se lowering of our body's resistance. For evidence you can go to your doctor and make the same complain and convince him/her to order the investigations like complete blood count, serum AG ratio, liver function test. These will give general idea. He/she may be persuaded to order for subacute combined immunodeficiency disorder.

2. I apologize for other symptoms paragraph. I was at that time thinking of some other patient who had symptoms of gastroesophageal reflux disease (GERD) so that is irrelevant for you.Please ignore.

3. I do not suggest you take this medicine but your treating doctor should make a note for this and give you an alternative should you feel the need of this drug.

I read your history carefully. The beauty of this asana is it can be performed with no effort without affecting any co existing illness. You do not have to stop treatment for other illness(s). Good Luck.

With Personal Regards.

Dr Anil Grover
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Anil Grover 21 minutes later
Thanks for your prompt reply. On some points that you haven't responded on:

1. Drowsiness after breakfast, any reasons and ways to avoid that?
2. Any connection between sex/ejaculation and weakness?
3. Do you think I should test for mycoplasma pneumoniae? Or do you agree with what my doctor said that it would be useless to test it as there's no way to eliminate it.
4. I like the recommendations you gave for the tests. Any other specific tests you would recommend me doing according to my status?
Answered by Dr. Anil Grover 1 hour later
Thanks for writing back. Here is what I feel about your questions.

1. No apparent reason except general apathy towards self. Try taking hot coco or coffee with breakfast. Usually that helps. You can go to washroom and try some XXXXXXX breathing exercises before going out to work.
2. In your case the feeling of general weakness and multitude of problems leading to stress are enough to affect sexual act leading to weakness, inadequate erection and premature ejaculation. That should take care by itself as you start feeling better.
3. Here, I would agree with your doctor, you do not seem to have symptoms suggestive of mycoplasma pneumonia.
4. Well, one can not predict the results of tests but a different algorithm starts once a test is positive then subsequently series of tests are necessary. That bridge has to be crossed once you reach that.

With Best Wishes.

Dr Anil Grover
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Anil Grover 1 hour later
1. So according to the current information there is no physical illness leading to this?
2. Got you.
3. Although I don't have pneumonia and its symptoms, I can still possibly be infected by the living being, e.g. throat? It's just not that severe to make me have a high fever etc., but it is there weakening me and causing the potentially existing low grade infection? Is there any possibility like this? And do you also agree there is no particular treatment to it? If not, what is the best medicine/treatment for it?
4. Got you.
Answered by Dr. Anil Grover 4 hours later
Thanks for writing back.

1. We have started with the assumptions that symptoms and signs of physical illness will be or at least can be different non conventional in you. So, I am not sure what illness you have but your asthenia and plenty of complaints point towards a somatic illness. It is just we have not been able to diagnose it.

3. In view of the above nothing can be excluded just because it can not be excluded, therefore, if tomorrow you turned up with altered immunity manifestations can be altogether different. So, I will revise my answer and say yes, you ought to be investigated. In medical science there is nothing like 100% certain.

With Best Wishes

Dr Anil Grover
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Anil Grover 7 hours later
1. Can u re-phrase? "different non conventional in you"?
2. So what's the action plan now: I should take the tests you mentioned and see what results are? I hope to get a complete initial test list from you so I'll go to the hospital and have everything checked once. So I need a clear opinion: in addition to the tests you mentioned yourself, do you think tests for diabetes, mycoplasma pneumoniae, enteroscopy etc?
3. Do u recommend seeing doctors with other areas of specialty, e.g. immunity? Nutrition?

Answered by Dr. Anil Grover 13 minutes later
Thanks for writing back:

Different or non conventional should have been the phrase. Meaning thereby, typhoid presents in conventional manner as fever with a little or no gastrointestinal symptoms. Non conventional presentation will be typhoid presents without fever with predominant gastrointestinal symptoms, then it is on testing we come to know about its existence.

Yes, please see your doctor and politely insist on certain tests which I do not see unreasonable.

If your weight is below what it should be for the age and height there is no harm in seeing either or both the specialists. Doctors are there to help people not to dissuade them even from consulting. It is patient's right to reasonably agree or disagree with what is told to them.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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