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Having sore throat, feeling nausea, headache, fever and chills. Found vitamin D insufficiency. Concerned

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General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Strange symptoms: Sore throat (2+ weeks), extreme fatigue, nausea, headache, fever and chills (from 96.6-100.8F in an hour) throughout the day muscle and joint pain, pain radiating from inner left bicep, up the arm, to the shoulder and collar bone, up the neck to ear and jaw. Sometimes when I breath in it causes a stinging sensation in my chest, near heart. Sometimes my ear feels warm and pulses similar to an ear infection, and sometimes my face feels a little swollen or numb right in front of my ear, down my jaw. Yesterday my veins from my elbow area (inner arm) up my shoulder and neck were VERY blue and prominent.. but not in my right arm. Beyond the nausea I have also had pain in my lower back, upper back right scapula, and have on and off "cramps" that are not related to menstral cycle. I am not pregnant. My last cycle was abnormal, and I had spotting 4 days before my cycle started. (My cycle has been very regular for 14 years.). I was checked for thyroid issues (I am slightly hypothyroid) and did a thyroid panel and thyroid ultrasound as well as a CBC and other tests. I was found to have a vitamin D insufficiency (27) and have been taking 50,000IU 1x/week. (i am only on my second week)
Posted Sun, 2 Sep 2012 in Vitamins
Answered by Dr. Shanthi.E 8 hours later

Thanks for posting your query.

To begin with, I do not think your symptoms are strange.

It seems like you probably had a streptococcal throat infection which gave rise to the fatigue, nausea, headache, fever and chills. I assume you have taken a course of effective antibiotic like Amoxicillin for this.

The joint pain and radiating pain are all symptoms of a viral flu. It may be possible that the infection has descended down to your lungs and that is why the stinging sensation in your chest.

There is a generalized viral infection that may be ongoing in you causing the symptoms in your ears as well. The blue veins may be a part of this.

All your symptoms point to a viral infection superadded by a bacterial infection to me.

For your current symptoms, it is advisable to get a chest x-ray done and rule out any infection in the lungs. You may also need another course of effective antibiotic like Amoxicillin or Azithromycin. It would be a better idea to get examined by your Meanwhile, take over the counter anti-pyretic like Tylenol for the fever to subside and also tablet. Zyrtec 10mg at night for the next 3 days.

I wish to know how low your thyroid hormones are.

Please do write back for further discussion on this.

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Follow-up: Having sore throat, feeling nausea, headache, fever and chills. Found vitamin D insufficiency. Concerned 9 hours later
A little more information that may be helpful as well..

My throat pain has been just over 3 weeks now. The pain gets worse and better throughout the day, not brought on by cold/hot drinks, etc. Just simply "whenever".

The joint/muscle pain is mostly on the left side. My left foot, left XXXXXXX left shoulder, both knees, and right hip. I have trouble getting up stairs, etc. Very arthritic feeling. My left arm feels significantly weaker than my right at all times, even when the pain is not radiating. However, I am left handed, and normally left hand dominant.

Wouldn't my WBC have shown slightly elevated numbers if i had a viral and bacterial infection? The CBC test result showed numbers almost exactly the same as my last CBC a year ago.

My left ear only bothers me when I have the radiating pain from arm-shoulder-up, but not any other time of the day on its own.

I was examined by my doctor 2 weeks ago and he did not seem to suspect any kind of infection. Who/where do I go from here? (And to my surprise, no swollen lymph nodes)

My thyroid levels are now within "normal range" while on the levothyroxine. TSH, T3, T4, etc.. all normal while on this dosage. As well as my thyroid antibody

Yesterday the pain radiating from bicep, to shoulder/clavicle, up neck was the same time I had an extreme headache (forehead, temples, ears, down back of head to neck) and very terrible nausea. It lasted about an hour. Not brought on by anything. I did take 2 tylenol and the headache went away eventually. The pain stopped radiating, but every time I took a very XXXXXXX breath, the chest pain would "Zing" near the end of the XXXXXXX inhale.

I have seen a primary and endocrinologist. Should I see a different primary? I have not had a chest Xray. Just blood work (CBC, All Thyroid Tests, Vit D, Vit B-12 and maybe 2 others), a thyroid ultrasound, and a 24hour urine test for cortisol which I have no received back yet. (Sent out).

Thank you..
Answered by Dr. Shanthi.E 39 minutes later

Thanks for writing in depth. The information gives more clues now.

I wish not to complicate the health concern at your age of 25. Let us keep the common things first.

Assuming you had a streptococcal sore throat 3 weeks ago, the cause of your current symptoms may be attributed to the post- streptococcal arthritis or reactive arthritis. This is most common.

It mostly affects all the major joints and manifests as joint pain and generalized fatigue.

Yes, the WBC count would be definitely high if there was a bacterial infection, though not seen so frequently in viral infections. However, if the infection was subclinical and the test was done in the early stages, then it could be falsely negative too.

Your doctor examined you 2 weeks ago, and he said that you were normal. I assume he did not start you on any antibiotics.

In any case, it is better for you to take a course of antibiotic containing amoxicillin and clavulinic acid or Azithromycin. Both are prescription drugs. Please get them prescribed by another doctor.

Just to be on the safer side, you may consider seeing a different primary and getting a chest X-ray done. There is no need to go back to the Endocrinologist for these symptoms.

I am glad that your thyroid levels are within normal range now.

Overall, I strongly feel you should give it some time to heal naturally. Eat healthy, drink plenty of fluids and fruit juices, stay warm, and relax your mind for some time.

I am sure you will do well very soon.

Please do let me know if you have more concerns.

Take care of yourself.

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