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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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PATIENT HISTORY Name of Patient: Mrs. Mayadevi K. Makhija, Female,

Answered by
Dr.
Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12002 Questions

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Posted on Sun, 10 Mar 2019 in Back Pain
Question: PATIENT HISTORY
Name of Patient: Mrs. Mayadevi K. Makhija, Female, age – 65, weight : 68.5 kg.
No. of children: 5 (4 females and 1 male, all alive)
1992 - detected hyper thyroid
1994 - Hysterictomy carried out due to fibroid uterous
1995 - Hypertension
1998 - cholestrol

During a general check up in 2016 the Bone quality index test carried out on right foot of the patient revealed her T.score at - 2.5 and Z score at -1.9 leading to BOI at 56.5 i.e. osteoporosis of bones. Was advised by Orthopaedic surgeon intake of (i) Gemitrol nasal spray for 3 months, (ii) Tablet Indrofos 150 one tab daily for 3 months, and (iii) Calcium capsule T.Cal 123 once daily for 3 months which she completed.

In February 2017 detected with diabetes-2 - under control with medication.
The patient some times has gastric problem which gets resolved with intake of rabaprazole (Rabium DSR– Rabeprazole sodium IP 20 mg + domperidone IP 30 mg.) capsule once daily.

All above ailments are well under control under regular medical treatment.

--Surgical treatments--
January 2015- Under went explotory laparatomy right retropetoneal Lipomatous Tumor of abdomen by a GI surgeon of Astha Oncology Hospital, XXXXXXX (India) .HPE by Astha Oncology findings : Well differentiated Liposarcoma/a typical lipomatic tumor. Second and third opinion -HPE by Dr. XXXXXXX Borges of SRL Diagnostic Centre, XXXXXXX and Tata Memorial Centre, XXXXXXX ruled out of malignancy/lipo sarcoma - Remarks a "Gigantic Lipoma".
Post operative follow-up carried out after 3 months of survery with USG Abdomen and pelvis - report N.A.D. after 6 months CT Scan was taken - result N.A.D. - after further 6 months USG was carried - result N.A.D. CT Scan was again carried out in January 2017 which showed no abnormalty.
USG ABD and Pelvis done in XXXXXXX 2017 – findings: incisional hernia at level of umbilicus with herniation of omentum. LAP repair of incisional hernioplasty carried out by a general MS surgeon on 12 July 2017. Post operative follow up after 3 and 6 months revealed no abnormality.
Follow up of lipomatic tumor surgery, repeated with HCG hospital in XXXXXXX 2018 – CT scan showed NAD. General check up follow up in Dec. 2018 revealed no NAD. CT ABD and Pelvis is advised as follow up in XXXXXXX 2019. The patient has completed 4 years to this surgery by now and 1 year 7 months to hernia mesh plasty conducted in July 2017.

Present questions:
Related to Osteoporosis. Patient is taking calcium and vitamin D3 since 2017.
OUR QUESTIONS –

We came to know that vitamin K2 MK-7 (highly available in fermented food like Natto) is efficient vitamin in increasing bone density and also helps in reducing calcification in arteries.

Considering different medical conditions would you recommend taking Vitamin K2?
If yes, what according to you can be therapeutic does of vitamin K2 MK7 for such patient?
Existing medicines taken by patient and contents are shared below:

Tab. Thyronorm, Thyroxin Sodium IP 37.5 mcg. (25+12.5),     Abbott Pharma - morning empty stomach

Tab. Azulix 1MF, Metformin Hydrochloride IP 500 mg SR Glimepiride IP 1 mg,Torrent Pharma- 11 am

Cap. T3, "Tocotrienols (50%) 60 mg.
Vitamin B6 IP 1.5 mg
Methylcobalmin IP 1500 mcg
L-methylfolate 400 mcg", Innovacare Life Sciences - 11 am

Tab. MBSON -SL,     Mecobalmin IP 1500 mcg - 2 pm

Tab. Nebicard SM, "Nebivolol Hydrochloride IP equivalent
to Nebivolol 5 mg.
S. Amlodipine Besylate IP equivalent to
S. Amlodipine 2.5 mg." - 2pm

Tab. LTK-H, "Losartan Potassium IP 50 mg.
Hydrochlorothiazide IP 12.5 mg." - 2pm

Tab. Ezorb Forte, "Calcium Aspartate Anhydrous 500 mg.
Calcium Orotate 500 mg.
Calcitriol 0.25 mcg.
Elemental Magnesium 50 mg.
Elemental Zinc 7.5 mg.
Folic Acid 1.5 mg.
Hydroxycobalmin 100 mcg." - 2pm

Tab Azulix 1MF, Metformin Hydrochloride IP 500 mg SR Glimepiride IP 1 mg. - 9 pm

Tab. Torvasan F     "Atorvastatin Calcium IP 10 mg.
Fenofibrate IP 160 mg." - 9 pm

Tab. Clonotril 0.5      Clonazepam 0.5 mg. - Does not take regularly. Only takes in case of sleep issues during last one month.
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Follow up: Dr. Praveen Tayal 0 minute later
PATIENT HISTORY
Name of Patient: Mrs. Mayadevi K. Makhija, Female, age – 65, weight : 68.5 kg.
No. of children: 5 (4 females and 1 male, all alive)
1992 - detected hyper thyroid
1994 - Hysterictomy carried out due to fibroid uterous
1995 - Hypertension
1998 - cholestrol

During a general check up in 2016 the Bone quality index test carried out on right foot of the patient revealed her T.score at - 2.5 and Z score at -1.9 leading to BOI at 56.5 i.e. osteoporosis of bones. Was advised by Orthopaedic surgeon intake of (i) Gemitrol nasal spray for 3 months, (ii) Tablet Indrofos 150 one tab daily for 3 months, and (iii) Calcium capsule T.Cal 123 once daily for 3 months which she completed.

In February 2017 detected with diabetes-2 - under control with medication.
The patient some times has gastric problem which gets resolved with intake of rabaprazole (Rabium DSR– Rabeprazole sodium IP 20 mg + domperidone IP 30 mg.) capsule once daily.

All above ailments are well under control under regular medical treatment.

--Surgical treatments--
January 2015- Under went explotory laparatomy right retropetoneal Lipomatous Tumor of abdomen by a GI surgeon of Astha Oncology Hospital, XXXXXXX (India) .HPE by Astha Oncology findings : Well differentiated Liposarcoma/a typical lipomatic tumor. Second and third opinion -HPE by Dr. XXXXXXX Borges of SRL Diagnostic Centre, XXXXXXX and Tata Memorial Centre, XXXXXXX ruled out of malignancy/lipo sarcoma - Remarks a "Gigantic Lipoma".
Post operative follow-up carried out after 3 months of survery with USG Abdomen and pelvis - report N.A.D. after 6 months CT Scan was taken - result N.A.D. - after further 6 months USG was carried - result N.A.D. CT Scan was again carried out in January 2017 which showed no abnormalty.
USG ABD and Pelvis done in XXXXXXX 2017 – findings: incisional hernia at level of umbilicus with herniation of omentum. LAP repair of incisional hernioplasty carried out by a general MS surgeon on 12 July 2017. Post operative follow up after 3 and 6 months revealed no abnormality.
Follow up of lipomatic tumor surgery, repeated with HCG hospital in XXXXXXX 2018 – CT scan showed NAD. General check up follow up in Dec. 2018 revealed no NAD. CT ABD and Pelvis is advised as follow up in XXXXXXX 2019. The patient has completed 4 years to this surgery by now and 1 year 7 months to hernia mesh plasty conducted in July 2017.

Present questions:
Related to Osteoporosis. Patient is taking calcium and vitamin D3 since 2017.
OUR QUESTIONS –

We came to know that vitamin K2 MK-7 (highly available in fermented food like Natto) is efficient vitamin in increasing bone density and also helps in reducing calcification in arteries.

Considering different medical conditions would you recommend taking Vitamin K2?
If yes, what according to you can be therapeutic does of vitamin K2 MK7 for such patient?
Existing medicines taken by patient and contents are shared below:

Tab. Thyronorm, Thyroxin Sodium IP 37.5 mcg. (25+12.5),     Abbott Pharma - morning empty stomach

Tab. Azulix 1MF, Metformin Hydrochloride IP 500 mg SR Glimepiride IP 1 mg,Torrent Pharma- 11 am

Cap. T3, "Tocotrienols (50%) 60 mg.
Vitamin B6 IP 1.5 mg
Methylcobalmin IP 1500 mcg
L-methylfolate 400 mcg", Innovacare Life Sciences - 11 am

Tab. MBSON -SL,     Mecobalmin IP 1500 mcg - 2 pm

Tab. Nebicard SM, "Nebivolol Hydrochloride IP equivalent
to Nebivolol 5 mg.
S. Amlodipine Besylate IP equivalent to
S. Amlodipine 2.5 mg." - 2pm

Tab. LTK-H, "Losartan Potassium IP 50 mg.
Hydrochlorothiazide IP 12.5 mg." - 2pm

Tab. Ezorb Forte, "Calcium Aspartate Anhydrous 500 mg.
Calcium Orotate 500 mg.
Calcitriol 0.25 mcg.
Elemental Magnesium 50 mg.
Elemental Zinc 7.5 mg.
Folic Acid 1.5 mg.
Hydroxycobalmin 100 mcg." - 2pm

Tab Azulix 1MF, Metformin Hydrochloride IP 500 mg SR Glimepiride IP 1 mg. - 9 pm

Tab. Torvasan F     "Atorvastatin Calcium IP 10 mg.
Fenofibrate IP 160 mg." - 9 pm

Tab. Clonotril 0.5      Clonazepam 0.5 mg. - Does not take regularly. Only takes in case of sleep issues during last one month.
doctor
Answered by Dr. Praveen Tayal 56 minutes later
Brief Answer:
She can have K2 MK-7.

Detailed Answer:
Hello,
Thanks for posting your query.
I have gone through the detailed history. She can take Vitamin K2 MK7 as it helps in better bone deposition and bone health. Between 100-300mcg per day is considered a standard dose. Dosages up to 600mcg per day for certain conditions may be necessary. She can start with 100 mcg per day and get her T- score and Z-score checked again to monitor the effect.
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.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Wishing you good health.
Regards.
Dr. Praveen Tayal.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Praveen Tayal 0 minute later
Brief Answer:
She can have K2 MK-7.

Detailed Answer:
Hello,
Thanks for posting your query.
I have gone through the detailed history. She can take Vitamin K2 MK7 as it helps in better bone deposition and bone health. Between 100-300mcg per day is considered a standard dose. Dosages up to 600mcg per day for certain conditions may be necessary. She can start with 100 mcg per day and get her T- score and Z-score checked again to monitor the effect.
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.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Wishing you good health.
Regards.
Dr. Praveen Tayal.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Tayal 13 hours later
Hello Dr. XXXXXXX

Thank you for your quick response and taking out time to respond to my query. Few last questions:


1) Will K2 have any interference in the workings of existing medicines the patient is taking?
2) We have heard that vitamin K2 is helpful for blood clotting (i.e. it is used to reverse the effects of “blood thinning” medications. Patient is not taking any blood thinning medications). What should we keep in mind considering this aspect in case of any future emergencies?
3) Presently patient is taking Cholecalciferol 60000 IU, one tablet, every 15 days. Is this ok?
4) About calcium, does this combination has better absorption than others at this age and health condition?
Tab. Ezorb Forte, "Calcium Aspartate Anhydrous 500 mg.
Calcium Orotate 500 mg.

Thank you very much and have a good day ahead.
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Follow up: Dr. Praveen Tayal 0 minute later
Hello Dr. XXXXXXX

Thank you for your quick response and taking out time to respond to my query. Few last questions:


1) Will K2 have any interference in the workings of existing medicines the patient is taking?
2) We have heard that vitamin K2 is helpful for blood clotting (i.e. it is used to reverse the effects of “blood thinning” medications. Patient is not taking any blood thinning medications). What should we keep in mind considering this aspect in case of any future emergencies?
3) Presently patient is taking Cholecalciferol 60000 IU, one tablet, every 15 days. Is this ok?
4) About calcium, does this combination has better absorption than others at this age and health condition?
Tab. Ezorb Forte, "Calcium Aspartate Anhydrous 500 mg.
Calcium Orotate 500 mg.

Thank you very much and have a good day ahead.
doctor
Answered by Dr. Praveen Tayal 8 hours later
Brief Answer:
Details below.

Detailed Answer:
Hello.
Thanks for writing again.
1) K2 will not interfere with the drugs that she is taking now.
2) This usually does not interfere with any emergency situation. Just take the medication after putting it into your physician's knowledge.
3) Regarding cholecalciferol, it is best to get her Vitamin D3 levels checked and then get the dosage adjusted accordingly.
4) The calcium you have mentioned has a good absorption but for better results she can start with coral calcium like Corcium C.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Praveen Tayal 0 minute later
Brief Answer:
Details below.

Detailed Answer:
Hello.
Thanks for writing again.
1) K2 will not interfere with the drugs that she is taking now.
2) This usually does not interfere with any emergency situation. Just take the medication after putting it into your physician's knowledge.
3) Regarding cholecalciferol, it is best to get her Vitamin D3 levels checked and then get the dosage adjusted accordingly.
4) The calcium you have mentioned has a good absorption but for better results she can start with coral calcium like Corcium C.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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