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Suggest treatment for hot flashes, restless legs and itchy skin

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Posted on Wed, 15 Jun 2016
Question: I am never physically comfortable for more than a few minutes - either I have a hot flash, restless legs, post-shingles itching/pain, or simply become overheated. This doesn't change with exercise, changes in diet (within last 2 months changed eating habits, losing weight to prevent diabetes type 2 onset - successfully reduced a1c from 7 to 6.2). Shingles outbreak was late November, 2015 - zoster sine herpete upper left thigh. I have daily itching and/or pain (pain is not comparable to initial outbreak: I would give that a 9... This is more a 5). I prefer room temperatures in the 50s to low 60s which is unrealistic - most find that unappealing. The lack of ability to be comfortable even for short periods is impacting my mental state. I am irritable and can't relax. I am having trouble concentrating. My lifelong familial tremor (left hand) is worsening. The only relief that I have had is narcotic (1 vicodin), but that is problematic for all the obvious reasons and more. First, stronger narcotics make me ill, and even with Vicodin, I can only take it at night. For that matter only at night once every 10 days or so, or it doesn't work. So that's not practical unless I am willing to accept one decent night's sleep every 10 days. And, this isn't just a sleep issue. I have tried SSRI meds for the hot flashes. They don't work for me and they make me feel weird. I tried Gabapentin, which didn't help either. I am out of ideas. The restless legs symptom is recent (post shingles).
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Answered by Dr. Shehzad Topiwala (29 minutes later)
Brief Answer:
Vitamin D deficiency

Detailed Answer:
Sorry to note how you feel.

Your symptoms are indeed puzzling and I see you have already tried various medical options.

When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH
Free T4
25 hydroxy Vitamin D

None of these tests require any fasting and can be done at any time of the day.

I am glad you were able to lower your A1c back into the non-diabetic range.

Sometimes vitamin D deficiency can cause muscle cramps which may mimic restless legs. So it is important to test for that
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Suggest treatment for hot flashes, restless legs and itchy skin

Brief Answer: Vitamin D deficiency Detailed Answer: Sorry to note how you feel. Your symptoms are indeed puzzling and I see you have already tried various medical options. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination: CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts) Electrolytes (Sodium and Potassium in particular) HbA1c (Glycosylated Hemoglobin = your 3 month glucose average) Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase) Kidney function tests (BUN, Creatinine) TSH Free T4 25 hydroxy Vitamin D None of these tests require any fasting and can be done at any time of the day. I am glad you were able to lower your A1c back into the non-diabetic range. Sometimes vitamin D deficiency can cause muscle cramps which may mimic restless legs. So it is important to test for that