Brief Answer:
Peripheral arterial disease

Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

Your symptoms indicate Intermittent claudication. This is most commonly (but not only) associated with compromised blood circulation in the legs (peripheral arterial disease - atherosclerosis)

Would you please clarify a few things for me?
1) do you smoke?
2)what is your height and weight?
3) any family history of heart disease, peripheral arterial disease, peripheral neuropathy, diabetes, hypertension?
4)any history of of back pain, Injury or surgery to the spine?
5)any discoloration over your lower legs/feet? Are your feet warm? Any numbness/tingling of legs /feet?
6)you mentioned an ultrasound of the legs? Was it a doppler study? Did it rule out arterial or venous disease?

My recommendation :
- a doppler study/angiography of your legs to check for narrowed blood vessels.
-an x-ray /MRI of your spine if spinal stenosis is suspected (based on the clinical findings)
- check blood homocysteine levels if atherosclerosis is detected.
- an electromyelogram, if indicated (the above are negative/normal) to check for local damage of nerves.

To address your concerns.,
Your blood levels of FE and vit b,although reduced, are still within the normal range and I don't think this has a direct effect on your symptoms.
It could however, reflect a malnutrition state or inflammatory process (due to smoking, alcohol, for instance) that could, over the long run , cause these symptoms.

Please consult a physician at the earliest to rule out above possibilities.
In the meantime, if you have chest pain, giddiness,any breathing difficulty, unexplained sweating, severe leg pain even at rest, cold,numb feet, difficulty walking, please go to the emergency right away
Hope I've been helpful and that you feel better,
Please let me know if there is anything else I can help you with.
Regards,
Dr. Shuba Hariprasad

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Brief Answer:
Please avoid strain till diagnosis is made to prevent worsening

Detailed Answer:
Hello,
Thank you for the follow up

I've gone through your reports. It mentions examination of your leg only and no mention of veins.
It says no ultrasound evidence of ischemic.

Few more clarifications please:
-Do you have pain only on the left calf?
-is the pain restricted only to your calf or is felt in the shin as well? Do you have pain just above your heel on the back of your leg?
- what kind of vehicle do you use to commute? If it is a bike, which leg do you put your weight on when it is stationary?
-is the pain present even at rest? Worsening when you walk?

I recommend :
-an ankle-brachial index test (ABI) . To check for exercise induced blood flow compromise. Doppler study of veins.
- avoiding anything that worsens the pain.
-Achilles tendinitis can cause similar symptoms and needs to be ruled out.
This condition can be diagnosed clinically by observing you while you stand on the ball of your feet and examining range of motion. X-ray /MRI will help to confirm diagnosis & check severity.

Please consult and orthopedic Doctor to check for Bone or tendon related injury.
If that is ruled out,I suggest a doppler to rule on venous disease and an ABI test.

Hope I've answered your query and have been helpful.
Please let me know if there is anything else I can help you with.

Wish you good health.
Regards,
Dr. Shuba Hariprasad

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