Question: I was having Vitamin D Low that was found 35 days back by the Blood Test.
I had taken 2 Arachitol 6Lac Injections.and 3 tablets of Uprise 60000 in last 35 days.
After the Medication , now I am not able to climb stairs , not able to walk fast and walks slowly.
Along with the Vitamin D medicines , I had not taken any calcium during this period.

Request to Kindly please advise the medication that can help me to walk properly and have proper Calcium and Vitamin D .
First Arachitol 6Lac Injection was taken on 21 XXXXXXX 2014. After one week I took first Uprise 60000 without calcium. After another week I took one more Uprise 60000 and their was no calcium supplement taken. I was then not able to walk properly and climb stairs.
After a week a took the third Uprise 60000 and still their was no calcium supplement taken.
I then took the second Arachitol Injection on 16 July 2014.
Still not able to walk fast and climb stairs.

Please advise the right dose of calcium and Vitamin D.
Please advise the treatment for this.
Please suggest the component of Blood for checking the Vitamin D Toxicity , Vitamin D and Calcium level.

Hi,

Thanks for the advise.

Please advise that when should be the serum calcium, serum albumin and 25 (OH)D test be done ( Before / After food).

I had also taken one Vitamin B12 Injection before 2 weeks.

Also please advise if other tests like CBC, Thyroid ,B12 is required.


Thanks and Regards,
XXXX

Hi,
Thanks for the advise.
I had already taken Vitamin D in this month. kindly advise that should I take calcimax forte 500mg as it is having Vitamin D although less.

Also I had taken one B12 Injection ( Nervup), so can I take B12 tablets.

Best Regards,
XXXX

Hi,

Please advise if Calcium with Vitamin D is good for me then I would take that and if you advise that Calcium with other preparation is good for me that I would take that.

Please Suggest again on the recommended medicine / brand name good for me.

Thanks and Regards,
XXXX

Hi,

I had got the blood Report with below result found.

ESR :
End of 1st hour : 35
End of 2nd hour : 75

Vitamin D : 35.21
Intact Parathyroid Hormore (iPTH) : 6.5
Calcium : 9.0
Vitamin B12 : 544
Anti CYCLIC CITRULLINATED PEPTIDE ANTIBODY : 0.15
BLOOD FOR C REACTIVE PROTEINS <6 ( Negative)
R A FACTOR 4.0 ( Negative)

Please advise on this and next step.

Please advise on the mediation / treatment .

I am having the same symptoms as updated before.

Additional symptoms
Feels something is stuck in stuck.
pain on back side and down of ear on the neck.
breathing cause pain feeling on the back side and down of ear on the neck but not always.
stomach ( feels like pulling down)
can not lift head while on the bed.
Vomiting feeling in the morning but can not vomit.

Kindly please advise.

Thanks,
XXXX

Hi,

I had got the blood Report with below result found.

ESR :
End of 1st hour : 35
End of 2nd hour : 75

Vitamin D : 35.21
Intact Parathyroid Hormone (iPTH) : 6.5
Calcium : 9.0
Vitamin B12 : 544
Anti CYCLIC CITRULLINATED PEPTIDE ANTIBODY : 0.15
BLOOD FOR C REACTIVE PROTEINS <6 ( Negative)
R A FACTOR 4.0 ( Negative)

Please advise on this and next step.

Please advise on the mediation / treatment .

I am having the same symptoms as updated before.
( Can not climb single stair , can not stand for more than 15 minutes at a place, slow walking, jaw and tong movement restricted, chewing difficulty, neck movement somewhat restricted...weight 39.9)

Additional symptoms
Feels something is stuck in Neck.
pain on back side and down of ear on the neck.
Breathing cause pain feeling on the back side and down the ear on the neck but not always.
stomach ( feels like pulling down)
Can not lift head while on the bed.
Vomiting feeling in the morning but can not vomit.
Feels like Strength is very less in hands and leg.

Kindly please advise.

Thanks,
XXXX

Hi,

Please find below the report result.

BLOOD UREA 18
URIC ACID 3.9

ELECTROLYTES
CHLORIDE 104
POTASSIUM 4.80
SODIUM 139


LEVER FUNCTION TEST
TOTAL BILIRUBIN 0.6
DIRECT BILIRUBBIN 0.02
INDIRECT BILIRUBIN 0.58
SGPT 12
SGOT 14
ALKALINE PHOSPHATASE 62
TOTAL PROTEIN 6.3
ALBUMIN 3.6
GLOBULIN 2.7
A/G RATIO 1.3

RFT was partially done
CREATININE 0.90

Lipid Profile was left by the mistake as I was checking the prescription file from the other website that I received from you.

Also on the day of blood test I was feeling week and had taken
1/2 cup of tea with a small biscuit and after some time 1/2 glass
of coconut water.
Could it have a significant impact / any impact on the report.

Also I was on period (Fourth day) on the day of blood test.

Kindly please advise on the possible cause of low PTH and high ESR.


Blood report mentions in commented line that hypercalcemia generally displays low or high PTH. Kindly advise that is it Hypercalcemia.


Is their any possibility of further rise in the calcium level as the last VITAMIN D3 injection was taken just 12 days back.( I had not taken any calcium after the injection)


Also please advise on the possible impact of low PTH and high ESR.


Please advise the medication and the next step that I can take.


Thanks and Regards,
XXXX

Dear Ma'm,

Thanks for the advise.

Dexa scan was done before the second dose of Vitamin D3 injection. It was done on 07 / 07/2014.

DXA Bone Densitometry Report

BDM measured at A P Spine L1-L4 is 1.088 g/cm2 with a T-score of -0.8 is normal.
Fracture Risk is low.

BDM measured at Femur Neck Left is 0.906 g/cm2 with a T-score of -0.9 is normal.
Fracture Risk is low.

BDM measured at Femur Neck Right is 0.837 g/cm2 with a T-score of -1.4 is considered moderately low. Fracture Risk is moderate.
Treatment advised if there are other risk factors.

BDM measured at Femur Total Left is 0.990 g/cm2 with a T-score of -0.1 is normal.
Fracture Risk is low.

BDM measured at Femur Total Right is 0.905 g/cm2 with a T-score of -0.8 is normal.
Fracture Risk is low.


BDM measured at Forearm Radius 33% is 0.802 g/cm2 with a T-score of -1.0 is considered moderately low.
Fracture Risk is moderate. Treatment advised if there are other risk factors.


Site           Region Age Mached Z-score     Young Adult T score
AP Spine      L1-L4          -0.8               -.08
DualFemur      Neck Left      -0.8               -0.9
DualFemur      Neck Right -1.3               -1.4
DualFemur      total left      00               -0.1
DualFemur      total right      -0.7               -0.8
DualFemur      radius 33%     -1.0               -1.0

BDM mentioned above.


1) Blood report mentions in commented line that hypercalcemia generally displays low or high PTH. Please advise on the possible cause of low PTH and high ESR and is it related to Vitamins or is their possibility of hypercalcemia.

2) Is their any possibility of further rise in the calcium level as the last VITAMIN D3 injection was taken just 12 days back.( I had not taken any calcium after the injection)

3) Primary hypoparathyroidism is suspected . Request to kindly update the medication and root cause for this.


Please advise on the possible impact of low PTH and high ESR and advise the medication and the next step that I should take which could help me to recover health.


Thanks,
XXXX

Dear Ma'm, Hi

Thanks for the Advise.

ESR
No Coughing and had not undergone chest X - ray.
Signs of weight loss but not significant.
Current Weight : 39.5 kg
Weight before 35 days : 41 kg
Weight is not increasing although taking proper food.
Height : 162 cm.


Please advise on the food that I could take to improve the weight.

Please advise on the possible cause of high ESR and ways to find it.
Please advise on the medication and treatment for making it proper.


PTH
Please advise on the possible cause of low PTH and ways to find it and make it proper.
Please advise on the possible cause of somewhat restriction of neck/tong/jaw movement and restriction of leg movement (not able to climb a single stair) and strength reduction of body.

Can not lift the head when laying on the bed and difficult to turn on the bed.
Walks very slowly.
Kindly also suggest that is it related to PTH and ESR.

Thanks and Regards,
XXXX