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Dr. Andrew Rynne

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Treated for asthma. Medical test done. Started hair fall and pain in forearm. Should I be concerned?

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Dr. Chakravarthy Mazumdar

General & Family Physician

Practicing since :2004

Answered : 1778 Questions

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Posted on Thu, 14 Feb 2013 in Asthma and Allergy
Question: I have been sick for about 1 year now. I have COPD/Asthma and have been hospitalized 3 different times totaling 5 weeks last year. I went to see an endocrinologist this XXXXXXX and here are some of the lab result I just received today. Protien Urine 24 H is 165, ALT is 55, Glucose is 115 and XXXXXXX screen is Positive with Vitamin D, 25-OH total is 19. Dr says not to worry about anything. I initially went to him because my thyroid is very swollen and I have a lump to the left of it that is painful. I have to follow up with my primary tomorrow. Are there questions I should be asking him. I am also concerned with sores that are coming out on both of my forearms. They start with a horrible itching which I scratch until they bleed. The only relief I get is to pla ice on my arms to freeze them. My hair is also falling out and has been for about 2 to 3 months. It is very very thin now but according to my labs T4 is 4.9 Thyroglobulin Antibodies is 26, and Rheumatoid Factor is <7. Also I am very exhausted due to lack of sleep, getting very depressed and am very stress about my son wanting to commit suicide. Please help.
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Answered by Dr. Chakravarthy Mazumdar 14 hours later
Hi,

I am surprised that no doctor picked your query for so long. When I read through it I could understand you have a multitude of conditions and is going to be complex to deal without understanding the complete history and the serial course of events. However you seem to have simple questions which have answers.

To simplify these were the queries that you currently have:
1) Were the lab values concerning?
2) How should you proceed further with the lump in the neck? How do you want your primary to deal with referrals?
3) What is the reason for the sores on the forearms?


My answers:
1) Lab values
24 hr Urine protein is slightly raised but could be due to medication and complex of medical conditions. This is not 100% concerning.
25OH VitD3 - This is low and needs to address after finding the root cause along with supplementing with Vit D and Calcium supplements. Ask you primary physician for the correct dose of supplements. The new recommended daily allowance (RDA) of VitD3 for your age is at least 600 IU daily. Hence need supplementation of at least 1000 IU per day.
AntiThyroglobulin Antibodies are not concerning. They are within reference range.
All else are normal range.

2) It would have been better if you do Serum TSH levels as well. For now it is better to get a referral to a surgeon / endocrine surgeon to deal with thyroid lump. They are the right experts.

Your primary should be cautious about the multiple pills and understand their interactions. He should frequently call you to change the doses and stop the pills that are not required. Sertraline, Pravastatin, Advair all three of them are mutually interactive. Benadryl has an addiction potential.

In addition your primary should be able to ascertain the reason for sores on the forearm and can treat them. Immediately we should stop the itch and scratch cycle with a good antihistamine like Cetrizine. The more you scratch the bad it bleeds and gives way for secondary infection. I still recommend an antibiotic therapy for your problem. A soothing application and cutting the nails short. If cold packs help your sores it can be done.

I know you are dealing harder problems both personally and family members. They should not last long. Every problem has right experts to deal with. You just need some emotional support. I will be with you for any such kind of support.

Let me address any other concerns in your next mail.
Above answer was peer-reviewed by : Dr. Aparna Kohli
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Follow up: Dr. Chakravarthy Mazumdar 2 days later
why is it when I respond and submit the message only states that it is saved? Why can't I get the message to you?
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Answered by Dr. Chakravarthy Mazumdar 8 hours later
I am able to read what you had typed here. There seems no problem in writing and submitting your follow up. Keep replying to me. I am there to assist you further.
Above answer was peer-reviewed by : Dr. Aparna Kohli
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