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What causes fluid retention in legs with inflammation and itching?

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Answered by

General & Family Physician
Practicing since : 2009
Answered : 674 Questions
Hi. I have a problem with water. I seem to need to drink quite a lot of it, but I've been told I need to drink less, because I get low in sodium. Presumably other essential nutrients are getting washed out too. But if i eat sodium rich foods, i get very thirsty I also retain fluid in the lower legs. If I use diuretics, or consume diuretic foods, I get dehydrated and need water. I tend to have bad circulation, to extremities, and this might be a cause of fluid retention. . I also get inflammation and itching on the lower legs, and arms, which perhaps suggests acidity. My digestive system is fragile, and bowel movement is sluggish. I seem to have no muscle peristalsis, and use herbal laxative I'm hoping that someone might be able to shed some new light on all this which might point to a better understanding of my body.
Posted Mon, 24 Mar 2014 in Kidney Conditions
Answered by Dr. Yogesh D 20 minutes later
Brief Answer: Balance sodium intake and water consumption. Detailed Answer: Hello Ms XXXXXXX Thanks for posting your query. I have gone through your query carefully and understand your frustration. From your description, it seems like you might be having a kidney condition that fails to filter the water/sodium properly at times. There are many causes for this condition including but not limited to Addison's disease Cirrhosis of the liver Nephrotic syndrome Glucocorticoid (steroid) deficiency Diuretic use Hypothyroidism SIADH etc., You need to consult a Kidney specialist (Nephrologist) to rule out each of these issues by undergoing a complete investigation, it will take time to correctly diagnose the issue, once diagnosed, it can be treated adequately. Your use of herbal laxatives could also be a reason for this and you should instead switch a Methylcellulose or liquid paraffin containing laxatives. Please do consult a nephrologist for further evaluation. I hope this answers your query, you are welcome to ask me if you have any doubts. Regards.
Above answer was peer-reviewed by
Follow-up: What causes fluid retention in legs with inflammation and itching? 21 hours later
Thanks Dr XXXXXXX I had another online analyst report done on a lengthy questionaire which I submitted and it came up with these concerns So I will take into account the possibility of hypothyroidism, type 2 diabetes, kidney disease and liver imbalance and treat them with lifestyle and diet changes. Stress is an issue for me. My question to you now, relates to your brief answer, to balance sodium and water intake. What kind of healthy sodium rich foods would you recommend that dont make me too thirsty? I eat seaweed products like nori and spirulina, and also chlorella. I try to avoid heavily processed foods, and drink mineral water rather than chlorinated tap water as much as possible. How much water per day would you recommend? Many thanks XXXXXXX
Answered by Dr. Yogesh D 42 minutes later
Brief Answer: Normal Sodium level is between 135-145 mEq/L Detailed Answer: Hello Ms XXXXXXX Thank you very much for writing back with additional details. I have gone through that exhaustive report which you linked. I would again like to stress here, you do need a complete evaluation, and you do need to get investigated to find the exact cause. In my practice I would advice my patients to do these tests.. 1. Liver function tests, 2. Kidney function tests, 3. Echocardiography, 4. Abdominal ultrasound scan, 5. Urine routine and creatinine clearance test, 6. Blood glucose levels, 7. Hormone assay of Antiduretic hormone, 9. MRI of the brain to rule out any pituitary or hypothalamus issue. These investigations will identify the underlying cause correctly and will guide in deciding further investigations or treatment. Now to answer you question, The normal sodium level in the blood should be between 135-145 mMol/L(mEq/Liter). Our body has very good adaptive mechanisms to conserve or remove sodium depending on how much of it is present in the blood, this is achieved by the kidney which makes urine more concentrated if there is more sodium and less concentrated if there is less sodium in the blood. I suspect this mechanism is not working well in your case, hence I urge you to get a complete evaluation done. Generally, adults require about 4 to 5 grams of added salt in a day (Total amount of salt that is added in all the meals, drinks while preparing them). In your case we do not know how much you need, so we do need to find out by doing the blood and urine tests. On an average, an adult human being requires about 2 liters of water in a day, if it is winter then the requirement will be slightly less (Around 1 to 1.5 liters) and if it is summer then it will be slightly more (About 3 liters). You do not need to consume more than this amount. I do not recommend any sodium rich foods at this point as your status is not known, please do get back to me with all the reports if you want to know that. I again urge you to consult a nephrologist(Kidney specialist) as soon as possible. Hope this answers your question. Wishing you good health. Kind regards
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Follow-up: What causes fluid retention in legs with inflammation and itching? 28 hours later
Ok, thanks Dr XXXXXXX I will go back to the doctor and look into these tests. I did have some general blood tests recently, which showed low sodium chloride and bicarbonate (127), also low urea, uric acid and creatinine. Which suggests that kidney mechanism may not be functioning properly as you suggested. Yesterday I went to a naturopathic chemist and she gave me salt tablets. She said they should regulate the balance and help correct the problem. After two weeks I will have another blood test done for sodium. I am also iron and protein deficient, have decided to try eating a little fish in my diet, which is currently vegan. My liver function in the recent tests appeared to be normal, however I will have further more detailed tests done as you recommend, and the ultra sound.Blood sugar also appears to be normal, as does cholesterol Thanks again I will get back to you soon as I feel you are a good doctor with perhaps more knowledge than mine Regards XXXXXXX
Answered by Dr. Yogesh D 3 days later
Brief Answer: Please do go ahead with the tests. Detailed Answer: Hello Mrs XXXXXXX Thanks for writing back with further details and updating me with your plan to go ahead with the tests. I apologize for the delay in responding to this followup. Yes, considering the new information you provided, I do suspect some kidney involvement, hence it is prudent to get these tests done so as to find the root cause of the problem. Once the condition is diagnosed properly, the treatment can be decided and tailored to your needs. I would suggest you to go ahead with introducing fish in your diet as fish are good sources of vitamins and proteins, which you do require. Please do write back and update me about the progress you are making so that I can help you further. Thanks again for using the service, it is my pleasure to help in your need. Take care. Best regards.
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