Question: Hi,

I'd be very happy for any sort of help. The thing that bothers me now is the persistent thirst and the bulging vein issues that seem to develop, maybe due to the thirst (more below). Here's some of the story. It's all very confusing and I keep on trying too many things to fix it, but don't know exactly what's important and what not.

Male, 35, 187cm, 73kg.

I've been eating a paleo type of diet (low carb) until 2 years ago, then switched to higher fruit and more dairy.

About 1 year ago, I started having some muscle pain/stiffness in my hands and legs, twitching, especially when it gets cold. It came during a period of stress, training, fasting (lost almost 10kg then), and too little sleep. I've been trying to stop the fasting after that and regained my weight.

3 months ago I started a baby aspirin after doc found borderline EKG and elevated creatine kinase (I've been weight training). I also started fasting a bit (lost 8 kg over the past 3 months), taking a lot of vit C (3-5g), magnesium (500-800mg), and drinking orange/lemon juice with some baking soda daily.
After 3-4 weeks on this my pulse and blood pressure got much lower.

Then suddenly I started having hot stabbing pains in my chest and back and blood pressure would go up quickly if I moved too much. ER didn't find anything on blood tests. 1 week later, I developed kidney pain, and then I started waking up with my heart skipping beats that would get a bit better after I had something to drink.

I stopped aspiring and kidney pain went away, though still heart skipping beats. 2 weeks later I resumed aspirin, but kidney pain came back with a vengence after 1-2 days, heart beat problems got worse and I started feeling like I was on a rocking boat while walking and standing up. I stopped the aspirin and kidney pain got better after 1 week. I had a blood test 1 week later and two things were off:
- CK slightly elevated
- ammonia elevated (85.3 umol/L (16-60))

At the same time I've been developing excessive thirst (had it for 1.5 months now). I have to get up several times at night to drink. It got a bit better after I once drank a lot of salt water. But after some days it got worse again. It gets much worse when I eat fruits and potatos (maybe it's the potassium).

On top of this, probably because of the thirst, my veins in my legs, feet, arms and hands have been getting bigger, bulging more and sometimes hurt after I eat a big meal, especially with carbs. The worst is with fruits/honey. Then my joints also get puffy. I tried it 2-3 times and every time I made it worse. It's like I'm getting varicose veins quickly. I think it's related to this thirst. Must be bood volume that is low or something. Heart beats better after I drink something, but the water doesn't stay much in me unless I add more salt to it.

I took some blood samples again 3 weeks ago. This is what I notice (there are more values):
- slightly elevated CK
- elevated total and direct billirubin

- Ammonia has come down.
- Calcium was 10.24 mg/dl (8.6-10.3), so close to XXXXXXX Anything there?
- total carnitine: 31 umol/l (30-70) - though Google says it could be a bit low
- free carnitine: 26 umol/l (20-55) - free/total ratio = 0.84 & Google says it should be bellow 0.4?

Given that I often feel thirsty and dehydrated maybe some of the values are slightly too high? It took the nurse a bit to get the blood flowing.

Regards,
XXXX

A few more things I forgot:

A cardiologist said I have slight hypertrophy of my left ventricle and moderate aortic insufficiency. One of the valves has a slightly thickened edge. Maybe from something I had a long time ago. But the cardio didn't think all these thirst and chest stabbing issue has anything to do with my heart. I'm awaiting a heart function MRI in a month.

I've had a general MRI and they found a narrowing of the superior mesenteric vein. It looked like it's squeezed by some surrounding adipose tissue. I've had some upper right abdomen pain/pressure sometimes over the past 3 years, and more recently.
My doc thinks it's just a chance find, so I don't know if it's related.

I've also been taking some vitamin K2 on and off that was supposed to help with reversing any calcification (I got nervous after they found the borderline EKG so I tried to do everything right).

I'm thinking probably the aspirin did something or/and my high vit C, Mg, bicarbonate contributed. I'm not taking any of these anymore, but somehow things got stuck in this thirst state.

Ps. A bit more info on the salt part.

I'm not sure about the NaCl water as I haven't tried it more than once (3 weeks ago). So I don't know if my Na or Cl or something is low now that I'm more thirsty again, or if it's something else that's low or too high.

The blood sample results I uploaded (taken 3 weeks ago), were taken about 1 week after I had tried to consume more salt. So 1 week before the blood test I ate/drank about 12g NaCl in a day and was able to sleep 6 hours without waking up. I also drank more soda to get calories from something without too much potassium. Then the following days I consumed about 2-3g and slowly gotten a bit more thirsty again. Now the past 2 weeks I've tried to just eat normal amounts (my doc said so) and gotten more and more thirsty. I again wake up every 2 hours to drink, and often I just keep feeling thirsty even after I drink (~250 ml). During a day I drink around 3 liters, so it's not that I'm overdrinking.

I also got my blood sugar measured 4 weeks ago and it was normal. So probably not diabetes.

Hi, thank you for the answer. I just want to ask a few more questions, and hope it's not too much.

I talked to my doctor today, and she said that she doesn't want do the ADH and osmolality tests because I don't urinate a lot and she doesn't think it's it. I might go to a private clinic in a week to do it if I don't get help before and nothing crazy happens til then.

I have a feeling that the varicose/swollen veins that are developing on both my arms are related. They're only clearly visible when it's warmer or after I eat - it's very clear and my hands and feet feel swollen also and the skin on them feels like being stung by small needles. They've been gradually getting worse over the past 3 weeks.

I also still often have a feeling like there is something stuck in my chest/throat.

I've attached some photos of my arms now, if you could have a quick look at them (back.JPG). I really don't think it's ok, especially because it just developed, and I never had them so deformed/uneven and large. My parents also say it looks strange and are nervous.

When they found the abnormal EKG and elevated CK 4 months ago, the docs gave me some blod thinner combo for 3 days including some aspirins and some injection and a few other pills. I started feeling a slight stabbing in my chest on the third day, but my CK had gone down and they said it probably was nothing but I should continue with the baby aspirin.

Could I have some clot somewhere or something that slows my bloodflow, perhaps something in my chest, but doesn't show up on regular blood samples? This is just something I found by Googling "varicose veins in amrs". Could something like that cause excess thirst too? Or something with the kidneys that doesn't show up? Could the ADH problems also cause that?

Another thing: Is vitamin K2 a bad idea? Could that cause some clotting somewhere? But then some of the clotting tests would show that I think - the D-dimer one maybe.

Actually, 1.5 months ago, I went blind in my lower right eye for 5 minutes. It was like completely grey. Then the vision came back. I thought it was a blod clot, but it's difficult to convince the doc about it given that there's nothing there anymore.

Thank you very much for your time.

Regards,
XXXX

The attachments:

front.jpg = front lower arms
back.jpg = back lower arms and hands

Ps. Would a pulmonary embolism show up on an MRI without contrast?

When I am in a state where I have the stabbing feeling and thirst, I also get out of breath quickly. My blood pressure rises very quickly from just climbing some stairs or doing a few squats. But I do have some periods where I do feel better, so I don't know...
Again, any ideas would be appreciated.

Thank you.

It's not only in my arms, but I've also gotten swollen veins in my feet and also the veins on their surface get painful when they swell up after a meal - especially a carb meal.

Hi. Thank you for the answer.

I'll tell my doctor next time (in a few days).

Can the thrombosis be a possibility even with my INR, PT and D-dimer values on my Test01 attachment? They are not marked as being wrong.

Can diet affect this? I've noticed that whenever I quit drinking milk, and eat a lot of carbs instead, my veins swell more easily and the thirst gets worse. I didn't use to have this kind of reaction 4 months ago. I used to drink 1-2 liters of milk for a while and then stopped suddenly. Can a sudden drop in calcium in the diet cause vein probelms?

I also don't move much during the day at work. I sit a lot, so it could affect things.

Thanks,
XXXX

Ok. Thank you for your help. I'm going to a lab to get a blood test now and will try to see if I can book time for a dopler.

Still waiting. It might take a week.

A doctor said it might be due to heart insufficiency. Left side was slightly hypertrophied. Will have it checked again today. Its strange that my heart was of normal size in XXXXXXX with discrete/mild insufficiency. Then in August When the symptoms started it was hypertrophied with moderate hypertrophy (sifferent private cardio) then I ate less cabs and drank a lot of goat milk and 1 month later it was normal sized again. Will tell the private cardio today about my changing heart size and if it could be due to my diet?

I did an echo of my legs and arms and the doctor couldn't see anything.

While waiting for the clotting blood tests, I want to ask, could it be that it is some bacteria or fungus, that does not show up on a standard test, that get activated only when I eat sugar/carbs? Just a thought, because the cardiologist found a 5mm thickening of one of the aortic valves. He said that it doesn't look like there are bacteria on it on the echo, and that it could be something I had when I was younger. He also said that there's only a mild insufficiency, which should give no problems.
So I'm thinking if there are some bacteria anyway, then they could be damaging the vein valves? Just theorizing without being a doctor.

Thank you again,
XXXX