Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
152 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

Suffering From Thyroid. Pain In Back, Knee, Swelling In Legs, Increased Levels Of ESR, Blood Sugar. Suggestions?

Hi Doctor, My Mother is suffering with thyroid past 4 years, her age is 43,weight 97KG, height 5.3 feet. Below i am attaching test report s and detail medicine which my mother is using daily. We came to know ESR , C reactive protein and RBS random blood sugar level is too high. please assist, how to reduce ESR AND SUGAR LEVEL, And also she is suffering with full muscle pain like, lower back, legs & knee, and stomach, legs and hand are swelling gradually. please guide how to get out from this situation,reduce pain and what are diet need to follow? is any permanent surgery are available for thyroid.? Below are the medicine, which doctor recommended to use, please let us know is below are the right medicines? using these many medicines daily will cause any side effects, like kidney problems, or any etc.. ? Medicine, which doctor recommended to use, please let us know is below are the right medicines? using these many medicines daily will cause any side effects, like kidney problems, or any etc.. ? TEST RESULTS:- HORMONAL ASSAY :- FT4 - 1.43 ng/dl TSH - 1.58 uIu/mL CLINICAL BIOCHEMISTRY:- Random Blood Sugar- 256 mg/dl Alkaline Phosphatase - 133 IU/mL Calcium - 8.5 mg/dl Phosphorus - 2.9 mg/dl C-Rective Protein - 10.4 mg/dl HAEMATOLOGY:- WBC count - 0000 cells/ ul RBC count - 5.13 Million /ul Hemoglobin - 14.5 g/dl Hematocrit - 47.1% MCV - 91.8 fl MCH - 28.3 pg MCHC - 30.8 g/dl platelet count - 3.47 lackhs/ul lymphocytes % - 26.9% Mixed cells % - 5.6% neutrophils - 67.5% ESR - 100 mm/1st hr MEDICINES:- Below are the medicine, which doctor recommended to use, please let us know is below are the right medicines? using these many medicines daily will cause any side effects, like kidney problems, or any etc.. ? Naprosyn 250 Galvus Met 50mg/500mg Deevit Soft Gels Foligem Folitrax 5MB Tab Rabisure-d Glycoment GP 0.5mg Thyronorm 100MG defcort 6mb D-power sachet Thanks Ameer
Sat, 25 Jan 2020
Report Abuse
Internal Medicine Specialist 's  Response
Hello,

She need to reduce weight, screen for autoimmune diseases as she is already on methotrexate. I would like to know why she is on methotrexate and folic acid? ESR is raised as her problem which you haven’t named as uncontrolled (for which she is taking methotrexate and folic acid). C reactive protein is raised due to a mild infection in her body and RBS random blood sugar level is too high secondary to steroids, mild infection and obesity. To reduce ESR increase dose of methotrexate to 7.5mg once a week AND to reduce SUGAR LEVELs, start metformin 500mg (if renal functions are normal) at noon and at night. Check her Echocardiography and renal function tests. Full muscle pain is related to the same problem as that which is causing body swelling and stomach pain is due to naproxen sodium and a lot of drugs. Legs and hand swelling can be cardiac (echocardiography test), nephrogenic (renal function test for kidney) or under-treated thyroid.(not in this case). She should follow diet of avoiding sweet bakery products and normal sugar and others rich in carbohydrates. Surgery will worsen the situation as it will further reduce thyroxin produced naturally. Medicines you are using are the right medicines. thyroid profile is normal. Sugar is raised, Alkaline Phosphatase is normal, Calcium - normal, Phosphorus -normal, C-Rective Protein – mild high, WBC count - 0000 cells/ul (wrong entry ? zero. if zero its very serious), RBC count - normal, Hemoglobin - normal, Hematocrit - normal, MCV – a bit high (need to check levels of folate and vitamin b12), MCH -normal MCHC - platelet count, and differential cell counts are normal ESR – very high Naprosyn 250. It should not be used or minimally used as it causes damage to kidneys. (5 to 7 tablets a month at max)
Galvus Met 50mg/500mg should be increased to additional half tablet at night. (if renal functions are deranged), Deevit Soft Gels to be continued as such, Foligem is okay, Folitrax 5MB. (methottrexate) Why this tablet is she using? Tab Rabisure-d containing rabeprazole. Is okay to be used for stomach safety. Glycoment GP 0.5mg glymepride is for sugar control and need to continue.
Thyronorm 100MG for throid and a must to continue.
Defcort 6mb steroid. Should be slowly tapered off to a minimum as early as possible (another cause of swelling on feet).
D-power sachet vitamin D. Should be used for 2 months and thereafter according to advise of specialist.
Defcort and naproxen shouldn’t be used for a long time.
Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Muhammad Faisal Bacha, Internal Medicine Specialist
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer. For a more detailed, immediate answer, try our premium service [Sample answer]
Share on
 

Recent questions on Hematocrit


Suffering From Thyroid. Pain In Back, Knee, Swelling In Legs, Increased Levels Of ESR, Blood Sugar. Suggestions?

Hello, She need to reduce weight, screen for autoimmune diseases as she is already on methotrexate. I would like to know why she is on methotrexate and folic acid? ESR is raised as her problem which you haven’t named as uncontrolled (for which she is taking methotrexate and folic acid). C reactive protein is raised due to a mild infection in her body and RBS random blood sugar level is too high secondary to steroids, mild infection and obesity. To reduce ESR increase dose of methotrexate to 7.5mg once a week AND to reduce SUGAR LEVELs, start metformin 500mg (if renal functions are normal) at noon and at night. Check her Echocardiography and renal function tests. Full muscle pain is related to the same problem as that which is causing body swelling and stomach pain is due to naproxen sodium and a lot of drugs. Legs and hand swelling can be cardiac (echocardiography test), nephrogenic (renal function test for kidney) or under-treated thyroid.(not in this case). She should follow diet of avoiding sweet bakery products and normal sugar and others rich in carbohydrates. Surgery will worsen the situation as it will further reduce thyroxin produced naturally. Medicines you are using are the right medicines. thyroid profile is normal. Sugar is raised, Alkaline Phosphatase is normal, Calcium - normal, Phosphorus -normal, C-Rective Protein – mild high, WBC count - 0000 cells/ul (wrong entry ? zero. if zero its very serious), RBC count - normal, Hemoglobin - normal, Hematocrit - normal, MCV – a bit high (need to check levels of folate and vitamin b12), MCH -normal MCHC - platelet count, and differential cell counts are normal ESR – very high Naprosyn 250. It should not be used or minimally used as it causes damage to kidneys. (5 to 7 tablets a month at max) Galvus Met 50mg/500mg should be increased to additional half tablet at night. (if renal functions are deranged), Deevit Soft Gels to be continued as such, Foligem is okay, Folitrax 5MB. (methottrexate) Why this tablet is she using? Tab Rabisure-d containing rabeprazole. Is okay to be used for stomach safety. Glycoment GP 0.5mg glymepride is for sugar control and need to continue. Thyronorm 100MG for throid and a must to continue. Defcort 6mb steroid. Should be slowly tapered off to a minimum as early as possible (another cause of swelling on feet). D-power sachet vitamin D. Should be used for 2 months and thereafter according to advise of specialist. Defcort and naproxen shouldn’t be used for a long time. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Muhammad Faisal Bacha, Internal Medicine Specialist