HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
159 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

What Causes Morning Palpitations And Fatigue?

I am 42 Year Old (weight: 84kg, Height: 5.11) having symptoms of morning palpitations, fatigue, lack of interest and unease in prolonged standing and walking from last some years. I am slightly overweight with fatty liver and abdomen fat deposits with low HDL and slightly high TG and LDL and i am non diabetic and non smoker, with more or less sedentary stressful lifestyle and chronic habit of masturbation. I recently made following biochemical evaluations from SRL Ranbaxy: Cortisol Serum= 4.81 ug/dl Prolactin= 6.6 ng/ml Testosterone = 180.94 ng/dl VIT D3= 24.44 ng/dl Bone Density= T= -1.7 (Osteopenia) and normal PTH, TSH and Calcium Phosphorus. Since symptoms are psychologically and physiologically significant, I would like to have your valuable medical advice as: 1. Is there any relationship between low Vitamin D3 and Testosterone 2. I have been taking 10 mg Propranolol with Alprozolam (1/2 0.25 mg) from last 8 years does it affect the above functions/ symptoms 3. is it hypopituitarism and necessarily needs any MRI evaluation Kindly provide your conclusions about above mentioned ailments.
Thu, 4 Sep 2014
Report Abuse
Internal Medicine Specialist,  's  Response
Hi,

Thank you for your query. I can understand your concerns.






1.The testicles have receptors for vitamin D, suggesting that this vitamin plays some role there.Avg. Adult Male T(Testosterone) Level 270-1,070ng/dL.The reference range of the total 25(OH)D level is 20-100 ng/mL. 10-25 ng/mL=mild to moderate vitamin 25(OH)D deficiency.
Vitamin D may modestly alter testosterone levels in males. Vitamin D supplementation results in relatively small but statistically significant increases in testosterone
2.Propranolol & chronic alprazolam treatment does not affect testosterone levels.
3. Fatigue, lack of interest and unease in prolonged standing and walking for 3 years may occur due to hypopituitarism.Hypopituitarism may develop insidiously.Take the blood pressure, lying and standing, to test for postural hypotension (cortisol deficiency secondary to ACTH deficiency). You have also low serum cortisol,low prolactin & low testosterone level. .To exclude hypopituitarism,measure basal levels of serum T4,TSH, estradiol, testerone,FSH,LH, prolactin,cortisol,glucose,GH. and subsequently triple stimulation tests.
MRI of the brain-the imaging technique with highest resolution will be the next step of investigation,if biochemical diagnosis of pituitary insufficiency is made .


Regards

Dr. T.K. Biswas M.D.
Mumbai
I find this answer helpful
Note: For further follow up on related General & Family Physician Click here.
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
 

Related questions you may be interested in


Recent questions on MRI


Loading Online Doctors....
What Causes Morning Palpitations And Fatigue?

Hi, Thank you for your query. I can understand your concerns. 1.The testicles have receptors for vitamin D, suggesting that this vitamin plays some role there.Avg. Adult Male T(Testosterone) Level 270-1,070ng/dL.The reference range of the total 25(OH)D level is 20-100 ng/mL. 10-25 ng/mL=mild to moderate vitamin 25(OH)D deficiency. Vitamin D may modestly alter testosterone levels in males. Vitamin D supplementation results in relatively small but statistically significant increases in testosterone 2.Propranolol & chronic alprazolam treatment does not affect testosterone levels. 3. Fatigue, lack of interest and unease in prolonged standing and walking for 3 years may occur due to hypopituitarism.Hypopituitarism may develop insidiously.Take the blood pressure, lying and standing, to test for postural hypotension (cortisol deficiency secondary to ACTH deficiency). You have also low serum cortisol,low prolactin & low testosterone level. .To exclude hypopituitarism,measure basal levels of serum T4,TSH, estradiol, testerone,FSH,LH, prolactin,cortisol,glucose,GH. and subsequently triple stimulation tests. MRI of the brain-the imaging technique with highest resolution will be the next step of investigation,if biochemical diagnosis of pituitary insufficiency is made . Regards Dr. T.K. Biswas M.D. Mumbai