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Anemia with possible metabolic myopathy.

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Sir,
i am 25 years old and a gym enthusiast. i had a ACL tear in my left knee two years back, but after 4 months of rest i returned to my routine. From the last 1 year i have started to feel joint pains, weakness and joints feel very fragile. I got a vitamin D test done, 3 months back, in which Vitamin D came out to be 13 ng/ml. I started a 60000 IU (once a week) dose followed by 1000 IU (daily) maintenance dosage. When i got it done again recently,Vitamin D came out to be 117 ng/ml. My questions are:-

1. Has vitamin D deficiency been cured?? or the levels came high because i was on supplementation?

2. I still feel the same weakness. My stamina has dropped down very very low. Is it because of the deficiency?and how can it be cured now?

3. I cant even throw a ball hard, my elbow and shoulder joints hurt. is it the same reason?.

4. I am not able to run now more than 200 mtrs now, whereas earlier i could easily run 4 kms. I start to feel intense lactic acid build up in legs and intense breathing (fatigue).

Please help sir, as i am unable to get the desired answers from anyone.

Regards

Category: Internal Medicine Specialist

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Category: HIV- AIDS Specialist
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Hello,

Thanks for your question at DoctorSpring.com.

Have you considered another possible reason for your joint pains and fatigue? The reason why I ask is that your Vitamin D levels seem to be up and normal but you are still experiencing symptoms. Here is what I suggest:

1. Get a full blood profile done including red blood cells, white blood cells, and platelets. This will reveal whether or not you have anemia or any platelet abnormality.
2. Consider the possibility of a metabolic myopathy. This is a defect in the metabolic pathway and can interfere with ATP (energy) production causing pain and cramping in muscles and joints and easy fatigue after and during exercise.
3. To diagnose you may require clinical examination, graded exercise tests, and a muscle biopsy.

This might give you a different approach to your illness and help you arrive at a diagnosis and/or solution sooner.

I hope this helps. Please ask any follow up questions, if any. Take care.


Patient replied :

Dear Sir,
Thank you for your response.

1. I have got the mentioned tests done, Please find the results attached.

2. With reference to your second point, kindly suggest what needs to be done. This may also be true because i do more short duration, high intensity exercises which rely primarily on ATP Stores.

3. With reference to your third point, kindly suggest which speciality (Doctor), should be consulted.

Regards


Your blood tests do not show any significant abnormality. There is no anemia as your counts and hemoglobin levels appear normal. You can continue to do further testing if you feel that this could be an issue related to metabolism as I suggested. Make an appointment with your local general medicine practitioner or a sports medicine specialist and discuss with him further testing you can do to support this. There is a blood test for serum creatinine kinase that is available, and also exercise testing (for lactic acid levels in the blood during exercise) can be done. In the meantime, work closely with a physiotherapist in doing exercises and routines to help you get back to your comfortable level of fitness.

Take care.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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