
I Have A Health Problem That Has Been Troubling Me

I suffer from vitamin D deficiency as well. i have attached blood analysis.
I also started to have old dental issues that i used to have. a cured abscess (about 2 years ago) started to increase under a tooth i have and caused swelling in my cheek, my dentist said it could be an immunity issue i am facing.

I suffer from vitamin D deficiency as well. i have attached blood analysis.
I also started to have old dental issues that i used to have. a cured abscess (about 2 years ago) started to increase under a tooth i have and caused swelling in my cheek, my dentist said it could be an immunity issue i am facing.


Vitamin D deficiency may cause your symptoms- treatment is needed
Detailed Answer:
Hello and welcome to "Ask a Doctor" service,
I carefully read your query and understand your concern.
I also checked the uploaded test report and noticed that there are minor and unsignificant changes in lipids and some liver tests but you had normal blood count and hormonal levels, thyroid included.
The only significant abnormality I noticed is low vitamin D levels (deficiency).
Vitamin D deficiency may cause most of your symptoms as it favors infections and may affect the mood and cause depression, which may represent with fatigue, sleepiness, etc.
I would advise you to get treatment for Vitamin D deficiency. A loading dose is recommended in the beginning (50.000 Ui of vitamin D3 taken 3 times a week for one month) and then you may continue with preventive dose of 800 Ui a day (2 drops of vitamin D3).
If your symptoms are related to vitamin D deficiency you will notice improvement. Also, studies show no increase in calcium levels in patients that take the loading dose of vitamin D3 if they have vitamin D deficiency.
If your symptoms are not better with this treatment, you still need to continue vitamin D3 preventive dose of 800 Ui a day as vitamin D deficiency may adversely affect the bones and teeth.
Furthermore, in this case, the doctor may need to add drugs to treat depression as this may cause some of your symptoms. SSRI drugs are generally preferred, they are quite effective and well-tolerated.
I hope this answers your query. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj,
General and Family Physician

Vitamin D deficiency may cause your symptoms- treatment is needed
Detailed Answer:
Hello and welcome to "Ask a Doctor" service,
I carefully read your query and understand your concern.
I also checked the uploaded test report and noticed that there are minor and unsignificant changes in lipids and some liver tests but you had normal blood count and hormonal levels, thyroid included.
The only significant abnormality I noticed is low vitamin D levels (deficiency).
Vitamin D deficiency may cause most of your symptoms as it favors infections and may affect the mood and cause depression, which may represent with fatigue, sleepiness, etc.
I would advise you to get treatment for Vitamin D deficiency. A loading dose is recommended in the beginning (50.000 Ui of vitamin D3 taken 3 times a week for one month) and then you may continue with preventive dose of 800 Ui a day (2 drops of vitamin D3).
If your symptoms are related to vitamin D deficiency you will notice improvement. Also, studies show no increase in calcium levels in patients that take the loading dose of vitamin D3 if they have vitamin D deficiency.
If your symptoms are not better with this treatment, you still need to continue vitamin D3 preventive dose of 800 Ui a day as vitamin D deficiency may adversely affect the bones and teeth.
Furthermore, in this case, the doctor may need to add drugs to treat depression as this may cause some of your symptoms. SSRI drugs are generally preferred, they are quite effective and well-tolerated.
I hope this answers your query. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj,
General and Family Physician

Detailed answer below
Detailed Answer:
Hello and welcome back,
Thank you for the reply and the extra information.
Studies show that a patient needs a minimum of 600.000 Ui before his/her vitamin D levels reach over 30 ng/ml (normal).
I would advise you to get 50.000 Ui 3 times a week for at least another 2-3 weeks. I would recommend you to take it as mentioned here as this may be more effective (taking it in 50.000 Ui other than larger doses at one time).
If this does not help with your symptoms, you will need treatment for depression as it may cause fatigue and sleepiness and may also affect the immune system. In this case, as explained above an SSRI drug can be considered (sertraline or citalopram, for instance). You will still need to continue with vitamin D3 800 Ui a day to prevent vitamin deficiency from reoccurring.
I did not see in the test report the glucose levels and ERS or CRP. The glucose levels are important to be checked to rule out diabetes and also ERS and CRP will tell us if you are fighting something (they increase in case of an infection or immune condition).
I assume your doctor already has checked your heart and it should have sound normal. Your blood pressure is a bit low but some patients have normally low blood pressure and this is not bothersome to them. Taking the pill your doctor gave you for the low blood pressure and making sure you do drink well (fluids) is very important.
I hope this answers your query. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj,
General and Family Physicianhigher

Detailed answer below
Detailed Answer:
Hello and welcome back,
Thank you for the reply and the extra information.
Studies show that a patient needs a minimum of 600.000 Ui before his/her vitamin D levels reach over 30 ng/ml (normal).
I would advise you to get 50.000 Ui 3 times a week for at least another 2-3 weeks. I would recommend you to take it as mentioned here as this may be more effective (taking it in 50.000 Ui other than larger doses at one time).
If this does not help with your symptoms, you will need treatment for depression as it may cause fatigue and sleepiness and may also affect the immune system. In this case, as explained above an SSRI drug can be considered (sertraline or citalopram, for instance). You will still need to continue with vitamin D3 800 Ui a day to prevent vitamin deficiency from reoccurring.
I did not see in the test report the glucose levels and ERS or CRP. The glucose levels are important to be checked to rule out diabetes and also ERS and CRP will tell us if you are fighting something (they increase in case of an infection or immune condition).
I assume your doctor already has checked your heart and it should have sound normal. Your blood pressure is a bit low but some patients have normally low blood pressure and this is not bothersome to them. Taking the pill your doctor gave you for the low blood pressure and making sure you do drink well (fluids) is very important.
I hope this answers your query. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj,
General and Family Physicianhigher





Detailed answer below
Detailed Answer:
Hello and welcome back,
Lip color may be difficult to evaluate for sure. It may seem purple, brown or even more bluish to the people but it is a medical professional that needs to evaluate it to make sure it is significant.
On the other hand, lips do become blue if the oxygen in blood declines. This happens generally in the case of lung or heart problems. If your doctor checked your lungs and heart in the office and the SPO2 in the office was normal (over 95%) very likely you do not have any lungs or heart problems.
You may benefit from a chest x-ray which will rule out these problems definitely. Also, make sure you are not exposed to carbon monoxide poisoning (smoke) in the place you live or work.
Another possible condition that may affect the lips (in rare cases) is Raynaud's phenomenon. This causes blue peripheries, including fingers and toes. Thus, in this case, you would have blue fingers and toes as well. ERS will help rule out immune conditions that may cause Raynaud's phenomenon as well. In some cases, ANA and RF may be checked as well, and other antibodies if the doctor suspects a certain autoimmune condition.
I hope this answers your query. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj,
General and Family Physician

Detailed answer below
Detailed Answer:
Hello and welcome back,
Lip color may be difficult to evaluate for sure. It may seem purple, brown or even more bluish to the people but it is a medical professional that needs to evaluate it to make sure it is significant.
On the other hand, lips do become blue if the oxygen in blood declines. This happens generally in the case of lung or heart problems. If your doctor checked your lungs and heart in the office and the SPO2 in the office was normal (over 95%) very likely you do not have any lungs or heart problems.
You may benefit from a chest x-ray which will rule out these problems definitely. Also, make sure you are not exposed to carbon monoxide poisoning (smoke) in the place you live or work.
Another possible condition that may affect the lips (in rare cases) is Raynaud's phenomenon. This causes blue peripheries, including fingers and toes. Thus, in this case, you would have blue fingers and toes as well. ERS will help rule out immune conditions that may cause Raynaud's phenomenon as well. In some cases, ANA and RF may be checked as well, and other antibodies if the doctor suspects a certain autoimmune condition.
I hope this answers your query. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj,
General and Family Physician


Not sure if this will relate.

Not sure if this will relate.
Neck pain is common in patients with stress and depression
Detailed Answer:
Hello and welcome back.
Neck pain is very common in patients with depression. This is due to muscle tension and tightness.
On the other hand, there are rare cases of arthritis that may cause joint pain in the neck and this may be the case if autoimmune conditions are considered as the cause of fatigue, joint pain, etc (this is very rarely the case).
I hope this answers your query. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj,
General and Family Physician

Neck pain is common in patients with stress and depression
Detailed Answer:
Hello and welcome back.
Neck pain is very common in patients with depression. This is due to muscle tension and tightness.
On the other hand, there are rare cases of arthritis that may cause joint pain in the neck and this may be the case if autoimmune conditions are considered as the cause of fatigue, joint pain, etc (this is very rarely the case).
I hope this answers your query. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj,
General and Family Physician


I have been feeling discomfort in my right side of my head when moving my jaw since i started having a dental problem 10 days ago in my lower right jaw, however after taking antibiotic injections, my dental issue healed.
but the discomfort that happens when moving my jaw still remains, while touching the back of my head i feel there is some sorta bulge in the back of my right side of my head. it feels very different from my left side of my head, also i havent suffered any physical injury or falls.
I am questioning if this could relate to my previous symptoms, and would this show on a brain ct scan, or is it more bone/skin related?

I have been feeling discomfort in my right side of my head when moving my jaw since i started having a dental problem 10 days ago in my lower right jaw, however after taking antibiotic injections, my dental issue healed.
but the discomfort that happens when moving my jaw still remains, while touching the back of my head i feel there is some sorta bulge in the back of my right side of my head. it feels very different from my left side of my head, also i havent suffered any physical injury or falls.
I am questioning if this could relate to my previous symptoms, and would this show on a brain ct scan, or is it more bone/skin related?
The symptoms you mention do not seem related to the issues mentioned above
Detailed Answer:
Hello and welcome back,
I am sorry for the late reply.
I think the jaw pain is not related to the issues you mentioned above. Jaw pain may be from problems with the jaw joint or so-called temporomandibular joint (especially if teeth problems are rule out and the pain is related to chewing or it is worse when pressing on the jaw joint). Ibuprofen may be used in this case 600 mg every 6-8 hours after food. If no improvement in a few days or if there is any worsening, you will need to have it examined with your doctor.
As for the bulge in the head, this is something a medical professional needs to assess to rule out lymph nodes or other lumps.
Often, muscles may feel tense and swollen in areas behind the head and this may happen, it is very common and nothing to worry about.
I hope this answers your query. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj
General and Family Physician

The symptoms you mention do not seem related to the issues mentioned above
Detailed Answer:
Hello and welcome back,
I am sorry for the late reply.
I think the jaw pain is not related to the issues you mentioned above. Jaw pain may be from problems with the jaw joint or so-called temporomandibular joint (especially if teeth problems are rule out and the pain is related to chewing or it is worse when pressing on the jaw joint). Ibuprofen may be used in this case 600 mg every 6-8 hours after food. If no improvement in a few days or if there is any worsening, you will need to have it examined with your doctor.
As for the bulge in the head, this is something a medical professional needs to assess to rule out lymph nodes or other lumps.
Often, muscles may feel tense and swollen in areas behind the head and this may happen, it is very common and nothing to worry about.
I hope this answers your query. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj
General and Family Physician

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