Could Confusion, Weakness, Tiredness And Persistent Loose Stools Be Due To Temozolomide?

Posted on Fri, 6 Jan 2023

Question: Hi I have glioblastoma, 2 resections since November 2017. Undergone 3 weeks of radiotherapy and chemotherapy (Temozolomide) which finished in February. Developed a pulmonary embolism in May 2018. I have loose stools up to 4 times a day, drs have checked for any infections etc. In the last week or so I have developed confusion, weakness, tiredness and still have loose stools. Is there any way I could be experiencing delayed side effects from the Temozolomide?

Thanks

Answered by Dr. Monish De (4 hours later)

Brief Answer:
Stool culture sensitivity test

Detailed Answer:

Hi,

Since you had glioblastoma and completed treatment with Temozolomide this February I do not think the loose stools you are having are due to delayed side effects of Temozolomide.

I think you are probably having a mixed bacterial infection for which I suggest you do a stool culture sensitivity test

Also, depending on the stool result, you may need to take sensitive antibiotics if there are any pathogenic bacterial presence.

Do ensure to take daily probiotics and increase fiber in your diet.

Let me know if I can assist you further.

Regards,
Dr. Monish De

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Monish De (13 minutes later)

Hi thanks for your reply

Drs have done a stool culture test which has come back as no infections, however a blood test came back as low albumin levels, I hope this helps

Thanks

Answered by Dr. Monish De (6 minutes later)

Brief Answer:
Low albumin level could be causing diarrhea

Detailed Answer:

Hi,

The cause of your diarrhea seems to be due to low albumin level in your blood.

Would advise you to take probiotics twice daily for 10 days after food. Also, increase protein in your diets such as eggs, cottage cheese, and chicken etc.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Monish De (14 minutes later)

Thanks for your advise much appreciated. Would low albumin also cause weakness and confusion?

Thanks

Answered by Dr. Monish De (4 minutes later)

Brief Answer:
Blood test for electrolytes should be done too

Detailed Answer:

Hi,

No, low albumin does not cause confusion, although weakness is possible.

I would advise you to do the blood test to check for serum sodium and potassium, calcium and magnesium.

Meanwhile, for confusion, you may take extra salt in your diet 2 gm for 10 days after discussing with your treating doctor.

Regards,
Dr. Monish De

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Above answer was peer-reviewed by : Dr. Arnab Banerjee