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Suggest Treatment For Excessive Weight Loss And Low Blood Platelet Count

Posted on Tue, 23 Jun 2015

Question: for last couple of months getting reeling of head XXXXXXX taken hard drinks. I am taking urimax 0.4 mg one caps at night during last 2 tears & also 1 tab of Thelma 40mg after breakfast. Lately lost weight significantly. I am non-diabetic aged 85 years. Should I go for T3. T4. TSH testing. Last month did CBC. platelet count showed 75000. Do I have any problem with pancreas and /or thyroid ?

Answered by Dr. Ajish TP (1 hour later)

Brief Answer:
Do thyroid function test and blood sugar

Detailed Answer:
Hi,

Welcome to HCM. I have gone through the question and understand your concerns.

Thyroid abnormalities can cause weight loss, tiredness, head ache and giddiness. It could also be due to diabetes. So even if your previous blood tests were normal repeat a blood sugar, thyroid function, serum electrolytes and blood routine. If platelets are still low do a peripheral smear.

Hope I have answered your questions. If you have any further queries I will be happy to help you

Regards,

Dr Ajish TP [MD,DM]
Consultant Endocrinologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (44 hours later)

As advised tests done. (1) Platelet 86000 (L)(on smear Appear adequate: Macroplatelets seen)(2) Neutrophils 39.1(L), Lymphocytes 49.8(H) (3) Blood sugar F 101, PP 110 (4) S Electrolytes Na 139. K 5.46 Chlorides 105, (5) T3 122 T4 4.83 TSH 5.34.Awaiting your advice.
I am on Urimax 0.4mg for almost last 3 years. Should I change over to Geripod(Silodosin) 4 mg ,though both have Dizziness as side effect > Forgot to mention about taking Omez 10 cap in empty stomach last 4 days to control gas problem ! Also taking 1 tab a day Supradyn.
Reeling/ feeling of heaviness of head continues along with weekness

How do I improve my platelet count ? Anything to do with pancreatic disoder ?

Awaing your advice. Thanks !

Answered by Dr. Ajish TP (21 hours later)

Brief Answer:
Platelets low, TSH higher side

Detailed Answer:
Hi,

Welcome back. I have gone through your reports.
My commends:

1. Platelets low - needs evaluation. Please consult a physician or haematologist. No need to worry as your blood smear is normal and white and red blood cells are ok. The usual test if clinically needed are ultrasound abdomen to look for spleen enlargement ( increased platelet destruction) and a bone marrow examination to see if platelet production is normal.

2. Thyroid is showing borderline abnormalities. A small dose of thyroxine 25 mcg may help to improve it. Repeat a TSH and Free T4 before starting treatment. This will improve your energy levels. Consult a physician for starting medications.

3. You can switch over to Silodosin as it is more selective to prostate and with lesser side effects.

4. Continue supradyn and omez.

5. We have to find out the cause of low platelets. If there are no causes , no treatment is needed. There are no off label medications to improve platelet count. It is in related to pancreatic disease.

Regards

Dr Ajish TP

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (1 hour later)

Pardon this old man in forgetting to inform you that on 27/03/15 did CBC when platelet count showed 132000. but wbc count showed 8300.Advised Tab Alevo 500mg 1 tab after meal for 15 days. On 22/04/15 did cbc again wbc showed 6700, but platelet count showed 79000. cbc done yesterday showed platelet 89000. I wonder whether reduction in platelet count is due to Alevo effect(drug related).
Awaiting your kind comments!

Very many thanks once again !

Answered by Dr. Ajish TP (5 hours later)

Brief Answer:
It could well be due to levofloxacin

Detailed Answer:
Hi,

Welcome back.

I understand your concerns.

Please forget my last answer on platelet count - haematologist opinion - ultrasound - bone marrow etc.

The low platelet count, as you said, could be a complication of levofloxacin (Alevo). The initial low platelets (1,32,000) could be due to some infection which was worsened by Alevo.

It may take few weeks to recover. Please follow up. It is a good sign that the platelet count is increasing recently.

If you have any further questions, I would be happy to help.

Regards
Dr Ajish TP

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar