Brief Answer:
Suggestions

Detailed Answer:
Hi
I am Dr Mittal.
i have read your message.
I think I can help you.

First, avoid hot chocolate. This has got caffeine. Now, while caffeine improves the constipation, there are high chances that the caffeine may actually increase the cramps and spasms as it is a stimulant. So avoid coffee and hot chocolate and anything that contains caffeine. The improvement you feel may be due to the associated potassium intake.

Second, having read your message, I think it is obvious that you have developed a hypokalemic periodic paralysis kind of symptoms. Please note, it is not hypokalemic periodic paralysis. There the most common cause is low potassium. In your case, the potassium has been repeatedly tested normal. However, some people do feel weakness with somewhat reduced or normal potassium.
This fact and the fact that the potassium in your hot chocolate helped seems to point to this possibility.
I therefore feel that you face the normokalemic weakness/spasm syndrome. It is quite a rare syndrome.And is usually well treated with potassium supplementation or tablets that preserve the potassium in the body.
Now, as I said, you should avoid the hot chocolate. The other possibility is coconut water. This is a very rich source of potassium and should be considered, especially as it has no caffeine.

As for the nephrologist, I cannot comment upon it from the information given. However, testing a urine routine test, kidney function tests and ultrasound of the abdomen may shed some light on this aspect and thereafter, a decision can be arrived at regarding a visit to the nephrologist. Having said that, the alkalosis might have been due to the lack of electrolytes- potassium and magnesium that you have reported. So we will have to watch that.

One part that I feel I may suggest is testing of thyroid profile. There is an entity known as thyrotoxicosis . Abnormal thyroid levels may actually cause similar symptoms- of sweating, tachycardia, cramps etc. So I sincerely feel that thyroid profile (in fasting state) should be tested.

I have tried to make it as simple as possible.
Please feel free to contact me for further details as you feel need clarification.
Best of luck, Dr Mittal

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Brief Answer:
Not recieved

Detailed Answer:
I think you did indeed forget to press enter.
The only follow up query I got is your question-
"Hello again, did you get my follow up info? I may have not pressed sent. "
Please enter your follow up query and resend it.
Best of luck, Dr Mittal

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Brief Answer:
SUGGESTIONS

Detailed Answer:
Thank you for your quick response Dr. I will do my best to stay away from hot chocolate, but can't promise it, as it's the only thing that has helped. I do not drink coffee as it tears my stomach up. I have tried coconut water but it does not give me the same result, maybe I will try coconut milk.

I am very sensitive to changes in my body and I think you are on the money thinking I'm still having symptoms when my potassium is normal. I was testing positive for pvc's at 3.4 which the Dr. said is not typical. I had a holter monitor for 48 hours. When my potassium was 2.7, the nurse said it's probably lower but they just can't see it. At the time of my admission for three days my blood pressure was 140/95 and I had a terrible headache and felt like I would die and the Dr. said that pressure isn't high either. My body is really sensitive. I forgot to say that I have had several urinalysis done and my creatinine is normal and GFR, but it always comes back high epithelial cells, sometimes with crystals and sometimes with casts. Also I've been told I had a possible uti a few times but they weren't sure because there were only a couple of markers and I didn't have any symptoms. If I take magnesium and potassium together I am bouncing off the walls like my body is starved of it.

I've had my thyroid tested so many times I can't count and it always comes back normal. Tsh is under 3 and T4 in a good range, however, my mother is hypothyroid as well as her mom and both on Synthroid.

Should I be alarmed my urine comes back cloudy?

I'm married to a paramedic and I know how to read most of the tests so that's why I'm so detailed. Plus I'm scared because I have fainted once and hit my head. One last thing, I had my aldosterone tested because the Dr. wanted to see if that was pushing my potassium out. The level came back at 10. I am sorry for so much info, I don't want to have a heart attack and die this early in my life. Cheers

HI
AS YOU HAD SAID, THE QUERY HAD GONE TO ANOTHER DOCTOR.
THIS WAS THE RESPONSE THAT I GOT FROM THAT QUERY.
I AM TYPING IN CAPS TO DIFFERENTIATE FROM YOUR OWN QUERY.

THANKS FOR YOUR DETAILS.
TESTING OF THYROID WAS JUST A SUGGESTION.
AS WAS THE URINE AND CREATININE TESTS.
HOWEVER, THE ULTRASOUND IS STILL LEFT.
IN VIEW OF THE OTHER CHANGES IN THE URINE, I WOULD SUGGEST TESTING A 24 HOUR URINE PROTEIN. I AM STILL NOT SATISFIED WITH THE TESTS DONE FOR URINE YET.

SINCE YOU FELT GOOD WITH THE HOT CHOCOLATE, I WOULD SUGGEST MODERATING THE QUANTITY (AS EXPLAINED WHY YOU NEED TO DO SO). YOU MAY ADD THE COCONUT WATER AS TOLD BEFORE.
PLEASE BE AWARE THAT TOO MUCH OF POTASSIUM ALSO HAS ADVERSE EFFECTS ON THE HEART.

ALL THIS DOES SEEM TO SUGGEST THAT YOU INDEED DO HAVE THE SYNDROME. SO I WOULD SUGGEST THAT YOU KEEP A REGULAR DIETARY SUPPLEMENT OF POTASSIUM AS YOU ARE DOING NOW.

I AM NOT SURE WHAT YOU MEANT BY 'YOU ARE PROBABLY ON MONEY THINKING'. SO I AM RESERVING MY COMMENTS ON THAT FOR NOW. BP OF 140/95 IS ACTUALLY BORDERLINE HIGH, AND USUALLY NOTHING TO WORRY ABOUT. COULD YOU DESCRIBE THE HEADACHE HOWEVER? I WOULD ALSO LIKE TO KNOW MORE ABOUT THE TIME WHEN YOU HAVE FAINTED. AND HOW ARE YOUR PERIODS?

LAST TIME YOU WANTED TO KNOW IF YOU SHOULD VISIT A NEPHROLOGIST. I AM STILL NOT SURE ABOUT THAT. BUT I THINK MEETING AN ENDOCRINOLOGIST MAY BE OF HELP.

BEST OF LUCK, DR MITTAL

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