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Suggest Treatment For Severe Muscle And Chest Pain
Question: I am so tired of trying to get this figured out. I have been diagnosed with Raynaud's Pnenomenon, GERD, Rhematoid arthritis (well by one doc and dismissed by another). I have been tested for Sjogren's - no, because I have dry eyes and mouth and my tongue is dry and hurts and feels gritty and has sores as well as my gums. I have abnormal ANA. extreme muscle pain all over to where I can hardly hold a glass. swelling in legs, bloated belly, unusual weight gain of 70 lbs. in 1 year, chest pain upon breathing deep, red scally areas on arms but no butterfly rash, I don't think I have had any fevers or infections. I have been tested for Lupus - where I'm going with this, but it comes back negative. This has been going on with other symptoms for a year and it's driving me nuts. Please help! My docs don't know what to do. My life is ruined.I have gotten off all my past meds in order to see if that had anything to do with it and no change.
Brief Answer:
Possible Autoimmune disease? Need long-term Oral Steroids
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
I have worked through your query in detail.
As per your description and clinical narration, you possibly seem to have an underlying autoimmune disease (possibly mixed connective disorder).
Since you have mentioned that you are positive for ANA, I request you to kindly upload the complete ANA profile report, as I would like to know the type of antibodies which have turned positive.
Further I would like to know why are you currently prescribed Acyclovir?
In your case. Steroids have to be the main background for treatment.
Are you ever placed on Steroid medications?
Additionally I would like to stress the need for complete Thyroid profile testing as many autoimmune diseases are associated with autoimmune thyroid disease.
Correction of thyroid abnormalities will cause marked symptomatic improvement .
GERD require an upper GI Endoscopy for further evaluation.
To conclude addition of Steroid medications in your case would change the course of the disease in your favour by offering great degree of symptomatic relief and disease control .
Post your further queries if any.
Thank you.
Possible Autoimmune disease? Need long-term Oral Steroids
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
I have worked through your query in detail.
As per your description and clinical narration, you possibly seem to have an underlying autoimmune disease (possibly mixed connective disorder).
Since you have mentioned that you are positive for ANA, I request you to kindly upload the complete ANA profile report, as I would like to know the type of antibodies which have turned positive.
Further I would like to know why are you currently prescribed Acyclovir?
In your case. Steroids have to be the main background for treatment.
Are you ever placed on Steroid medications?
Additionally I would like to stress the need for complete Thyroid profile testing as many autoimmune diseases are associated with autoimmune thyroid disease.
Correction of thyroid abnormalities will cause marked symptomatic improvement .
GERD require an upper GI Endoscopy for further evaluation.
To conclude addition of Steroid medications in your case would change the course of the disease in your favour by offering great degree of symptomatic relief and disease control .
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you for your very thoughtful response. I will answer your questions here.
I will contact my doctor on Monday to get the details of the ANA profile report.
I take Acyclovir as the only thing that seems to help a little with the mouth and tongue sores.
I have never been prescribed steroids. I would be very hesitate to get on steroids because of the many side effects like weight gain. As I have mentioned I have gained 70 lbs. in the last year which is very strange for me and I think part of this problem.
I had a complete thyroid profile and it was negative.
My GERD is very serious so I did have an upper endoscopy which found an ulcer and celiac disease and IBS.
I will get back to you with the ANA. Thank you so much. At least you are on to something . . . more then my doctor.
I will contact my doctor on Monday to get the details of the ANA profile report.
I take Acyclovir as the only thing that seems to help a little with the mouth and tongue sores.
I have never been prescribed steroids. I would be very hesitate to get on steroids because of the many side effects like weight gain. As I have mentioned I have gained 70 lbs. in the last year which is very strange for me and I think part of this problem.
I had a complete thyroid profile and it was negative.
My GERD is very serious so I did have an upper endoscopy which found an ulcer and celiac disease and IBS.
I will get back to you with the ANA. Thank you so much. At least you are on to something . . . more then my doctor.
Brief Answer:
Steroids in low doses can have minimal side effects.
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
The oral sores in your case are strongly related to autoimmune disease and not any viral infection.
Hence the use of Acyclovir is not justified.
Moreover, there is an increasing need to test for 2 antibodies of thyroid namely anti TPO and anti TSH, particularly in presence of normal thyroid profile.
Steroids in your case can be started at high dose and then gradually tapered over 3 months to attain lowest therapeutic dose where side effects are minimal.
Additionally, once the improvement kicks on , you can be simultaneously placed on other immunomodulatory drugs which can act as Steroid sparing medications.
Hence, you need not worry about side effects like Weight gain at the moment.
Further, I would like to know, if you are receiving any treatment for Coeliac disease?
As you mentioned, that there is an ulcer on Endoscopy , it's pretty important that you start taking drugs like PANTOPRAZOLE , which are antiulcer agents.Please check with your physician if he shares my view and if can prescribe these pills to you.
Kindly get back with the ANA profile to make further major therapeutic decisions.
Post your further queries if any.
Thank you.
Steroids in low doses can have minimal side effects.
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
The oral sores in your case are strongly related to autoimmune disease and not any viral infection.
Hence the use of Acyclovir is not justified.
Moreover, there is an increasing need to test for 2 antibodies of thyroid namely anti TPO and anti TSH, particularly in presence of normal thyroid profile.
Steroids in your case can be started at high dose and then gradually tapered over 3 months to attain lowest therapeutic dose where side effects are minimal.
Additionally, once the improvement kicks on , you can be simultaneously placed on other immunomodulatory drugs which can act as Steroid sparing medications.
Hence, you need not worry about side effects like Weight gain at the moment.
Further, I would like to know, if you are receiving any treatment for Coeliac disease?
As you mentioned, that there is an ulcer on Endoscopy , it's pretty important that you start taking drugs like PANTOPRAZOLE , which are antiulcer agents.Please check with your physician if he shares my view and if can prescribe these pills to you.
Kindly get back with the ANA profile to make further major therapeutic decisions.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Sonia Raina
Dr. Heijebu,
You are the first doctor to take me seriously and provide real help. I just can't thank you enough.
I will stop the Acyclovir, it's expensive, and I was taking it wishing it was helping, but it isn't. The mouth sores are terrible.
I was given Prednisone for something long ago and had a horrible allergic reaction. So, I won't be able to take it in any case. I have read about people taking a spice Tummeracic (spelled wrong) with black pepper in a processed capsule. I also
heard of going on a 60 day juice cleanse to reboot the body.
No, I'm not receiving any treatment for the Celiac disease - didn't know I should be?
For the ulcer my doctor put me on Prilosec and Pepcid. I will ask her about Pantoprazole.
I will also ask my doctor for the anti TRO and anti TSH test immediately.
I will get back to you. Again, thank you so much.
You are the first doctor to take me seriously and provide real help. I just can't thank you enough.
I will stop the Acyclovir, it's expensive, and I was taking it wishing it was helping, but it isn't. The mouth sores are terrible.
I was given Prednisone for something long ago and had a horrible allergic reaction. So, I won't be able to take it in any case. I have read about people taking a spice Tummeracic (spelled wrong) with black pepper in a processed capsule. I also
heard of going on a 60 day juice cleanse to reboot the body.
No, I'm not receiving any treatment for the Celiac disease - didn't know I should be?
For the ulcer my doctor put me on Prilosec and Pepcid. I will ask her about Pantoprazole.
I will also ask my doctor for the anti TRO and anti TSH test immediately.
I will get back to you. Again, thank you so much.
Brief Answer:
Acyclovir can be stopped.
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
For oral ulcers , I suggest you go on Oral pills of RIBOFLAVIN for 3-6 months for effective relief.
In case if you are allergic to prednisolone , then other immunomodulatory agents can be used as alternative.
Turmeric and black pepper capsules can be often effective, so as 60 day juice.
Coeliac disease can also be managed with immunomodulatory agents.
PANTOPRAZOLE is superior to the other two.
Keep me updated with due test results .
Post your further queries if any.
Thank you.
Acyclovir can be stopped.
Detailed Answer:
Hello, Madam.
I can certainly understand your concern.
For oral ulcers , I suggest you go on Oral pills of RIBOFLAVIN for 3-6 months for effective relief.
In case if you are allergic to prednisolone , then other immunomodulatory agents can be used as alternative.
Turmeric and black pepper capsules can be often effective, so as 60 day juice.
Coeliac disease can also be managed with immunomodulatory agents.
PANTOPRAZOLE is superior to the other two.
Keep me updated with due test results .
Post your further queries if any.
Thank you.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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