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Suggest Treatment For Symptoms Of Anxiety

Posted on Wed, 19 Apr 2017

Question: Dr. RISHU SAXENA CARDIOLOGIST, sir hi XXXX, regarding tab. stalopan plus 10mg i met neurologist for two months back i was having mild head ache, light headed, and face slight numbness like. i have some tension, stress of work in my office, so i consulted him regarding it. Dr. said these light headed , face numnness etc are are due to stress. to control stress he has prescribed Tab. Stalopan Plus. in november two days i taken but felt vomiting sensation in morng so i told drr. and stopped it , then again theybefore yest day felt little stress so i have taken 1/2 tab 5mg but since yest day my hand and feets are swetting so dr. i decided not to take that tablet from yest night and stop.

Answered by Dr. Rishu Saxena (1 hour later)

Brief Answer:
Doses should be reduced,A low dose benzodiazepene is enough for mild anxity

Detailed Answer:
Hi again,

Mild and moderate anxiety should be treated with low doses of Benzodiazapenes (clonazepam or etizolam),Selective serotonin reuptake inhibitors are usually given when symptoms of anxiety are overlapped with some degree of obsession or depression.
Mild headache with numbness can be a symptom of migraine( specially if headache is unilateral involving half of the head).You can reconsult your neurologist or you can take a secondary opinion from another neuro about stalopam plus.As per my opinion i dont think there is any need of using SSRI (escitalopam) in your case.A small dose of clonazepam 0.25mg or escitalopam 0.25mg would be good for you.
If the feeling of headache with associated numbness still persists a low dose calcium channel blocker like flunarazine or beta blocker like propranolol should be used.
Advice
Clonazepam 0.25 or Escitalopam 0.25 for few weeks should be enough for mild anxiety.I dont feel there is any need to add a SSRI to your regimen.
Thank you.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Rishu Saxena (36 minutes later)

Dr. Yestday night i havent taken tab only theybfore night i have taken 5mg yest day i didnot take any tab. But still little swetting in hands & feet persists. Does it be. How long it will be presently i decided to stop taking any tab.

Sorry for troubling dr XXXXXXX

Answered by Dr. Rishu Saxena (1 hour later)

Brief Answer:
Will take a day or two

Detailed Answer:
Hi again,
Escitalopam with take atleast 24-48 hours to clear out from your blood.Once cleared from blood things will settle down.
Don't panic it will take a day or two!
Thanks

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Rishu Saxena (34 hours later)

Dear Doctor hai, as u said it got cleared thanks a lot. Dr. today i have FBS, LIPIDS, HBIAC.
Fasting Plasma Glucose Normal : 105
LIPID PROFILE TG 197, TOTL CHOLESTEROL 213, LDL CHOLESTRL 129,
HDL-45, VLDL 39, TOTAL CHOLESTROL /HDL RATIO - 4.73, LDL Cholesterol/HDL Cholesterol Ratio- 2.86, Glycosylated Haemoglobin- 5.8, dOCTOR can u please see these and tell how can i get back to normal, doctor i want to know does eating banana's increase tryglycerides level, bcoz i have stopped eating since 1 week, does BANANA EATING effect sugar, level.. doctor according to this readings what exactly to eat and decrease my levels is it possible to decrease. BROWN RICE IS IT GOOD FOR REDUCING CHOLESTROL AND FBS. COCONUT WATER . I AM NOT ABLE TOUPLOAD REPORTS. CAN I CONTINUE EATING BANANA.

THANKS A LOT DOCTOR
XXXX

Answered by Dr. Rishu Saxena (1 hour later)

Brief Answer:
Follow up advice

Detailed Answer:
Hi,
Yes reports are almost normal with very mild dyslipidemia.Follow life style modification for three months and it will be fine.
No eating banana will not invcrease your triglyceride level.
Yes banana has a high glycemic index and increase level of glucose in blood rapidly.Your fasting blood sugar is almost normal hence you can have two bananas a day.
Prefer brown rice over white however eat less rice in diet overalll.
Decrease fat uptake
Avoid ghee,butter,cream,over oily and fast food.
Decrease salt in diet.
Increase fibre uptake in diet.
Eat pear and oranges.
Take rice XXXXXXX oil and olive oil for cooking.
Strenous exercise for 45 minutes a day.
Brisk walking at 5.1 km/hr for 20 minutes a day.

Repeat lipid profile after 3 months.

Thanks

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rishu Saxena (8 hours later)

Dr wat do u sujjest taking tab ROSURAS 5MG for TGs lowering or follow diet and control .. which is better.. dr i stopped rab. Sompraz 40 and gaviscon for acidity.. 4 days back feeling better now but some times slight pain/burn like in chest rt/lt just like muscle cramp. ??? but dr is milk. Apples muskmelon watermeln good .
Dr i want to control BP - SUGAR - CHOLESTROL

THANKS A LOT DOCTOR

Answered by Dr. Rishu Saxena (2 hours later)

Brief Answer:
Follow up advice

Detailed Answer:
Hi again,
Follow diet control and life style modification for 3 months after that we would consider adding rosuvas 5mg.
For tightness and burning sensation you can take pantoprazole 40mg for few days,Every thing should be done gradual;ly stopping all medicines suddenly will not help,as you have stopped all medicines now take pantoprazole 40mg once daily for a few days once your body adapts to new changes stop it.You should always give proper time to your body to adjust to new changes.
Yes cold milk,curd,yoghurt would be good for you.
Apple,Muskmelon,Water melon etc you can take them all.
You are a normal person,Don't feel you are sick.You just need to follow some precautions that's it,Apart from that you can eat every thing which a normal person can eat.

Though not asked by you yet some general instructions apart from medicines to help you in Fast recovery are-

- Increase XXXXXXX warm water intake
- Try to eat vegetable,Take a lot of Yoghurt along with food.
- Eat plentiful "fresh oranges" and "pear "
- do some exercise everyday as per your capacity try to take a 20 minute walk.
-Don't worry too much.
- Take a diet which is very low in Fat.
-Add lot of vegetables and fruits to your diet.
-Fruit juices should be taken.
- Frequent and small meals should be taken.

Thanks!

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Rishu Saxena (6 days later)

HI DOCTOR THANKS a lot, dr. now since two weeks i have been eating brown rice in night, what if i stop brown rice and take chapathi, and normal rice, my bp is also 120/70, 124/74, 135/84 , eating brown rice does it decrease cholesterol, sugar, im eating pears, oranges.... is muskmelon, apples good,

thanks a lot

Answered by Dr. Rishu Saxena (31 minutes later)

Brief Answer:
Follow up answer!

Detailed Answer:
Hi
Its good to see that you are maintaining your blood pressure normal.
Yes you can switch from brown rice to white rice but as i always said make it gradual.First alternate them and then start on white rice only. Brown rice is a bit superior to white rice for lowering lipids and as glycemic index of brown rice us a bit low so it doesnot convert to glucose as fast as white rice, Hence prevents overloading of pancreas.
As I always said fruits are good for you, Yes you can eat every fruit you want.
So how are you overall better or not?

Waiting!
Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Rishu Saxena (4 days later)

HI DR. HI IM FINE DOING WELL, thanks a lot for your suggestions... TO DAY I CHECKCED BP IT SHOWS 126/74, IM FINE, BUT since yest-day evening i some wat feel like my left feet fingers and under feet sweating and slightly numbness, and also my palms sweat, normally before also my hands used to sweeat. is this a normal issue...
is it due to any allergy..... or what

Answered by Dr. Rishu Saxena (39 minutes later)

Brief Answer:
Hyperstimulation of autonomous nervous system due to increased anxiety.

Detailed Answer:
Hi
Its very good to hear that you are doing good.
Most likely increased sweating is because of your high anxiety levels. Increased anxiety stimulates the autonomous nervous system. Overstimulation of autonomous nervous system causes increased sweating and perspiration.
Keep on following all the things i advised earlier.
Now your blood pressure is in normal range. Once you maintain it normal for few weeks, we will move on to anxiety and stress relieving also.
Lets take one thing at a time.
Thanks!

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Rishu Saxena (24 hours later)

Hi Dr. Another is that today my wife aged abt 35 yrs she had tea morning around 7.30am and left for office there at 9 am she fainted and fell on her face down. For abbt 1/2 minute she was unconscious . (Yestday night she had eaten chicken curry which was much chilli... ) she had loose stools twice today. She complains abt stomach pain.. (pet me gadbad ) Then her colegues gave her water she us ok. She had lunch in noon. She is ok but now she is feeling giddiness and still stomach upset. Her bp shows 110/70.... sir any tab to use

Answered by Dr. Rishu Saxena (33 minutes later)

Brief Answer:
Gastroenteritis.

Detailed Answer:
Hi,

Your wife is having Gastroentritis. It is an intestinal infection marked by diarrhoea, cramps, nausea, vomiting and fever. Toxins released by bacteria during the flu destroys the gastro intestinal flora. G.I flora is responsible for proper digestion of food. Once the flora is destroyed there are a number of digestive problems like bloating , belching, pain, loose stools and tenderness will go away.

Give her Electral solution one glass each after every episodes of loose-motion.
Medication advised are--
Tab Norflox TZ Twice daily for 5 days
Tab Spasmindon(Dicyclomine) twice daily
Cap Racicadotryl 100mg thrice daily for
Cap Econorm(lactobacillus) twice daily
Cap Pantocid 40mg once daily

Monitor blood pressure twice daily. Take these for 3 days.
Please discuss the above mentioned options with your gastroenterologist and obtain the necessary prescription.

Tell her to take plenty of fluids, Orange juice and coconut water would be best.
Give her semi-solid bland foods (eg. Moong ki dal Khichadi) and curd.
Avoid oily spicy and heavy food for few days.

Do get one Ultra sound abdomen done.
A stool routine and microscopy should also be done to rule out any impending infection.
She will be much better after taking single dose.
Thanks!

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

Follow up: Dr. Rishu Saxena (12 days later)

HI Dr. Rishu, how r u, Thanks a lot Doctor, dr. im fine doing well, last week i checked my bp it is on 14/2/17 -- 124/74 & on 22/2/17 it is 127/73 im fine doing well in my dinner im having brown rice, have beetroot juice is this good, does it effect sugar, and one more thing dr. yest day i have gone for walking, and in office i sat for long time keeping leg on leg sitting, but today i feeling some wat that my left leg below knee and feet slight numbness why does it happen. exactly one month back also i faced the same problem, below knee and feet, numbness, that time i have put my feet in hot water in bucket, for two times, then by morning itsgone. why does this happen Dr. what does it comes every month like this. what is the remedy for this. please suggest..... prescribe...
and reg. my burning in chest it has completely gone. only some times very rarely it burning like.

Answered by Dr. Rishu Saxena (11 minutes later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi Dear,
Good to hear that you are feeling much better now dear.
Beet root juice and brown rice is good.Don't worry its not going to have negative impact on your sugar levels,As even a diabetic diet consist of 60% carbohydrates.So don't worry about that.
This feeling is of numbness and parasthesia can be there due to deficiency of vitamin B12 also known as methylcobalamine. However sitting or maintaining the same posture for long time can also cause numbness.
Get your vitamin B12 levels tested once.
Try to avoid sitting in same posture for a long time,try to take a 5 minute break after every hour and move your legs a bit.
Don't panic just get your vitamin B12 level checked.

Follow up with report.
Thanks and good luck.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rishu Saxena (20 hours later)

Hello doctor hai, i have uploaded some reports vit b12 vit d etc, can u please verify these and tell, in these how to get all the readings to normal level please help. if posble with diet.... only..... what does vit b12 mean, please tell me how to get all levels to normal in cholesterol and vit b12 vit d based on my previous reports also .

thank u Dr. XXXXXXX

Answered by Dr. Rishu Saxena (2 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi XXXXXXX
Have seen all your details,

Your vitamin D and vitamin B12 levels are critically low.
Start taking XXXXXXX Tayo k 60000 i.u once a week for 2 months and once a month for next four month.

Start taking vitamin B12 supplement once a day Methylcobalamin capsule 1500mcg once a day for 3 months.

As levels are critically low hence correcting them only by diet is not possible right now, however once the levels are restored to normal they can be maintained by following a proper diet.

As per your question-

It helps maintain the health of nerve cell including those needed for neurotransmitter signals and helps form the protective covering of nerves, called the cell’s myelin sheath. This means that when vitamin B12 levels are low, almost every cognitive function can suffer.Most likely cause of numbness in your foot is deficiency of vitamin B12.

Cholestrol and triglycerides are mildly deranged for which you are folowing life style modification.
It will take at least three months for lipid profile to get better by strict adherence to life style modification.However if you want you can take a herbal substitute(prelipid) along with life style changes to control dyslipidemia.

Thanks

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

Follow up: Dr. Rishu Saxena (20 hours later)

sir A DR. HAVE WRITTEN TABS UPTISE D2 1 A WEEK
METHYCOBOL 500MCG 1 A DAY
PERG B12 FOR 15 DAYS
SIR ( Ihave told dr thw same that below knee leg and feet feels.like slight numb ..) i have strtd my dose today.. how much time.does it take.to get normal levels.
how does PERG B12 WORK

dr i sent sent tab images is perg b13 wat for is this tabs ok

Answered by Dr. Rishu Saxena (5 hours later)

Brief Answer:
Follow up answer

Detailed Answer:
Hi dear,
I've seen the tablets.

Methylcobalamine is not given in appropriate dose,

Maximum daily recommended dose of Methylcobalamine is 1500mcg, while in your case Preg B12 contains 1500mcg methylcobalamine while Methycobal tablet contains 500mcg of methylcobalamine.

So, initially start with Preg B12 For 10 days as advised, after that you can shift to methylcobalamine 1500mcg plus alpha lipoic acid combination for 3 months.

Thanks

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

Follow up: Dr. Rishu Saxena (14 hours later)

DR. Then can i take Methycobal 500mcg 3 tabs i.e 1500mcg and skip PregB12, what for is preg b12, does taking preg b12, causes SWEATING IN ARMS AND FEET, AND ALSO DOCTOR HAS SAID TO TAKE TWO TIMES A DAY , BUT SOME TIMES TAKING THE TATBLET WE GET SLEEPINESS.
DR. AS U SAID NUMBNESS IN FEET AND BELOW KNEE casuses due to low. vit b12 and vit d. then can i take only meth-1500mcg, skipipng pregb12.... dr, in my reports sent to you, IN LFT - protein is 8.3 and gloulin is 3.9 slightly higher, whhy does it become high, is it good or no. is the numbness due to thhis.

because taking preg b 12 it sleepiness in morning

what are sideeffects of taking pregb12 how does it work

thank u doctor.

Answered by Dr. Rishu Saxena (6 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi XXXX,
No taking 3 tabs per day is not a good idea,Most of the medicines are sustained release prepration these days;that means that instead of releasing all granules at a time the drug is released slowly and slowly over a period of 24 hours,Hence facilitating better absorption.
Pregabalin is usually used to treat neuropathic pain(pain due to nerves compression or inflammation).But as your chief complaint was numbness rather XXXXXXX pain i don't think pregabalin is required especially in high doses(75mg twice daily).Taking pregabalin twice daily does not make any sense.Basically you need methycobalamine and there is no indication to give pregabalin.
Side effect of pregabalin is drowsiness,confusion,Sleepiness.
Suggestion,
You should take methylcobalamine 1500mcg capsule(single dose) once daily,its better if it is in combination with alphalipoic acid(Cap myelamin).
Personally i don't feel That pregabalin is required.
Methylcobalamine plays important role in both the synthesis and the maintenance of myelin in nerves.
Mild deranged serum protein does not have any significance.
In case you have any other query feel free to ask.

Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Rishu Saxena (56 minutes later)

hi dr. then can i stop taking pregabulin and take only methylcobalamine 1500mcg., can i ask my dr. to change the med. methycobalimine 500mcg to 1500mcg... dr. what do u suggest should i skip pregabulinb12, becoz this numbness in below knee and feet was thtere last month also for 1 day then it wentaway, again i felt little bit theybefore yestday, it was there for 1 day , but today im feel im better... rarely once or twice, some times in my head in left side on top of ear side i feel some nerve pain means something is pulling like....

dr. does this VIT D & B12 when the levels are low, does it increase our bp, surgar levels, htn, is it any related, bcoz sir, in the month of oct, nov i used to get drowziness, giddiness, and something like my head is rounding felt like i will faint, two or three times, that time my bp was 140/80 like that, is it due to vit d &B12 low levels becoz sir , as i discussed with you some time back that my wife fainted, when i got her some tests done like VIT B12 & d CBPESR, HER vit b 12 & D, are very low, cbp count is 8. so i want to know that what WHEN OUR VIT D & B 12, are low our bp incresass when checked her bp it was 110/70, .

thanks a lot doctor,

Answered by Dr. Rishu Saxena (3 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
From my side i don't think there is any need to take pregabalin.
Yes you should ask him to recommend methylcobalamine in optimal dosage i.e 1500mcg per day.
Just take mehylcobalamine for 2 weeks.
However i would suggest you to take tab paroxetine for few days,It will help to lower your anxiety levels,Which i feel are quiet elevated.

Vitamin B12 and vitaminD has nothing to do with blood pressure,blood sugar.
Above age of 40 years blood pressure 140/90mm of hg is considered as normal,So your symptoms during october and november were not related to blood pressure.
No as told earlier blood pressure is not related to vitamin levels.

Blood pressure 110/70mm in female is considered as normal.

In case of any other query feel free to ask.
Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rishu Saxena (2 days later)

hi goodeveng Dr.
today morng took rest on left side for some time weight in my left hand .. in afternoon sometimes feeling some tingling means like numbness pin pointing in my hand fingers like why is it so Dr. is it due to medicines im taking preg bq2 and methy 500mcg..

Answered by Dr. Rishu Saxena (24 minutes later)

Brief Answer:
follow up answer.

Detailed Answer:
Hello and a very good evening,

Sleeping with an arm beneath your body or head can compress nerves which results in numbness or tingling often refered to as paraesthesia by patient.However as your vitamin B12 level is quiet low this can be because of demylenisation of nerves also.
As per your question Numbness and tingling can be a side effect of pregabalin(one component of preg bq2),However methylcobalamin will help you by preventing demylenisation of nerves.
Please mention what doses are you following right now.
Thanks.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Rishu Saxena (3 hours later)

HI. Dr. i have done ecg, which was pending in previous investigations so i done, i was tensed and while taking ecg, was breathing got suffocated like, is it a normal ecg, im taking preg b12 two times, methycob-500mcg 1 time daily, uprise d3 weekly once Dr. what to do to get rid of this thing in hand will this go on its own.

dr. in ecg it is LVH BY VOLTAGE CRETERIA is there any prblm, ihad taken lunch at 1 pm noon, then around 2.30pm went to ecg, there i felt little bit tension and if we get cold how we some times take deepbreath like that it was once.

is there any thing prblm in ecg, how can it be reduced.,

is it due to cholesterol......levels...............

Answered by Dr. Rishu Saxena (1 hour later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi Dear,
I understand your concern,But your e.c.g is normal.
For LVH,QRS should be greater then 0.12 sec,Which is normal in your case.
Secondly ECG is a very basic test of cardiology and diagnosis of LVH requires 2d echo.However your ecg is normal and i don't feel you need to be concerned about it.
Sokolov-Lyon voltage criteria says (S wave depth in V1 + tallest R wave height in V5-V6 > 35 mm)-In your case its less then 35mm.
On top of that Voltage criteria must be accompanied by non-voltage criteria(QRS>0.12sec) to be considered diagnostic of LVH.So i don't think that its LVH in your case.
Tingling and numbness in hand can be due to high doses of pregabalin also ,so consult your primary doctor to lower the doses to 75mg once daily initially,Apart from that methycobalamine is also given in higher then optimal doses.Please request your doctor to revise your treatment.

In case you have any other question feel free to ask.
Thanks

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rishu Saxena (12 days later)

HI DOCTOR GOOD EVENING, IM FINE DOING WELL, DR. LAST WEEK I CHECKED BP 124/74 YEST DAY AFTER A WEEK I CHECKED 120/77, DR. REG my vit b12 & d since this is low im drinking daily beet juice mix with sugar, or honey, is it good does it effect increase, my cholesterol, tryglycerides level... and daily night i drink milk with honey mix, is it good.......... dr. regarding preg b12 after 15 days today i have met him he said to continue preg b12 for another 15 days....

Answered by Dr. Rishu Saxena (24 minutes later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hello dear,
Its really nice to hear from you that you are doing fine and you are maintaining your blood pressure very well.
Beet root juice is good but sugar and honey can increase the level of glucose in blood ,as they are have high glycemic index.
Increased blood sugar levels puts you on high risk of dyslipidemia,And increases the risk of heart attack or stroke in future.
PregB12 can be taken once daily for next 15 days if its helping.
Hows your pain now and what about your numbness.Is it responding to medicines?

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rishu Saxena (9 hours later)

hi dr good morng thank u very much
dr. numbness was there monthly once but now its not there.. chest pain burng also hone. as per my previous reports .. dr how can i reduce my cholestrol tryglycerides . dr wat abt milk taking molk adding 2tsp of homey instd of dugar. is it ok
Dr then how to take beet juice.

Dr. iam going to walk but some times missing going 3 tomes.in week feel like tired some times is i due toit.

Answered by Dr. Rishu Saxena (3 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hello Dear, Good Morning.
As numbness is relieved its a good sign your body is responding well.
As per your query honey and sugar both are simple carbohydrate in different form,I don't think it makes any difference whether you are taking honey or sugar.
You can use 1 tablet of sugar free with beetroot.
If you are tired during walk then start taking a good multivitamin or antioxidant daily.
Your lipids are just mildly deranged as told earlier follow life stle change for 3 months if not relieved-
Decrease fat uptake
Avoid ghee,butter,cream,over oily and fast food.
Decrease salt in diet.
Increase fibre uptake in diet.
Eat pear and oranges.
Take rice XXXXXXX oil and olive oil for cooking.
Strenous exercise for 45 minutes a day.
Brisk walking at 5.1 km/hr for 20 minutes a day.

If not relieved in 3 months medicines could be started.
Thanks

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Rishu Saxena (5 days later)

HELLO DOCTOR, IM FINE DOING WELL, but since yestday evening, and today morning onwards, im feeling pain in my legs from knee joint to below. and rarely some times pain in low back. can i take pain killer, like TAB. HIFENAC, OR ULTRACET.
is it due to vit deficiency, and again some times feeling burning sensation in chest last week 3 to 4 days back i have eaten masala which was chilly and spicy, is it due to it i doubt.

thanks a lot dr.

Answered by Dr. Rishu Saxena (3 hours later)

Brief Answer:
Yes you can take ultracet.

Detailed Answer:
Hi Dear,
Good to hear that you are doing well.
Burning sensation in chest was due to Gastritis and Dyspepsia due to eating spicy food.
You can take Rablet l(rabeprazole and levosulpiride) tablet for immediate relief whenever you take spicy food.An antacid can also be taken along with it.
Pain below knee can either be muscular or because of low calcium and vitamin D levels.Yes you can take ultracet as and when required for pain.
However if you have backache also a screening MRI lumbosacral spine can be planned to see any nerve compression or disc herniation.
In case you have any other query feel free to ask!
Wish you quick recovery.

Thanks!

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rishu Saxena (13 hours later)

dr. is there any specific time to take tab. methycobol and Tab uprised3. day or night.

dr want to know whether my leg pain relate to vit deficency .. ( pain means if one stands for a long time or walik etc for long ... the pain we feel in legs frm knee to feet ) is it anything to worry........

Answered by Dr. Rishu Saxena (3 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi,
Methycobalamine should be taken at night time.
UpriseD3 can be taken with half cup of milk any time.
Yes leg pain can be because of deficiency of methylcobalamin.However if pain is radiating to legs can be due to compressed nerve in spine.So if you are not relieved by pregabalin and methylcobalamin,A MRI can be planned.
But the nature of pain you are describing is most likely because of Calcium or vitamin D deficiency.
If you are responding to medicines you are on then there is no need to worry.

Thanks.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Rishu Saxena (3 hours later)

hi dr.
yestday night i have taken DOLO 650MG, felt relaxed, but again since morning the same pain like if we stand fr too long hours how our legs pain like that. but there is no back pain. dr. today evening i went for a walk, morning i couldnt go so, felt little relaxed but suddenly below knee slight pain in Rt. leg. again it has gone. Dr. is this anything serious problm to worry.
Doctor i doubt whether i can go for WALKING AS REGULAR or NO, . BCOZ SINCE LAST TWO DAYS I HAVENT GONE FOR WALKING. Dr. HOW MANY DAYS IT WILL BE LIKE THIS, AND will this problm get solved, how to get rid of this, wat to eat for getting calcium, in our body, and this problem goes immediately. bcoz i have to sit in office for 7-8 hours,becoz month end ill be much buzy dr. and due to this pain like getting worried. pls suggest if there is any remedy for immediate relief from this.... should i go for CALCIUM TEST.

thank you Dr.

Answered by Dr. Rishu Saxena (2 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
Most likely the pain is muscular as it responded well to parcetamol.
For few days take Tab Diclofenac 100mg slow release once daily.Give your legs rest,Don't over exert.Diclofenac ointment can also be applied locally over painful areas.
I think it wil take 5-7 days to recover fully.
Take calcium tablets(CC-74) once daily for 1 month.
Yes check levels of calcium and serum sodium and potassium before starting tablets.

For immediate relief tahe tablet Signoflam/Willigosp/ZerodolSP twwice daily for 5 days.

Please answer fromhow many days are you having pain?
How long does this pain persists?
Any relieving factor?
Are you a smoker?
History of varicose veins in family?

Waiting for answers

Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rishu Saxena (22 minutes later)

dr, having pain since sunday evening, monday i.e. yestday, it was there almost full day, today also, (dr, on thursday satday sunday while morning walk i walked little fast, completed 4000mts in 30 mins) is it due to this. dr. I dont smoke, some times i feel relieved, but i feel some pain no much pain. no history of varicose vain, recently my dad also had fell and taken to hospital then his vit b12 was less checked, he was unable to lift his left leg, dr. suggested NCV LIMBS, in which the test result was normal. when checked b12 it was low.

its like when stress full walk or run we have pain in legs below knee in calves,

dr. incase of vit deficiency what kind of pain does a person have it is in legs or bones....

Answered by Dr. Rishu Saxena (14 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi agian,
Yes don't overstrain yourself.
Inceease your capacity gradually.
Most likely your calf pain is due to over straining your calf muscles.Firstly i would advice you to takr rest for few days.Once your muscles are ok increase things gradually,Try to increase your limits slowly.
Vitamin defieciency(B12 in specific usually causes severe parasthesia,tingling and numbess and not XXXXXXX pain.
I would suggest you to go for bone density scan test to rule out possibilities of osteoporosis.
Thanks

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Rishu Saxena (6 hours later)

Hi, I have provided some attachments. Please review them.

dr. sorry for troubling , dr. i have done calcium potassium sodium, all r normal i feel,
i attached the report, and images of my leg where it is pain like. dr. can i go for morning walk, yestday night i have taken tab. dolo, today felt ok, not much than yestday, some times feeling like legs are aching like u said stress full, thats all.

yest day i have checked my bp it was 123/76. ...
Dr. can i eat dates, dr. i have cut down on salt, almost, can i increase it or no. presently eating less than normal salt....

XXXX

Answered by Dr. Rishu Saxena (1 hour later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi Dear,
Yes you can take Dates.
You can use XXXXXXX salt instead its a low sodium salt with same flavour dear.
Why are you restricting salt?Npormal persom can take 3 grams of sodium daily.
Yes dolo 650 can be taken as and when required for pain.Give rest to your legs,Spray ointment volini thrice daily.If not relieved diclofenac sodium sr can be taken.
Reports are normal.Don't wory slight variation of numbers are insignificant.

Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rishu Saxena (18 hours later)

Hi Dr. i have met dr. told him my leg pain he suggested to take Preg b12 twice daily. & CAP. EVION 400 1 tab daily if it is vit def for how long does it exists does it goes away with vit tabs .... is it any serious issue........

thank u Dr.

Answered by Dr. Rishu Saxena (5 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi XXXXXXX
No its not a emergency issue but yes cause has to be ruled out before reaching a particular diagnosis.
Pregabalin 75 mg twice daily is to high a dose,And it should be given only if the pain is sciatica(MRI lumbo sacral) spine should be done.
I don't think this pain is related to vitamin B12.
I would advice you to go for MRI scan before taking such high doses of Pregabalin.

Thanks and get well soon.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rishu Saxena (41 minutes later)

dr wat abt EVION 400 CAP

Answered by Dr. Rishu Saxena (1 hour later)

Brief Answer:
Vitamin E.

Detailed Answer:
Hi,
Evion is vitamin E and is a general body rejuvenator.

Thanks!

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

Follow up: Dr. Rishu Saxena (9 hours later)

sir can i take it or no taking preg b12 once and evion

Answered by Dr. Rishu Saxena (31 minutes later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi again dear,
As already expalined above Preg B12 once a day is ok,But taking it twice daily doesn't make any sense.
Preg B12 contain methylcobalamine 1500mcg.
So taking it twice daily makes methylcobalamine 3000mcg a day which is not an optimal dose and on top of that without a proper diagnosis you will be on 150mg pregabalin which is a bit high dose.

Had not you doctor suggested you a bone density scan?
You are already on high dose pregabalin and B12 from a month,Are you relieved?

Please reply
Waiting.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Rishu Saxena (3 hours later)

hi Dr good afternoon
dr i have sent prescpton, dr actuly wat i remember last week one day while about to travel on vehicle sitting behind bike suddenly my leg muscle behind (knee joint to feet) caught (pair me narm pakadliya) sudnly i stood erect it got released. then again on satday night while sleeping my lower back muscle & leg muscle was slightly cought ( XXXXXXX ka naram ) got released . immediately.... then frm next day sunday eveng monday morng onwards my legs pain started...
Dr. yestday night i have taken pregb12 , methycobl at 7pm again due to litle pain in leg at around 10 pm i have taken HIFENAC P TAB... i have not taken Evion tab now morng i am feelling better no pain till now only felt once or twice some muscle puling like. otherwise feeling better without pain. even not taken PREGB12 DOSE MORNING.. DR is it due to the two situations .. the prblm is...
THANK U DR.
.

Answered by Dr. Rishu Saxena (8 hours later)

Brief Answer:
Muscular pain.

Detailed Answer:
Hi dear,
Take tab sumoflam/signoflam/willigo sp twice daily
spray volini tbrice daily.
Its musclular pain.
Vitamin B12 can be taken however pregabalin i don't feel has any role in treatment of muscular pain.
Thanks

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Rishu Saxena (11 hours later)

hi dr goodmorng

yestday night i have taken only methycbl & pregb12 only no pain killer. but again frm morng same both legs slightly pain.. ????

Answered by Dr. Rishu Saxena (9 minutes later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi again Dear,
As already explained to you pregabalin is for neurogenic pain(pain cause due to faulty nerves),But as in your case pain is muscular or bony,Pregabalin has no role.Therefore you were not relieved by pregabalin.
Your doctor is a general physcian?
see you have to take pain killer initially.
Does pain involve any joints also.
Please enumerate all medicines you are on at one place.
All medicines(for anything) and their doses you are on?

Waiting.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Rishu Saxena (1 hour later)

Hi, I have provided some attachments. Please review them.

sir DR I HAVE ATTACHED PRESCRIPTION presently taking UPRIDE D3 METHYCBL 500 MCG AND PREG B12 ONLY.
NOT TAKING EVION .....

SIR How many days pain be .. how many days should i use pain kiler. joint pain No very rarely some times while sitting on chair feel pain othetwise no. pain is like stress pain in legs like one stand for long duration or walk long..
sir wat is Evion is vitamin e and body rejuventor means wat ???
sorry
thank u very much

Answered by Dr. Rishu Saxena (8 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi again Dear,

Vitamin E is a multivitamin and is helpful in keeping body and muscles healthy. However a direct correlation with pain is not there.

As per your query, pain killer with combination of serratiopeptidase should be taken for 5 days, a bone density test should be done.

Vitamin B12 you can take 1500mcg every day. However taking pregabalin does not make any sense.

Do you have any family history of arthritis or joint pains?
Any one in your family has this problem?
From how many months are you having this pain?
Any factor which increases or decreases the pain?
Have you ever used hot water fomentation?

Who has prescribed you with methylcobalamin and pregabalin and why?

Awaiting..

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

Follow up: Dr. Rishu Saxena (1 hour later)

hi dr.
no family history of joint pains.
no body has this prblm in dec my father had vit b12 deficency
just from 20/3/17 ie from monday onwards .
pain is constant some times less.. while walking less but when sittng on offce in chair feeling pain when i took HiHigen p they bfore yeatday night the next day there was no pain but yestday o havent taken any tab today sligjt pain like.
physician has prescribed me for Vit b12 and vit d
pregablin becoz i was having slight numbness like in my left leg one day one month back in XXXXXXX 17 and the same feling like numbness in lft leg below knee aftr one month in feb 23 so i done vit tests and shpwed to physician he has prescribed . preg for for leg numbness.

EVION TAB ALSO I SAID HIM I HAVING PAIN IN LEG THEN HE WRITEN THIS.
ASKED TO GO FOR MRI LUMBER SPINE TEST

Answered by Dr. Rishu Saxena (10 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
As i adviced you MRI lumbar spine screening should be done.
Taking pregabalin unnecessarily without a proper diagnosis in high doses of 150mg makes no sense.
Most leg pain results from wear and tear, overuse, or injuries in joints or bones or in muscles, ligaments, tendons or other soft tissues.Once spinal nerve compression is ruled out,You would be treated on lines of the above mentioned causes.Responding to pain killers and no effect of pregabalin shifts diagnosis more towards wear tear and bone related problem.
Evion is virtamin E good for overall XXXXXXX
Give rest to your legs and go for two tests-
Bone density scan.
MRI spine.

Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Rishu Saxena (54 minutes later)

hello docto. preg was written bcoz i had numbns in feet and leg left. now it is cured. on monday ie 20 march i.had pain in.my legs i went to.dr
and told him he asked me wat tabs are u taking i showed his prescription then he asked.abt PREG dosage i was taking i told him i was taking only once then he asked me.whether i have done mri and NCV i said mo he asked.me.to do both tests. he has.written Preg two times and Tab EVION. Tabs he said go.for mri lumbar spine to rule.out.any compressed nerves
sir as u told yestday night i have taken Tab signoflam feeling ok... some times.the pain will be in both legs or some times in one yeatday i was feeling pain in rt. but today in left. pain like strain in leg. dr today i have gone for regular walk morng.
dr if it is a muscle.pain what will it be for a.week.. i am planing for.mri tomorow..
dr. wat do.u suggest aBOUT TAB EVION....

THANK U DR...

Answered by Dr. Rishu Saxena (13 hours later)

Brief Answer:
Folow up advice.

Detailed Answer:
Hi
Most likely your pain is muscular,Don't go for walk etc.Give rest to your body.Keep on taking signoflam twice daily for 5 days and report how you feel after that.

Yes a MRI should be done to rule out possibilities of sciatica.

Tab evion is vitamin E and can be taken once in a week.
Go for MRI and follow up with reports.
Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rishu Saxena (37 hours later)

hi Dr... i have changed the dr. not interested in taking that dose. i consulted anothet dr today now i have attached prescription. he has writen inj methycobl 500mcg and TAYO 60K TWICE A WEEK

Answered by Dr. Rishu Saxena (13 minutes later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
Nice to hear from you that you have changed your doctor.From the first day i was saying the same thing that he was prescribing you medicines in very high doses which were not optimal and were not even required.
Though i can't find any attachments with the question(new).Yet i feel the treatment is ok.
But doses of methylcobalamine should be 1500mcg not 500mcg and Tayo k is taken once in a week for 2 months then once in a month for 4 months.
I don't exactly know why every doctor is prescribing you either under or over doses.

What about MRI it should be done.

Thanks

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Rishu Saxena (8 hours later)

dr. I HAVE ATTACHED NOW A PRESCRIPTION,,,,,, dr has written INJ METHYCOBOL 500MCG, ALTERNATE DAY X 10 INJECTIONS, AND THEN ONCE A WEEK FOR ONE MONTH
TAYO60K TWICE A WEEK FOR ONE MONTH.....

I SAID DR. THAT I WAS HAVING NUMBNESS FOR ONE DAY MONTH AGO, AND LEG PAIN LAST WEEK, ASKED HIM WHY IS THIS PAIN AND NUMBNESS HE SAID IT IS DUE TO VIT DEFICIENCY.... HE SAID TO TAKE INJ. DOSES AND TAYO TAB. IN TWO TO THREE DOSES IT WILL BE CLEARED, AS PER HIS SAYING THERE IS NO NEED OF MRI, SINCE IT IS VIT DEFICENCY,

THANKS U Dr....

Answered by Dr. Rishu Saxena (12 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
See if its due to methylcobalamin deficiency things will start getting better after 5 shots of intramuscular injections. However in case if not relieved even after that go for MRI screening of spine.
So lets keep our fingers crossed. Get you I/m shots and seehow your pain tingling and numbness is responding to it.
You should start feeling better after 5th injection.
Thanks.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Remy Koshy