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Suggest Treatment For Weight Loss And Frequent Urination
Question: Dear Dr. I have several symptoms but I want to specify two. I have frequent urination....mostly every day...sometimes normal...overall it is getting worse. I have had urinary problems for a long time (I am 50---had hem since 30's). My urologist keeps checking...finds nothing wrong...says I have BPH ( he assures not serious). he prescribed Flomax...which is somewhat helpful but overall ineffective. I have also lost a lot of weight...first intentional but now unintentional...I am stabilizing on a weight but it seems I need to eat more to maintain...I initially changed to a low carb diet as I was classified as pre diab. My PCP assures me that my sugar levels are not high enough to cause weight loss and freq urination. Is it possible that I have type 1 diabetes ( and not pre diab type 2?)...Now I am going to visit a neurologist in March. I also have problems sleeping. and nightmares occasionally. My mother had Lewy Bodies at young age (42). At that time they thought she had psychol problems at first...it took them three yrs and they diagnosed her with early on set Alzheimers....but her pronounced system was hallucinations ( like Lewy Bodies). I think that my brain/neuro system is affecting my systems. As you can see I am confused and desperate. Should I consult another PCP? I don't think my current PCP completely believes me. I also have a history of anxiety...maybe it is Gen anx disorder. Should I consider possible neurological problem? Thanks!
XXXX
Dr, My HGS A1c level was 5.7 which is just past the high normal range for non diab....my glucose was 99 on one test and 100 on the latest test. (99 is high normal limit)...so I am pre diab...but almost non diab.
sorry...I meant "pronounced symptom" was hallucinations
Sorry...one more point...I was around 195-200 lbs two years ago...I weigh 170 lbs now. I lost most of the weight in four months.
maybe or maybe not helpful...My Mother showed first noticeable signs at age 42 ...approx. 1977....she passed away from pneumonia in 1992
XXXX
Dr, My HGS A1c level was 5.7 which is just past the high normal range for non diab....my glucose was 99 on one test and 100 on the latest test. (99 is high normal limit)...so I am pre diab...but almost non diab.
sorry...I meant "pronounced symptom" was hallucinations
Sorry...one more point...I was around 195-200 lbs two years ago...I weigh 170 lbs now. I lost most of the weight in four months.
maybe or maybe not helpful...My Mother showed first noticeable signs at age 42 ...approx. 1977....she passed away from pneumonia in 1992
Brief Answer:
You are a Pre-Diabetic.It's not Type 1 Diabetes.Non-neurological.
Detailed Answer:
Hi XXXX,
Thanks for being here on Healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
Your blood sugars have been borderline on the upper margin of normal limits and glycosylated hemoglobin (5.7) is just landing into 'impaired glucose tolerance' or Pre-diabetes. At this age and these borderline values, this can't be Type 1 Diabetes.
It is not possible to have frequent urination and weight loss due to your borderline blood sugar levels here and anyway, your frequent micturition is well explained by BPH at your age (as diagnosed by your urologist).
Your occasional sleep disturbances and nightmares are most likely physiological. You being confused and desperate and loss of confidence in your physician appear just to be a manifestation of anxiety.
Anxiety coupled with intentional steps to lower down weight and diabetic diet regime (change in food habits) are sufficient reasons to cause weight loss and weight loss does not appear to be pathological in your case.
Your mother had Lewy body disease, just don't mean that you are going to have anything like that. Hallmark symptoms of Lewy body disease are-
1)Visual hallucinations and Delusions
2)Fluctuating cognition
3)Very frequent sleep disturbances
4)Rigidity and bradykinesia
You don't appear to have any of these symptoms, neither memory loss. It appears to be 'anxiety disorder' in your case that is causing symptoms and not any neurological involvement.
Hope I have answered your queries. If you have some follow-up queries, I shall be glad to answer them.
Dr.Ajay Panwar,
MD,DM(Neurology)
You are a Pre-Diabetic.It's not Type 1 Diabetes.Non-neurological.
Detailed Answer:
Hi XXXX,
Thanks for being here on Healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
Your blood sugars have been borderline on the upper margin of normal limits and glycosylated hemoglobin (5.7) is just landing into 'impaired glucose tolerance' or Pre-diabetes. At this age and these borderline values, this can't be Type 1 Diabetes.
It is not possible to have frequent urination and weight loss due to your borderline blood sugar levels here and anyway, your frequent micturition is well explained by BPH at your age (as diagnosed by your urologist).
Your occasional sleep disturbances and nightmares are most likely physiological. You being confused and desperate and loss of confidence in your physician appear just to be a manifestation of anxiety.
Anxiety coupled with intentional steps to lower down weight and diabetic diet regime (change in food habits) are sufficient reasons to cause weight loss and weight loss does not appear to be pathological in your case.
Your mother had Lewy body disease, just don't mean that you are going to have anything like that. Hallmark symptoms of Lewy body disease are-
1)Visual hallucinations and Delusions
2)Fluctuating cognition
3)Very frequent sleep disturbances
4)Rigidity and bradykinesia
You don't appear to have any of these symptoms, neither memory loss. It appears to be 'anxiety disorder' in your case that is causing symptoms and not any neurological involvement.
Hope I have answered your queries. If you have some follow-up queries, I shall be glad to answer them.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you Dr. Panwar,
I am satisfied with the endrocinlogical explanation (i.e. re: diabetic involvement)
for my symptoms.
I do still think that I should follow up with my appointment in March with the neurologist ( a purported expert in the area of Lewy Body at NYU Langone Med Center).
As you stated the symptoms, I do not have hallucinations...However, once in a while I do forget what road I am on when driving....things like that. But, I also am the type that is pre-occupied with other thoughts and I do have a history of diagnosed GAD. Maybe later I will go back on the Zoloft prescribed by a psychiatrist.
I am just concerned because my mothers' sickness and all I have read about Lewy Body indicate that it is a very gradual and "sneaky" sickness and also difficult to diagnose. Hopefully my assessment at NYU will be helpful.
In any case, I appreciate you putting me in proper perspective. Thanks.
Perhaps a brief follow up response should be sufficient,. Thanks for your help. Happy New Year!
XXXX
Dr. Panwar,
Just want to add that at times my nightmares are very vivid with me yelling out as I awake (I dream of strange animals). I had these types of nightmares recently. I am single so I don't know if I "act out" my dreams. ( which my mother did as I recall).
Thank you.
I am just wondering if these types of nightmares and my waking up several times per night..it is becoming more frequent and as a result I feel tired during the day many days....are something to worry about neurologically? (Perhaps I should have not said "occasional" nightmares. They are more frequent).
Please respond if you can. Thanks.
I am satisfied with the endrocinlogical explanation (i.e. re: diabetic involvement)
for my symptoms.
I do still think that I should follow up with my appointment in March with the neurologist ( a purported expert in the area of Lewy Body at NYU Langone Med Center).
As you stated the symptoms, I do not have hallucinations...However, once in a while I do forget what road I am on when driving....things like that. But, I also am the type that is pre-occupied with other thoughts and I do have a history of diagnosed GAD. Maybe later I will go back on the Zoloft prescribed by a psychiatrist.
I am just concerned because my mothers' sickness and all I have read about Lewy Body indicate that it is a very gradual and "sneaky" sickness and also difficult to diagnose. Hopefully my assessment at NYU will be helpful.
In any case, I appreciate you putting me in proper perspective. Thanks.
Perhaps a brief follow up response should be sufficient,. Thanks for your help. Happy New Year!
XXXX
Dr. Panwar,
Just want to add that at times my nightmares are very vivid with me yelling out as I awake (I dream of strange animals). I had these types of nightmares recently. I am single so I don't know if I "act out" my dreams. ( which my mother did as I recall).
Thank you.
I am just wondering if these types of nightmares and my waking up several times per night..it is becoming more frequent and as a result I feel tired during the day many days....are something to worry about neurologically? (Perhaps I should have not said "occasional" nightmares. They are more frequent).
Please respond if you can. Thanks.
Brief Answer:
It's still appears to be non-neurological.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
You seem to have read a lot about 'Lewy body disease' and appears to be pre-occupied with the same considering your mother's history.You probably think you have some sort of REM behaviour disorder with complaints of vivid nightmares(which you tend to act out) you are telling about,but I still think it's physiological only(as it can be physiological also).
I have seen many patients of 'Lewy body disease' being a neurologist in my clinical practice.Believe me,none of them presents like you.Dementia is seen in 100% cases,Hallucinations in 85%,Rigidity and Bradykinesia in 90%.Without these hallmark symptoms,no one can make a diagnosis of Lewy body disease.
These symptoms are probably due to your 'Generalized anxiety disorder'.You can start treatment for the same and these symptoms shall improve.
But as it is well said,treating the thoughts is very important to treat the patient.I must say that you should go to the neurologist as you have already planned and get thoroughly examined to rule out any neurological involvement.
I hope it helps.If you have some follow-up questions,you are welcome,else you can close the thread-rate it and please write a review.
Dr.Ajay Panwar
MD,DM(Neurology)
It's still appears to be non-neurological.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
You seem to have read a lot about 'Lewy body disease' and appears to be pre-occupied with the same considering your mother's history.You probably think you have some sort of REM behaviour disorder with complaints of vivid nightmares(which you tend to act out) you are telling about,but I still think it's physiological only(as it can be physiological also).
I have seen many patients of 'Lewy body disease' being a neurologist in my clinical practice.Believe me,none of them presents like you.Dementia is seen in 100% cases,Hallucinations in 85%,Rigidity and Bradykinesia in 90%.Without these hallmark symptoms,no one can make a diagnosis of Lewy body disease.
These symptoms are probably due to your 'Generalized anxiety disorder'.You can start treatment for the same and these symptoms shall improve.
But as it is well said,treating the thoughts is very important to treat the patient.I must say that you should go to the neurologist as you have already planned and get thoroughly examined to rule out any neurological involvement.
I hope it helps.If you have some follow-up questions,you are welcome,else you can close the thread-rate it and please write a review.
Dr.Ajay Panwar
MD,DM(Neurology)
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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