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What Causes Fatigue And Pain In Rib Cage Area?
Question: I am a 70 year old female with early stage CLL, otherwise healthy, vegan, daily exercise.
Only other current health concern is hypothyroidism. Taking 50mcg Synthroid A.M., Cytomel 12.5mcg A.M. & P.M.
Two symptoms of concern: Afternoon fatigue and moderate pain in spleen area (under left center rib area).
Out of range labs: wbc 12, lymphocyte absolute 8, immunoglobulin M 24. (Imm. G 746, A 66)
Oncologist cannot figure out fatigue or pain.
Any suggestions would be greatly appreciated.
Only other current health concern is hypothyroidism. Taking 50mcg Synthroid A.M., Cytomel 12.5mcg A.M. & P.M.
Two symptoms of concern: Afternoon fatigue and moderate pain in spleen area (under left center rib area).
Out of range labs: wbc 12, lymphocyte absolute 8, immunoglobulin M 24. (Imm. G 746, A 66)
Oncologist cannot figure out fatigue or pain.
Any suggestions would be greatly appreciated.
Brief Answer:
Possibilities.
Detailed Answer:
Good day.
Noted your concern. Thank you for providing the lab values. I would like to know if you had a calcium profile or a recent thyroid blood work done? If so , could you attach those reports as well? Have you ever had a calcium blood test done? What treatment are you on for CLL.
The fatigue could be from the CLL itself or an other reason like thyroid or low cortisol levels. It could also be from anemia associated with CLL.
The pain in left rib area could be from an enlarged spleen which is common in CLL. Does the ultrasound show an enlarged spleen or splenic infarct? It could be a simple muscle pain or rib bone pain. A physical examination will be really helpful.
Regards
Binu
Possibilities.
Detailed Answer:
Good day.
Noted your concern. Thank you for providing the lab values. I would like to know if you had a calcium profile or a recent thyroid blood work done? If so , could you attach those reports as well? Have you ever had a calcium blood test done? What treatment are you on for CLL.
The fatigue could be from the CLL itself or an other reason like thyroid or low cortisol levels. It could also be from anemia associated with CLL.
The pain in left rib area could be from an enlarged spleen which is common in CLL. Does the ultrasound show an enlarged spleen or splenic infarct? It could be a simple muscle pain or rib bone pain. A physical examination will be really helpful.
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your kind attention to my questions.
Oncologist says not yet time for CLL treatment since I am in an early stage.
She did examine spleen area and did not feel abnormality, but discomfort is below bone area and under ribcage toward center or body. Area does not feel particularly enlarged compared to right side. Does not feel like muscle pain and is not present all the time.
Calcium: 9.4 Free T3:2.6 Reverse T3: 14 TSH Ultra: 4.240 Free T4: 0.6
Do you have an opinion regarding the idea of taking a third cytomel mid afternoon, or do you feel thyroid meds should be limited to early part of day?
Best regards,
XXXXXXX XXXX
Oncologist says not yet time for CLL treatment since I am in an early stage.
She did examine spleen area and did not feel abnormality, but discomfort is below bone area and under ribcage toward center or body. Area does not feel particularly enlarged compared to right side. Does not feel like muscle pain and is not present all the time.
Calcium: 9.4 Free T3:2.6 Reverse T3: 14 TSH Ultra: 4.240 Free T4: 0.6
Do you have an opinion regarding the idea of taking a third cytomel mid afternoon, or do you feel thyroid meds should be limited to early part of day?
Best regards,
XXXXXXX XXXX
Brief Answer:
Antacids
Detailed Answer:
Good day,
Noted the thyroid blood report. Infact, Endocrine society doesnt recommend adding Cytomel ( T3) to Synthroid (T4). To be XXXXXXX i do not think adding another cytomel would be a good idea. But i would recommend increasing your Synthroid to 100 mcg on sundays and continue with 50 mcg other days.
The description of your pain sounds like that of an acid reflux type pain. You could try with some antacids for few days.
Antacids
Detailed Answer:
Good day,
Noted the thyroid blood report. Infact, Endocrine society doesnt recommend adding Cytomel ( T3) to Synthroid (T4). To be XXXXXXX i do not think adding another cytomel would be a good idea. But i would recommend increasing your Synthroid to 100 mcg on sundays and continue with 50 mcg other days.
The description of your pain sounds like that of an acid reflux type pain. You could try with some antacids for few days.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you again. I will immediately try both of your suggestions.
Brief Answer:
Get well soon.
Detailed Answer:
Wish you good health. Hope you will get well soon
Get well soon.
Detailed Answer:
Wish you good health. Hope you will get well soon
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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