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What Causes Persistent Muscle Twitching?
Question: I have been experiencing muscle twitching for the past several weeks. The twitching began in my left quad muscle near the knee. The twitching is only noticeable when the leg is relaxed and extended (usually when laying down), and does not twitch when seated. The twitching occurs in various places in my body, but has been persistent in this left quad for several weeks. I also have experienced an intermittent buzzing sensation in my left foot. I had a physical exam last Friday and my physician noted normal reflexes and "good" strength. Is this something I should have investigated further, or just chalk up to a benign annoyance?
Brief Answer:
Chalk up to Benign annoyance
Detailed Answer:
Good evening. My name is Dr. Dariush Saghafi and I am a neurologist in the U.S.A. I'd like to address your concerns with a poem:
If it twitches while in song,
If it twitches but it's strong,
If it twitches, twitches,
Twitches, TWITCHES ALL night long.
If it twitches here or there,
If it twitches everywhere,
Yet the fibers do not rustle,
When you go to make a muscle.
And you've been to Doctor 1,
And you've been to Doctor 2,
And you've been to Doctor 3,
But they all just look at you!
And you've done your labs,
Your sticks, your jabs,
And those painful EMG's
To be told you're fine,
You're good- Go home
An allergy to Cheese?
So finally, you arrive at home
And those muscles twitch no less.
Think back to what your Granny said,
"Dear Child- it's BFS!"
I hope that little prose that I've come up with to help me remember the clinical characteristics of Benign Fasciculation Syndrome.
Now, the above is all well and good IF AND ONLY IF your physician has done the proper work in terms of labs and other studies (given your symptoms of the buzzing in the foot) to rule out anything more clinically significant. I would not simply "take" magnesium unless there was clear and present evidence that it was clearly low (but REALLY LOW) in serum. Also, are you on any medication that be causing these symptoms? Diuretics? Anti-depressants? Tri-cyclics? Excess thyroid medication?
I might also consider an imaging study of your head to be sure nothing else is up before "chalking" it up to a benign annoyance.
I hope this has been instructive in some way...and maybe even mildly amusing...because I certainly enjoyed coming up with the little poem in Dr. Seuss style! LOL....(we'll include that in the Medical School curriculum for toddlers sequence! HAHA!). If this has answered some of your questions I'd greatly appreciate your written feedback and a STAR RATING so I can know how close I came to addressing your concerns.
Also, if there are no further questions or comments to pose would you terribly mind CLOSING THE QUERY on your end? This will signal to the network that it may process, archive, and credit this particular question for future reference.
You may also address specific questions to me by perusing:
http://doctor.healthcaremagic.com/doctors/dr-dariush-saghafi/68474
or looking me up by name (DARIUSH SAGHFI, MD- XXXXXXX Ohio, USA on this network)
Alternatively, if you would like to try a real time webcam consult you can find me doing consults either by webcam, texting, or by audio at:
www.healthtap.com/drsaghafi
You can find me on this network on Wed-Sat, 3a-6a (New York City Time) as well as Sunday 11p-3a. Other days and times are possible but we'd need to make an appointment.
This query required 60 min. physician specific time for review, research, and final draft compilation for envoy.
Chalk up to Benign annoyance
Detailed Answer:
Good evening. My name is Dr. Dariush Saghafi and I am a neurologist in the U.S.A. I'd like to address your concerns with a poem:
If it twitches while in song,
If it twitches but it's strong,
If it twitches, twitches,
Twitches, TWITCHES ALL night long.
If it twitches here or there,
If it twitches everywhere,
Yet the fibers do not rustle,
When you go to make a muscle.
And you've been to Doctor 1,
And you've been to Doctor 2,
And you've been to Doctor 3,
But they all just look at you!
And you've done your labs,
Your sticks, your jabs,
And those painful EMG's
To be told you're fine,
You're good- Go home
An allergy to Cheese?
So finally, you arrive at home
And those muscles twitch no less.
Think back to what your Granny said,
"Dear Child- it's BFS!"
I hope that little prose that I've come up with to help me remember the clinical characteristics of Benign Fasciculation Syndrome.
Now, the above is all well and good IF AND ONLY IF your physician has done the proper work in terms of labs and other studies (given your symptoms of the buzzing in the foot) to rule out anything more clinically significant. I would not simply "take" magnesium unless there was clear and present evidence that it was clearly low (but REALLY LOW) in serum. Also, are you on any medication that be causing these symptoms? Diuretics? Anti-depressants? Tri-cyclics? Excess thyroid medication?
I might also consider an imaging study of your head to be sure nothing else is up before "chalking" it up to a benign annoyance.
I hope this has been instructive in some way...and maybe even mildly amusing...because I certainly enjoyed coming up with the little poem in Dr. Seuss style! LOL....(we'll include that in the Medical School curriculum for toddlers sequence! HAHA!). If this has answered some of your questions I'd greatly appreciate your written feedback and a STAR RATING so I can know how close I came to addressing your concerns.
Also, if there are no further questions or comments to pose would you terribly mind CLOSING THE QUERY on your end? This will signal to the network that it may process, archive, and credit this particular question for future reference.
You may also address specific questions to me by perusing:
http://doctor.healthcaremagic.com/doctors/dr-dariush-saghafi/68474
or looking me up by name (DARIUSH SAGHFI, MD- XXXXXXX Ohio, USA on this network)
Alternatively, if you would like to try a real time webcam consult you can find me doing consults either by webcam, texting, or by audio at:
www.healthtap.com/drsaghafi
You can find me on this network on Wed-Sat, 3a-6a (New York City Time) as well as Sunday 11p-3a. Other days and times are possible but we'd need to make an appointment.
This query required 60 min. physician specific time for review, research, and final draft compilation for envoy.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Very clever poem, Dr. Saghafi! I got a good laugh, and I think it provided me with some answers. As you can imagine, the worst case scenario, ALS, popped into my mind.
I gather from above that twitching in the absence of weakness is a positive sign. As is the fact the twitching only occurs when the muscle is at rest. Am I correct here?
Also, my exam included a reflex test in both arms and legs as well as a strength test in my legs and arms, and a grip test.
I have not been given an EMG, and would prefer to avoid that. My labs ordered on Friday asked for CMP an CPK. I've yet to receive the results.
I am not on any medications that could be causing these symptoms, and live an active, fitness-driven lifestyle.
I greatly appreciate your assistance, and you can count on that positive review.
I gather from above that twitching in the absence of weakness is a positive sign. As is the fact the twitching only occurs when the muscle is at rest. Am I correct here?
Also, my exam included a reflex test in both arms and legs as well as a strength test in my legs and arms, and a grip test.
I have not been given an EMG, and would prefer to avoid that. My labs ordered on Friday asked for CMP an CPK. I've yet to receive the results.
I am not on any medications that could be causing these symptoms, and live an active, fitness-driven lifestyle.
I greatly appreciate your assistance, and you can count on that positive review.
Brief Answer:
Glad you deciphered the riddle!
Detailed Answer:
I figured you were either one of the challenged or one of the challengees in this ALS bucket challenge. Great cause to be sure...my whole family did it but on the down side...the awareness that people have gained about this disease has now turned otherwise, normal everyday people in clammoring, frothing at the mouth, nervous wrecks (all young people under the age of 35-40...most under 30 and some as young as 17 years old being convinced that THEY MUST HAVE ALS....I got some people even asking me if they could've possibly contracted the disease just by pouring cold water on themselves as part of the challenge. I very clearly said RIDICULOUS....but just imagine............
I take care of many patients with ALS who are especially war veterans and others. I have had colleagues contracting the disease. I have a friend I am caring for right now who is in his final phase of a disease which is a cousin to ALS. So I think it's safe to say that I've seen a good portion of the pie that is out there.
I don't want to be so egotistical to say that I TOTALLY KNOW ALS as if I could possibly be privy to all the different ways Nature develops the LOOk of this disease or in whom, etc. But I am pretty sure of when I see people who DON'T have it....sometime more than people who DO have it.
And you DO NOT HAVE the signs or symptoms of ALS. Weakness and massive loss of weight is the most common way people come to medical attention. Therefore, twitching in a limb which is nice and strong and bulky with muscles and subcutaneous fat is a very healthy sign against the notion of ALS.
Twitching muscles ONLY at rest in the absence of weakness or loss of weight is the sine qua non of Benign Fasciculation Syndrome (BFS). Twitching can be turned off when the muscle is voluntarily activated by the patient.
Reflexes in ALS are typically very brisk or hyperactive. Of course, in some normal subjects (especially younger individuals) reflexes may still be rather risk so where it really helps us make a decision if we happen to know what the person's reflexes were like at some point in the remote past and then, compare to what they are today. Reflexes should not be depressed for any reason in any form of ALS. Sounds like strength was good in all limbs and that's a positive sign....just like the poem says! HAHA!
Not wanting an EMG is fine....I never OFFER EMG's (except to those who wish to know what Spanish Inquisitional Techniques were like in the 14th and 15th centuries) if clinically or historically I have a very low index of suspicion for ALS.
I expect CPK to be normal with normal neurological examination but remember CPK can vary durinally and high numbers may also be present in physically fit and active athletes or people who train which would be perfectly normal...I don't ever get CPK's until there is true evidence of muscle deterioration or change in the patient's overall strength index in all the limbs. Then, I start following CPK...but until then,....you're just spending money for little purpose...and sticking the patient).
Check on the NO medication felt to be contributory.
How about caffeine, fatigue, insomnia, OTC sleep aids?
If I've been of some use to answering your questions can I ask you for a little written feedback and then, a STAR RATING? That would be OUTSTANDING if you'd do that for me. Also, if there are no further questions or commentaries on this thread, CLOSING THE QUERY on your end will guarantee that the network will process, archive, and credit me appropriately for this conversation.
Once again, you may also address specific questions to me in the future by perusing:
http://doctor.healthcaremagic.com/doctors/dr-dariush-saghafi/68474
or looking me up by name (DARIUSH SAGHFI, MD- XXXXXXX Ohio, USA on this network)
Even though I sense I've convinced on this last volley of questions that you are ALS in my opinion, if you would like to try a real time webcam consult you can find me doing consults either by webcam, texting, or by audio at:
www.healthtap.com/drsaghafi
You can find me on this network on Wed-Sat, 3a-6a (New York City Time) as well as Sunday 11p-3a. Other days and times are possible but we'd need to make an appointment.
This query required 29 minutes of physician specific time to review, research, and document the final draft for envoy
Glad you deciphered the riddle!
Detailed Answer:
I figured you were either one of the challenged or one of the challengees in this ALS bucket challenge. Great cause to be sure...my whole family did it but on the down side...the awareness that people have gained about this disease has now turned otherwise, normal everyday people in clammoring, frothing at the mouth, nervous wrecks (all young people under the age of 35-40...most under 30 and some as young as 17 years old being convinced that THEY MUST HAVE ALS....I got some people even asking me if they could've possibly contracted the disease just by pouring cold water on themselves as part of the challenge. I very clearly said RIDICULOUS....but just imagine............
I take care of many patients with ALS who are especially war veterans and others. I have had colleagues contracting the disease. I have a friend I am caring for right now who is in his final phase of a disease which is a cousin to ALS. So I think it's safe to say that I've seen a good portion of the pie that is out there.
I don't want to be so egotistical to say that I TOTALLY KNOW ALS as if I could possibly be privy to all the different ways Nature develops the LOOk of this disease or in whom, etc. But I am pretty sure of when I see people who DON'T have it....sometime more than people who DO have it.
And you DO NOT HAVE the signs or symptoms of ALS. Weakness and massive loss of weight is the most common way people come to medical attention. Therefore, twitching in a limb which is nice and strong and bulky with muscles and subcutaneous fat is a very healthy sign against the notion of ALS.
Twitching muscles ONLY at rest in the absence of weakness or loss of weight is the sine qua non of Benign Fasciculation Syndrome (BFS). Twitching can be turned off when the muscle is voluntarily activated by the patient.
Reflexes in ALS are typically very brisk or hyperactive. Of course, in some normal subjects (especially younger individuals) reflexes may still be rather risk so where it really helps us make a decision if we happen to know what the person's reflexes were like at some point in the remote past and then, compare to what they are today. Reflexes should not be depressed for any reason in any form of ALS. Sounds like strength was good in all limbs and that's a positive sign....just like the poem says! HAHA!
Not wanting an EMG is fine....I never OFFER EMG's (except to those who wish to know what Spanish Inquisitional Techniques were like in the 14th and 15th centuries) if clinically or historically I have a very low index of suspicion for ALS.
I expect CPK to be normal with normal neurological examination but remember CPK can vary durinally and high numbers may also be present in physically fit and active athletes or people who train which would be perfectly normal...I don't ever get CPK's until there is true evidence of muscle deterioration or change in the patient's overall strength index in all the limbs. Then, I start following CPK...but until then,....you're just spending money for little purpose...and sticking the patient).
Check on the NO medication felt to be contributory.
How about caffeine, fatigue, insomnia, OTC sleep aids?
If I've been of some use to answering your questions can I ask you for a little written feedback and then, a STAR RATING? That would be OUTSTANDING if you'd do that for me. Also, if there are no further questions or commentaries on this thread, CLOSING THE QUERY on your end will guarantee that the network will process, archive, and credit me appropriately for this conversation.
Once again, you may also address specific questions to me in the future by perusing:
http://doctor.healthcaremagic.com/doctors/dr-dariush-saghafi/68474
or looking me up by name (DARIUSH SAGHFI, MD- XXXXXXX Ohio, USA on this network)
Even though I sense I've convinced on this last volley of questions that you are ALS in my opinion, if you would like to try a real time webcam consult you can find me doing consults either by webcam, texting, or by audio at:
www.healthtap.com/drsaghafi
You can find me on this network on Wed-Sat, 3a-6a (New York City Time) as well as Sunday 11p-3a. Other days and times are possible but we'd need to make an appointment.
This query required 29 minutes of physician specific time to review, research, and document the final draft for envoy
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your responses above. Can BFS also cause twitching in the tongue? The front left of my tongue has been twitching for the past couple of days. It is visible in the mirror, particularly after swallowing or spitting. It can also be felt. It looks like that area of the tongue tightens up and releases. Needless to say, this also has me worried. I thought it was in my head at first, but it is very visually apparent.
To answer your questions above, I do suffer from insomnia from time to time, and have been a regular caffeine user all my life.
Any thoughts? Thank you for your response.
To answer your questions above, I do suffer from insomnia from time to time, and have been a regular caffeine user all my life.
Any thoughts? Thank you for your response.
Brief Answer:
I'd have to see the tongue to determine
Detailed Answer:
Yes...occasionally BFS can be a cause of tongue fasciculations. However, keep in mind that tongue fasciculations are best seen while the tongue is resting QUIETLY on the floor of the mouth....not sticking it out in a mirror or trying to grab it and look at it by twisting and things like that.
Also, tongue fasciculations take some experience to differentiate from normal voluntary movements since most people while awake move their tongue about even when they are at rest themselves. Here is a really good YOUTUBE video of tongue fasciculations even though is sticking out of the mouth which is not the best position to see the fascics. Nevertheless, it's a very good video of the phenomenon.
http://www.youtube.com/watch?v=xuwdvBXcr30
If you would like me to take a look at your tongue on webcam to tell you whether or not I believe you truly have lingual fasciculations or not then, we should set up a time to do this by webcam.
Both insomnia and regular caffeine use can impact on the presence and intensity of bodily fasciculations so I don't know if there may be utility to try and get you to improve things in those 2 regards to see if the fascics don't improve as well?
If you'd like to do the webcam thing let me know and we can set something up for a convenient day and time to make the intercast connection.
Please don't forget the written feedback regarding how much you may have been helped through this conversation as well as a STAR RATING which are both greatly appreciated.
Also, if and only if there are no further questions or comments please CLOSE THE QUERY so as to initiate the process of archiving and crediting this thread for future reference.
18 minutes of physician specific time was required for review, research, and documentation of final draft for envoy.
I'd have to see the tongue to determine
Detailed Answer:
Yes...occasionally BFS can be a cause of tongue fasciculations. However, keep in mind that tongue fasciculations are best seen while the tongue is resting QUIETLY on the floor of the mouth....not sticking it out in a mirror or trying to grab it and look at it by twisting and things like that.
Also, tongue fasciculations take some experience to differentiate from normal voluntary movements since most people while awake move their tongue about even when they are at rest themselves. Here is a really good YOUTUBE video of tongue fasciculations even though is sticking out of the mouth which is not the best position to see the fascics. Nevertheless, it's a very good video of the phenomenon.
http://www.youtube.com/watch?v=xuwdvBXcr30
If you would like me to take a look at your tongue on webcam to tell you whether or not I believe you truly have lingual fasciculations or not then, we should set up a time to do this by webcam.
Both insomnia and regular caffeine use can impact on the presence and intensity of bodily fasciculations so I don't know if there may be utility to try and get you to improve things in those 2 regards to see if the fascics don't improve as well?
If you'd like to do the webcam thing let me know and we can set something up for a convenient day and time to make the intercast connection.
Please don't forget the written feedback regarding how much you may have been helped through this conversation as well as a STAR RATING which are both greatly appreciated.
Also, if and only if there are no further questions or comments please CLOSE THE QUERY so as to initiate the process of archiving and crediting this thread for future reference.
18 minutes of physician specific time was required for review, research, and documentation of final draft for envoy.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I would be very interested in meeting up via webcam. I live in XXXXXXX TN, so I'm on central time. I'm available any time today or this evening if you have any time. Otherwise, the evening works best for me any other day.
Thank you Dr. Saghafi!
Thank you Dr. Saghafi!
Brief Answer:
Let's see if this works
Detailed Answer:
I am on ET in the XXXXXXX
Very good....I would like an opportunity to see what's going on (if there's anything to show)....I realize that sometimes these things are kind of hit or miss. If we're going to be looking at the tongue and I will ask you to KEEP IT INSIDE the mouth for the purpose of assessing its movements then, can you try and get a good flashlight or light source that can shine directly on it...either someone can hold it or you yourself can hold it.
You can find my website on the webcam network at www.healthtap.com/drsaghafi
Follow the instructions to set up an account and from that point you should be able to CHOOSE ME as the doctor you want to speak with. They will ask you which state you're from. The trouble with that is if you don't specify the doctor you want to speak with then, you are automatically routed to the first doctor on call within your state boundaries.
If you have trouble making the connection for some reason please call TECH SUPPORT and they should be able to give you clearer directions as to how to make the hookup.
Let's shoot for tonight. I will await your internet call on the platform at 10p ET. We are 1 hour ahead of XXXXXXX
Don't forget about closing this query out at your earliest convenience as well. Thanks and----Looking forward.
Let's see if this works
Detailed Answer:
I am on ET in the XXXXXXX
Very good....I would like an opportunity to see what's going on (if there's anything to show)....I realize that sometimes these things are kind of hit or miss. If we're going to be looking at the tongue and I will ask you to KEEP IT INSIDE the mouth for the purpose of assessing its movements then, can you try and get a good flashlight or light source that can shine directly on it...either someone can hold it or you yourself can hold it.
You can find my website on the webcam network at www.healthtap.com/drsaghafi
Follow the instructions to set up an account and from that point you should be able to CHOOSE ME as the doctor you want to speak with. They will ask you which state you're from. The trouble with that is if you don't specify the doctor you want to speak with then, you are automatically routed to the first doctor on call within your state boundaries.
If you have trouble making the connection for some reason please call TECH SUPPORT and they should be able to give you clearer directions as to how to make the hookup.
Let's shoot for tonight. I will await your internet call on the platform at 10p ET. We are 1 hour ahead of XXXXXXX
Don't forget about closing this query out at your earliest convenience as well. Thanks and----Looking forward.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. I can get to your profile page, but I don't see where it says to connect via webcam.
Brief Answer:
Hmmmmm
Detailed Answer:
I'm trying a couple of things here to see what's up....I must admit I don't know exactly what your end of the platform looks like.....all I know is that people connecte with me all the time....so some how they FIND ME on the network.....perhaps, I have to be SIGNED ON the network which I am right now in order for the system to give you the option of CONSULTING with me?
Maybe you could contact Tech Support and they can walk you through the process of getting an account and then, getting directly to me if I say that I'm going to be on the network tonight at 10pm ET.
Hmmmmm
Detailed Answer:
I'm trying a couple of things here to see what's up....I must admit I don't know exactly what your end of the platform looks like.....all I know is that people connecte with me all the time....so some how they FIND ME on the network.....perhaps, I have to be SIGNED ON the network which I am right now in order for the system to give you the option of CONSULTING with me?
Maybe you could contact Tech Support and they can walk you through the process of getting an account and then, getting directly to me if I say that I'm going to be on the network tonight at 10pm ET.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
It's working now, as I see I have the ability to connect with you. Thanks!
Brief Answer:
That's because I placed myself online
Detailed Answer:
However, I'm really NOT available now....still at the hospital so we can still keep the 10p my time appointment and I'll be sure to be available for our conference.
Cheers!
That's because I placed myself online
Detailed Answer:
However, I'm really NOT available now....still at the hospital so we can still keep the 10p my time appointment and I'll be sure to be available for our conference.
Cheers!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Saghafi,
I have updated my health records in health tap, but I can't figure out how to notify you through that sight. Hopefully you can go in and view them. Thank you for the time and the discussion tonight.
Regards,
XXXXXXX Tonnar
I have updated my health records in health tap, but I can't figure out how to notify you through that sight. Hopefully you can go in and view them. Thank you for the time and the discussion tonight.
Regards,
XXXXXXX Tonnar
Brief Answer:
Message sent back to you
Detailed Answer:
I just tried sending a message back to you through HealthTap so we'll see if you receive it and if you're able to return a message to me. I don't know what the mechanisms are from the patient's side of the platform otherwise, I'd tell you about them. Perhaps, you can check with the Tech Support people tomorrow and get more details as to how you can send email messages to the doctors. You may notice that I did make a recommendation for a very good psychologist who is on the HealthTap network. This was only to keep the discussion alive of how I think it would be of great help to you overall (and very well in this present case) for you to be involved with a professional therapist. Dr. Weixel is a very sensitive and caring psychologist who I've referred a number of patients to on the HT network. But by no means should that be taken as the only possible recommendation. It may make just as much sense or more to get someone who is local to you. Your choice but I just wanted to keep the discussion on that point fresh.
I looked at your chart just a few moments ago but did not see any of your labs you were telling me about.
Also, you'll want to be careful on this network for sending messages back and forth too many times. I believe you have a limit before they begin charging you again. Therefore, it behooves you to find out ASAP how to initiate and carry on conversations or emails with me on the other network as soon as possible.
It was a pleasure speaking with you tonight as well. I look forward to seeing your labs uploaded (weren't in your chart that I could see as attached files or anything). As soon as the labs get loaded and I've had a chance to go over your case another time then, we can decide on a next appointment.
Cheers.
Message sent back to you
Detailed Answer:
I just tried sending a message back to you through HealthTap so we'll see if you receive it and if you're able to return a message to me. I don't know what the mechanisms are from the patient's side of the platform otherwise, I'd tell you about them. Perhaps, you can check with the Tech Support people tomorrow and get more details as to how you can send email messages to the doctors. You may notice that I did make a recommendation for a very good psychologist who is on the HealthTap network. This was only to keep the discussion alive of how I think it would be of great help to you overall (and very well in this present case) for you to be involved with a professional therapist. Dr. Weixel is a very sensitive and caring psychologist who I've referred a number of patients to on the HT network. But by no means should that be taken as the only possible recommendation. It may make just as much sense or more to get someone who is local to you. Your choice but I just wanted to keep the discussion on that point fresh.
I looked at your chart just a few moments ago but did not see any of your labs you were telling me about.
Also, you'll want to be careful on this network for sending messages back and forth too many times. I believe you have a limit before they begin charging you again. Therefore, it behooves you to find out ASAP how to initiate and carry on conversations or emails with me on the other network as soon as possible.
It was a pleasure speaking with you tonight as well. I look forward to seeing your labs uploaded (weren't in your chart that I could see as attached files or anything). As soon as the labs get loaded and I've had a chance to go over your case another time then, we can decide on a next appointment.
Cheers.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. Saghafi,
I have been on the road for work the last couple of days. My labs have indeed been uploaded to the "Files" section on HT. I still can't find a way to direct message you on there, so I will have to call support tomorrow. Hopefully you can see them. If not, I'll reach out to support to see what I can find out.
Thanks, XXXXXXX
I have been on the road for work the last couple of days. My labs have indeed been uploaded to the "Files" section on HT. I still can't find a way to direct message you on there, so I will have to call support tomorrow. Hopefully you can see them. If not, I'll reach out to support to see what I can find out.
Thanks, XXXXXXX
Brief Answer:
How about uploading those files on this site?
Detailed Answer:
good afternoon and thanks for the return message.
I am not able to locate those files but you should be able to send those as attachments to this particular site and I will check them out here. Must be some sort of technical glitch but I wouldn't know where to even begin to tell you how to resolve it. i'll check back on the site a little bit later and see what I find.
You can send the reports at YYYY@YYYY and address it to my name Dr. Dariush Saghafi
Have a great weekend.
How about uploading those files on this site?
Detailed Answer:
good afternoon and thanks for the return message.
I am not able to locate those files but you should be able to send those as attachments to this particular site and I will check them out here. Must be some sort of technical glitch but I wouldn't know where to even begin to tell you how to resolve it. i'll check back on the site a little bit later and see what I find.
You can send the reports at YYYY@YYYY and address it to my name Dr. Dariush Saghafi
Have a great weekend.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi, I have provided some attachments. Please review them.
Brief Answer:
All labs normal
Detailed Answer:
Evening sir. Thank you very much for enclosing your labs for review.
The labs you provided are all within normal limits.
I would have to go back and check the other labs and messages we sent back-and-forth but have you had your magnesium, calcium, as well as ionized calcium levels checked?
If all of those are normal, there would be little chance of finding any metabolic reason for the twitching. so we come back to the likelihood of benign fasciculation syndrome.
All labs normal
Detailed Answer:
Evening sir. Thank you very much for enclosing your labs for review.
The labs you provided are all within normal limits.
I would have to go back and check the other labs and messages we sent back-and-forth but have you had your magnesium, calcium, as well as ionized calcium levels checked?
If all of those are normal, there would be little chance of finding any metabolic reason for the twitching. so we come back to the likelihood of benign fasciculation syndrome.
Above answer was peer-reviewed by :
Dr. Raju A.T
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