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What Causes Tiredness While Treating Kidney Failure And BP?
Question: Hello,
I am a 73 year old man. Lately I have low energy, get tired easily. I take blood pressure meds, but because my bp readings have been improving, I am taking them every other day without affecting my numbers. About ten years ago I was hospitalized with kidney failure, but my kidney function has steadily improved to be within normal range. I wonder if this could be a reason for my weakness. Otherwise, I have a good diet, rest a lot and I used to think I was in good health generally. What do you think might be going on?
XXXX
I am a 73 year old man. Lately I have low energy, get tired easily. I take blood pressure meds, but because my bp readings have been improving, I am taking them every other day without affecting my numbers. About ten years ago I was hospitalized with kidney failure, but my kidney function has steadily improved to be within normal range. I wonder if this could be a reason for my weakness. Otherwise, I have a good diet, rest a lot and I used to think I was in good health generally. What do you think might be going on?
XXXX
Brief Answer:
Improve hydration. Few tests necessary.
Detailed Answer:
Hi XXXX,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. Good to know, you are on a good diet with general good health.
2. At present, your low energy level might not be due to past reduced kidney function. If your kidney function is improved and urea, creatinine levels are normal, then its probably not. However, erythropoetin, an hormone secreted by kidney if affected, can affect red blood cell levels. An hemoglobin estimation will rule out any problem in relation to blood.
3. If hemoglobin levels are normal, we need to look into thyroid hormone levels. The thyroid functions might be reduced in hypothyroidism, which can cause tiredness and is the second most common cause of loss of energy after anemia.
4. Improve your hydration. Dehydration can cause weakness. Atleast 6-8 liters of water per day is necessary. Due to rise in temperature, and inadequate fluid intake, improvement in hydration is necessary.
Early morning slight activity like walking is necessary to give a adrenaline push for the rest of the day.
Hope you blood sugar level is normal, if not, fasting blood sugar will be necessary.
Do improve hydration. Also get the hemoglobin levels, ESR and thyroid hormone levels done. Based on tests results, further opinion possible.
Hope it helps.
Any further queries, here to help again.
Dr. Prakash HM
Improve hydration. Few tests necessary.
Detailed Answer:
Hi XXXX,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. Good to know, you are on a good diet with general good health.
2. At present, your low energy level might not be due to past reduced kidney function. If your kidney function is improved and urea, creatinine levels are normal, then its probably not. However, erythropoetin, an hormone secreted by kidney if affected, can affect red blood cell levels. An hemoglobin estimation will rule out any problem in relation to blood.
3. If hemoglobin levels are normal, we need to look into thyroid hormone levels. The thyroid functions might be reduced in hypothyroidism, which can cause tiredness and is the second most common cause of loss of energy after anemia.
4. Improve your hydration. Dehydration can cause weakness. Atleast 6-8 liters of water per day is necessary. Due to rise in temperature, and inadequate fluid intake, improvement in hydration is necessary.
Early morning slight activity like walking is necessary to give a adrenaline push for the rest of the day.
Hope you blood sugar level is normal, if not, fasting blood sugar will be necessary.
Do improve hydration. Also get the hemoglobin levels, ESR and thyroid hormone levels done. Based on tests results, further opinion possible.
Hope it helps.
Any further queries, here to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dr. XXXXXXX HM,
Thank you for your response! I have scheduled a blood exam including a test for thyroid function. When I get the results, may I forward it to you for your recommendations? Meanwhile, I will drink a lot more water.
XXXX
Thank you for your response! I have scheduled a blood exam including a test for thyroid function. When I get the results, may I forward it to you for your recommendations? Meanwhile, I will drink a lot more water.
XXXX
Brief Answer:
Will wait for reports.
Detailed Answer:
Hi, XXXX,
You are welcome.
Do stay well hydrated. Dry skin, use moisturizers. Use soft soaps, and bathing once a day with soap is adequate. More soap, means more drying, as skin oil is lost.
Do get back with reports and attach the reports.
Will wait for reports. No need to reply until the reports are ready.
Hope it helps.
Any further queries, here to help again.
Dr. Prakash HM
Will wait for reports.
Detailed Answer:
Hi, XXXX,
You are welcome.
Do stay well hydrated. Dry skin, use moisturizers. Use soft soaps, and bathing once a day with soap is adequate. More soap, means more drying, as skin oil is lost.
Do get back with reports and attach the reports.
Will wait for reports. No need to reply until the reports are ready.
Hope it helps.
Any further queries, here to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Prasad
Dr XXXXXXX
I have received my blood test results. Everything seems normal except for the following:
Bun 28 high
Creatinine,Serum1.33
eGFR if non XXXXXXX Am 53
Calcium,Serum 8.0
Iron ,Serum 11
Hemoglobin 6.7
I look forward to your interpretation of these results and would appreciate any advice you may have for me. Thank you!
Dr. XXXXXXX HM,
In my previous message, I neglected to mention the following results:
RBC 3.22
Hemoglobin 6.7
Hematocrit 23.3
MCV 72
MCH 20.8
MCHC 28.8
RDW 16
Sorry about that, and thanks again for your consideration.
XXXX
I have received my blood test results. Everything seems normal except for the following:
Bun 28 high
Creatinine,Serum1.33
eGFR if non XXXXXXX Am 53
Calcium,Serum 8.0
Iron ,Serum 11
Hemoglobin 6.7
I look forward to your interpretation of these results and would appreciate any advice you may have for me. Thank you!
Dr. XXXXXXX HM,
In my previous message, I neglected to mention the following results:
RBC 3.22
Hemoglobin 6.7
Hematocrit 23.3
MCV 72
MCH 20.8
MCHC 28.8
RDW 16
Sorry about that, and thanks again for your consideration.
XXXX
Brief Answer:
Iron deficiency anemia - cause of weakness.
Detailed Answer:
Hi XXXX,
Thanks for replying with results.
You renal functions are a bit abnormal, but if its improving to previous values, nothing to bother about for now.
More important here is the anemia. This appears to be the main cause of tiredness. You are having severe iron deficiency anemia and correction through oral medication or injections will be necessary.
Ferrous fumarate tablets along with Vit C supplements on an empty stomach daily should help in iron levels improvement. After 2-3 weeks, reticulocyte count, if done, should show elevation, indicating good bone marrow response to iron supplements.
Increase iron in diet through green leafy vegetables, red meat, etc. Oranges and lemons, are rich in Vit C and helps in better absorption of iron.
As your general condition is good, no blood transfusion is necessary. Continue with supplements. Hope the thyroid levels are normal.
For skin, continue with moisturizers and maintain adequate hydration. Anemia correction to normal would take around 4 months. It will improve, not to worry.
You can take prescription for iron supplements and Vit C. If you are thinking of injections, watch out for any allergic reactions.
Hope it helps.
Any further queries, here to help again.
Dr. Prakash HM
Iron deficiency anemia - cause of weakness.
Detailed Answer:
Hi XXXX,
Thanks for replying with results.
You renal functions are a bit abnormal, but if its improving to previous values, nothing to bother about for now.
More important here is the anemia. This appears to be the main cause of tiredness. You are having severe iron deficiency anemia and correction through oral medication or injections will be necessary.
Ferrous fumarate tablets along with Vit C supplements on an empty stomach daily should help in iron levels improvement. After 2-3 weeks, reticulocyte count, if done, should show elevation, indicating good bone marrow response to iron supplements.
Increase iron in diet through green leafy vegetables, red meat, etc. Oranges and lemons, are rich in Vit C and helps in better absorption of iron.
As your general condition is good, no blood transfusion is necessary. Continue with supplements. Hope the thyroid levels are normal.
For skin, continue with moisturizers and maintain adequate hydration. Anemia correction to normal would take around 4 months. It will improve, not to worry.
You can take prescription for iron supplements and Vit C. If you are thinking of injections, watch out for any allergic reactions.
Hope it helps.
Any further queries, here to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you so much doctor! What dosage of the iron supplement do you suggest? Would it be alright to get some over the counter iron medicine, or should I really get a physician to prescribe it for me?
XXXXXXX
Dr. XXXXXXX H M,
I have ordered some ferrous fumerate, 324 mg. Would it be advisable to take more than one per day? It's difficult for me to understand how I could be so iron deficient as I do have, at least, a pretty good diet. What regulates iron or hemoglobin in the body? I thank you very much for all your advice!
XXXX
XXXXXXX
Dr. XXXXXXX H M,
I have ordered some ferrous fumerate, 324 mg. Would it be advisable to take more than one per day? It's difficult for me to understand how I could be so iron deficient as I do have, at least, a pretty good diet. What regulates iron or hemoglobin in the body? I thank you very much for all your advice!
XXXX
Brief Answer:
Upto 3 times daily can be taken.
Detailed Answer:
Hi XXXX,
Thanks for asking again.
Yes, you can take upto 3 times daily. However, as you will be taking on a empty stomach, possibility of gastritis maybe present. Atleast be in upright position for 30 minutes, after taking medication. Stools will be dark in color, due to iron and so do not worry about it.
No prescription is necessary. You can order it however, you want. Do take with Vit C or Vit C rich diet to improve absorption.
Causes, could be bleeding anywhere (mild bleeding) or malnutrition (iron poor diet or malabsorption) overtime. Difficult to identify the cause now, as you might not have noticed any bleeding. Until hemoglobin improves to more than 13g%, you continue with treatment.
Iron is necessary for hemoglobin formation. Iron absorption is dependent on iron stores in the body, lower the stores, better the absorption. As your iron stores are pretty low, iron absorption will be better. Do not take excessively, as you run a risk of gastritis.
Do not forget to get a reticulocyte count repeat after 15 days, or a repeat hemoglobin after a month. Response to treatment evaluation is very important. Also watch, if you have any bleeding anywhere and improve your diet.
Hope it helps.
Any further queries, here to help again.
Dr. Prakash HM
Upto 3 times daily can be taken.
Detailed Answer:
Hi XXXX,
Thanks for asking again.
Yes, you can take upto 3 times daily. However, as you will be taking on a empty stomach, possibility of gastritis maybe present. Atleast be in upright position for 30 minutes, after taking medication. Stools will be dark in color, due to iron and so do not worry about it.
No prescription is necessary. You can order it however, you want. Do take with Vit C or Vit C rich diet to improve absorption.
Causes, could be bleeding anywhere (mild bleeding) or malnutrition (iron poor diet or malabsorption) overtime. Difficult to identify the cause now, as you might not have noticed any bleeding. Until hemoglobin improves to more than 13g%, you continue with treatment.
Iron is necessary for hemoglobin formation. Iron absorption is dependent on iron stores in the body, lower the stores, better the absorption. As your iron stores are pretty low, iron absorption will be better. Do not take excessively, as you run a risk of gastritis.
Do not forget to get a reticulocyte count repeat after 15 days, or a repeat hemoglobin after a month. Response to treatment evaluation is very important. Also watch, if you have any bleeding anywhere and improve your diet.
Hope it helps.
Any further queries, here to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Shanthi.E
Dr. XXXXXXX H M,
For quite some time I have noticed black stools, but did nothing about it. Now, I have discovered that could be the reason for my anemia i.e. internal bleeding. For some reason, possibly because of the extensive rest and hydration I've been getting, my stools have become more normal in appearance. I believe the iron supplements I will be getting soon will improve my condition a lot. When my Medicaid part 2 kicks in, I will get a colon exam and find out what's going on with it. Meanwhile, I appreciate your advice and consideration a lot! I will close this discussion after receiving your response and give you a very excellent review. Will I be able to request you in the future if need be? Thanks again for your thoughtful and useful advice!
XXXXXXX
For quite some time I have noticed black stools, but did nothing about it. Now, I have discovered that could be the reason for my anemia i.e. internal bleeding. For some reason, possibly because of the extensive rest and hydration I've been getting, my stools have become more normal in appearance. I believe the iron supplements I will be getting soon will improve my condition a lot. When my Medicaid part 2 kicks in, I will get a colon exam and find out what's going on with it. Meanwhile, I appreciate your advice and consideration a lot! I will close this discussion after receiving your response and give you a very excellent review. Will I be able to request you in the future if need be? Thanks again for your thoughtful and useful advice!
XXXXXXX
Brief Answer:
Do get a colonoscopy and Upper gastrointestinal endoscopy later.
Detailed Answer:
Hi XXXX,
Thanks for replying.
Change in color or frequency of stools or urine, at this age is very important finding. If you had black colored stools, possible internal gastrointestinal bleeding. Do get a colonoscopy, and also a upper gastro intestinal endoscopy. Black stools, usually upper GI cause. Once you medicaid kicks in, do get it done.
Another important thing is continue with good hydration, nutritious diet and medication. Good sleep with mild exercises also needs to be incorporated.
Do check your hemoglobin levels after a month and a reticulocyte count, to evaluate the bone marrow response. Hemoglobin improvement is a very important step at present.
Hope it helps.
Any further queries, here to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Thanks.
Regards,
Dr. Prakash HM
Do get a colonoscopy and Upper gastrointestinal endoscopy later.
Detailed Answer:
Hi XXXX,
Thanks for replying.
Change in color or frequency of stools or urine, at this age is very important finding. If you had black colored stools, possible internal gastrointestinal bleeding. Do get a colonoscopy, and also a upper gastro intestinal endoscopy. Black stools, usually upper GI cause. Once you medicaid kicks in, do get it done.
Another important thing is continue with good hydration, nutritious diet and medication. Good sleep with mild exercises also needs to be incorporated.
Do check your hemoglobin levels after a month and a reticulocyte count, to evaluate the bone marrow response. Hemoglobin improvement is a very important step at present.
Hope it helps.
Any further queries, here to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Thanks.
Regards,
Dr. Prakash HM
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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