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Ask Dr. R. Bora Your Own Question
Dr. R. Bora
Dr. R. Bora, Doctor
Category: Health
Satisfied Customers: 5233
Experience:  14 years experience in the emergency room.
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I am a 30 y/o male. For the last two years I have routinely

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I am a 30 y/o male. For the last two years I have routinely shown low hemoglobin levels (fairly constant at 128 g/L) in blood tests. My iron levels are normal so it is not "iron-deficiency-anemia". I have seen 5 different doctors now and all chalk it up as "unexplained anemia". The following tests have been done with nothing alarming coming up from any (aside from the low Hgb): Blood test (10x), Urine test (10x), Fecal Occult Blood Test (2x), Chest x-ray (2x), and abdominal ultrasound (1x).

In addition, in June 2012 I was diagnosed with Rhabdomyolysis a couple days after a workout (chin ups, burpees, and sprints) when I arms swelled up, urine turned very dark, and blood test showed my CK levels peaking at 59,000 U/L.

Since June, I have had 4 more blood tests with my Hemoglobin levels consistantly at 128 g/L and CK levels between 5900 and >7800 U/L.

My current doctor is unsure what is causing both. My only other symptoms I can think of are that I am always tired (usually ready to nap by 2PM) and cannot put on any weight (I am 6-feet tall and 160 lbs) while eating everything in sight!

I have a hypothesis, but please let me know if this is at all possible or just me thinking too much: I think I may have some sort of parasite/tapeworm/pinworm (possibly explaining the anemia and lack of weight gain) and this could also be causing my body to starve, thus muscle breakdown (= high CK levels). Again, I may be overthinking but this has not yet been explored.

Can you please let me know any thoughts on this matter. The continuous tests and visits to the doctor are just causing frustration.

Thank you for your time.

Dr. R. Bora :

Hello and welcome, I am happy to help you today.

Dr. R. Bora :

Your question was locked by another expert, so you had to wait for an answer.

Dr. R. Bora :

I was following your question and see that you have a very high CK level which cannot be underestimated.

Dr. R. Bora :

Do you have any weakness of your limb muscles?

Dr. R. Bora :

Use reply to respond.

Dr. R. Bora :

Please reply to respond.

Customer:

Not that I have noticed. I have been to the gym once a week with no discomfort.

Dr. R. Bora :

Alright.

Dr. R. Bora :

High CK levels indicate damage to your limb muscles or heart muscles.

Dr. R. Bora :

You mentioned that while doing gym, your urine turned brown. So, there was definite muscle breakdown.

Customer:

Yes, I had done about 30 full chin ups and then once I couldn't do anymore I would do "inverted" chinups - I'd jump up and hold onto the bar an let myself down slowly for another 30 or so.

Dr. R. Bora :

So, you will have to be tested for "musculoskeletal diseases" like polymyositis.

Customer:

Definitely did some damage there. Arms swelled up a day later, urine turned brown, so I went to emergency.

Dr. R. Bora :

Polymyositis is a type of inflammatory disease of the muscles.

Customer:

They did some more tests there and went through 3 IV bags

Dr. R. Bora :

Are you taking any medicines like Statins for high blood lipids?

Customer:

I haven't experienced that since, but my CK levels are constantly between 5900 and ~7800

Customer:

No, no medicines or vitamines

Dr. R. Bora :

Alright. I would say that your doctors need to find out if you are having any diseases that causes myopathy or muscle inflammation and breakdown.

Customer:

OK, what kind of test(s) would that take?

Dr. R. Bora :

Like polymyosistis is one possibility.

Dr. R. Bora :

Tests like electromyography or if necessary muscle biopsy.

Customer:

OK, thank you. Any thoughts on the slight anemia? Could it be related?

Dr. R. Bora :

You should also check for autoantibodies.

Dr. R. Bora :

The anemia is likely consequent of the muscle protein damage , I am not sure but looks secondary to something other than anemia.

Dr. R. Bora :

Please talk to your doctors about myopathic diseases.

Dr. R. Bora :

I hope my answer has helped you.



Please remember to choose accept or to rate me excellent service ( 5 or 4 positive rating)to give credit for my answer and time.Bonuses are warmly appreciated.

Customer:

Now, the anemia was showing over a year before my CK levels were elevated. Maybe they are separate?

Customer:

Hard to tell online, I know, but just thinking aloud.

Dr. R. Bora :

Yes, I understand. Get a bone marrow biopsy done to get to the core of everything.

Customer:

Ok, thank you.

Dr. R. Bora :

You are welcome.

Dr. R. Bora :

God Bless you!

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