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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35069
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I was doing some research my c3 and c4 levels are high but

Customer Question

I was doing some research my c3 and c4 levels are high but ana sedrate rh factor are all normal
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 2 years ago.
I am Dr. Arun and will be helping you today.
I am sorry that your question was unanswered for long.
Your symptoms need evaluation mainly for;
1) Neuropathy
2) Pinched nerves in neck and lower back.
3) Immunological arthritis / inflammatory spinal issue.
An high C3 and C4 indicate increased immune response but since your other investigations like ANA, RA factor etc are normal; you would need further investigative work up to pin point the cause and start a specific management plan. Following investigations should be done by your primary care physician or a neurologist;
1) Electromyography/nerve conduction studies (EMG/NCS)
2) MRI of the spine and brain
3) blood glucose, glucose tolerance test and glycosylated hemoglobin
4) serum B12 level with methylmalonic acid (with or without homocysteine),
5) serum protein electrophoresis
6) Anti-nuclear antibody
7) Lyme testing
8) Rheumatoid factor
9) Sjogren's syndrome testing (Anti-Ro, Anti-La Antibodies)
Skin and nerve biopsy may also berecommended after the results of these investigations.
This should give the diagnosis and guidelines for the management.
Following are the causes to looked for;
1) Diabetes
2) An underactive thyroid gland
3) Excessive use of alcohol
4) Thiamine deficiency
5) Vitamin B 12 deficiency (pernicious anemia)
6) Vitamin B 6 (pyridoxine) taken in excessive amounts
7) Drugs, medications, herbs
8) Autoimmune diseases
9) Heavy metals such as lead and mercury.
Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
Thanks for using Just Answer.
Expert:  Dr. Arun Phophalia replied 2 years ago.
You may also need to look for other causes like nutritional or metabolic causes which may cause neuropathy. Following work up may be necessary as the next step, if everything comes out negative;
Investigations to ascertain the nutritional neuropathy;
Thiamine (vitamin B 1 ) deficiency: A serum thiamine (vitamin B 1 ) level
Pyridoxine (vitamin B 6 ) level
Folate deficiency: Serum folate levels .
Niacin (vitamin B 3 ) deficiency: Urinary excretion of N -methylnicotinamide
Cyanocobalamin (vitamin B 12 ) level
Pantothenic acid deficiency: Excretion is less than 1 mg/d.
Alpha-tocopherol (vitamin E) deficiency: The serum α -tocopherol (vitamin E) level
Hypophosphatemia: Serum phosphate level
Biotinidase levels
Aminolevulinic acid synthase in urine (porphyria)
Arylsulfatase A and B (leukodystrophies)
Urine oxalate levels
Serum lactate, ammonia, and pyruvate
Urine myoglobin
Muscle histochemistry
Enzyme assays of muscle, blood, and fibroblast
Leukocyte glycogen levels to detect acid maltase deficiency
Leukocyte, DNA analyses (McArdle disease)
It is privilege assisting you.
Please let me know if you have further queries or unanswered questions.
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Thank you.
Wishing you all the very best in life.
Expert:  Dr. Arun Phophalia replied 2 years ago.
Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited for my work.
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Thank you.