Have Medical Questions? Ask a Doctor Online!
I am Dr. P. Jyoti, MD. I promise to use my full experience and knowledge to provide answers specific to your question. Feel free to ask me anything.
hello would you like to chat on this?
Thank you for your time sir
hello why do you think she has water retention? does she have edema?
she has both pitting as well as non-pitting edema.
she has it in her face, arms and legs. the face in the morning and arms and legs during the day or evening.
has she had renal tests like clearance tests?
yes. they came back fine. She went to a kidney specialist as well and said everything was in good order. The only thing that came back from several tests was a slight fatty liver.
in that case there are two possibilities
almost all possibilities have been checked up in her case
as you realize she has already been checked up by many specialists and so a quick diagnosis is not possible here
however i can suggest two possibilities that you should check out with your doctor
the first is lymphatic block
disorders in lymph drainage can cause edema in different parts of the body
the fact that she has non-pitting edema is significant here since water retention would cause pitting edema only
a test which can check for lymphatic drainage is lymphoscintiography
discuss this with her doctor
this needs to be ruled out
the second possibility is that it is her anemia which is causing this
anemia can lead to edema
her iron deficiency should be corrected
since she cannot tolerate iron orally, you should discuss with her doctor about giving her IV iron
i mean her iron deficiency
you should discuss with her doctor about giving her IV iron
her lymph nodes in her neck are heavy.
this can heal her from the edema
yes, that can be an indication of blocked lymphatic flow
Any other tests I can specifically suggest her doctor to do?
almost all her tests have been done
the other important tests are cardiac function tests
yes. we have not had those done yet and its on my list.
full heart function tests should be done since this can also cause water retention
she needs to do ECHO and stress tests
these tests should detect any cause of retention
these tests are the ones to discuss with her doctor, along with correction of iron levels
OK. Thank you.
Are you satisfied with my answer? Please remember to rate my service once you have all the information you need. Rating system is the row of faces below - click on a happy face to give a good rating. Thank you.
glad to help
any further questions?
One last question.
Her cortisol levels are very low. Once they pitted below the low average. Could his have any cause and effect?
yes that can also be significant
low cortisol will also lead to edema
she needs to have them rechecked
ok. 6am check is the best?
if they show low cortisol again then further testing to rule out Addison's
anything she can do to raise those levels?
yes, 6 am test and 24 hour urine collection tests
good diet and exercise, which she is already doing
ok. this is awesome. this gives me some good directions.
if it is low it could be addison's and needs cortisol supplementation
If the question has been answered to your satisfaction, please rate my service.Rating system is the row of faces below - click on a happy face to give a good rating. Bonus is always welcome Thank you.Dr. P. Jyoti