instruction: hello doctor I started taking vitamin and calcium more than I should have in the beginning of the year later on I started to feel weak and dizzy at work my feet and hands tingle and would go pale and my neck in the thyearoid area started to hurt I have been to the doctor to have blood work but they say there is nothing significant enough to be concerned but I still have the same symptoms what to do
output: hi in your attached he electrophoresis report abnormal hemoglobin is not present so you are not having any abnormal hemoglobinopathy your main complaint is weakness dizziness and tingling so anemia b12 deficiency thyearoid issue liver disease renal disease vitamin deficiency and peripheral neuropathy should be ruled out I suggest you investigate with serum b12 estimation abc complete blood count serum ash thyearoid stimulating hormone estimation sept serum glutamic pyearuvic transaminase got serum glutamic oxaloacetic transaminase serum urea and creatinine estimation for further work up to rule out peripheral neuropathy your neurological physical examination should be done according to cause specific treatment can be given I suggest you rule out diabetes as well by random blood sugar estimation meanwhile you can be prescribed riconia forte like multivitamin tablet for your problem