instruction: hello doctor last week I went to the doctor for several reasons like headche weakness tightness and pressure in the head and body pain he ordered some blood work and chest ray doctor told me that chest ray report is good and he just told I have low vitamin b12 level and I have bacteria in stomach he prescribed me omeprazole clarithromycin and amoxicillin and I took five shots of vitamin b12 but still I feel tightness in the head and several headaches my hemoglobin and hematocrit level is too high my bowel habits is also changed I pass stools right after eating three to four times a day all my symptoms meet cancer do you think I have polycythemia or polycythemia vera do you want me to consult hematologist please give your opinion
output: hello welcome to the icliniq com I have gone through your history and reports you had a complaint of left side abdominal pain with a headache hence gastritis can be the possibility and for that antibiotic and antacid course are prescribed sometimes upper gastrointestinal infection can lead to poor absorption of vitamin b12 and so deficiency can occur but here your b12 value is borderline in the report so further work up can be done at that time by measuring homocysteine and methylmalonic acid measurement for confirming b12 deficiency anyhow you completed the course of b12 injection so no need for measurement of homocysteine your stool frequency is increased and it seems to be stress related irritable bowel syndrome stress anxiety lead headache as well yoga meditation and exercise will be beneficial in reducing stress consume more fruits and green leafy vegetables if needed psychiatrist help can be taken if stress and anxiety are not related then us ultrasound abdomen or endoscopy like workup can be planned only if gastrointestinal symptoms worsening in your attached abc report values are within limits in polycythemia which you are suspecting he is greater than 17 abc count and platelets also can be high rec values are high and hit is more than usually so here polycythemia is not the possibility repeat abc after completing your antibiotic course lack of sleep hypoglycemia smoking stress irregular meal habit migraine etc are some other causes for headache I hope this helps