Experiencing Unexplained Symptoms: Low Calcium, Blood in Urine, and Back Pain - Seeking Guidance
41 years old, 5’2, weighing 51 kg I am currently supplementing with multivitamins, including an additional 3000 IU of Vitamin D3 along with K2. I have no known medical conditions and do not take any medications. For several years, I have suffered from intense pain in my lower back. My doctor suspected ankylosing spondylitis, but MRI results came back normal. Additionally, I experience discomfort in my left flank, often accompanied by both gross and microscopic hematuria. At times, there’s been minimal clotting, yet multiple urine cultures indicate no infection present. The discomfort in my lower back and flank tends to peak in the morning. While urination alleviates some of the intensity, the discomfort persists consistently. Applying pressure to my left flank relieves a rather unpleasant sensation, though it isn't severe pain. Urology investigations, including bladder cystoscopy, urodynamic testing, and ultrasound examinations have all yielded normal results. Nephrology has declined to see me since all my kidney-related blood tests, including urine Albumin-to-Creatinine Ratio, fall within the standard limits. My iron and ferritin levels are at the lower end of normal, with some readings indicating low levels. I often feel fatigued, irritable, and generally unwell; however, I'm unable to pinpoint the source of this malaise. I recently underwent additional blood tests that included coagulation studies. Despite everything remaining in the normal range, I have observed a decline in my calcium levels. Does anyone have insights on what might be happening or recommendations on which specialist I should be referred to?
Answers (1)
3/23/2025, 3:41:00 PM
OpenHealth AI
Your symptoms, including low calcium levels, blood in the urine, and persistent lower back pain, are concerning and warrant a comprehensive approach to understand what is happening. With investigations yielding generally normal results and your ongoing discomfort, it’s understandable to feel frustrated and weary.
Key Points:
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Low Calcium Levels:
- Low calcium can stem from various reasons, including dietary insufficiency, issues with absorption, or thyroid/parathyroid gland problems. It’s crucial to identify the underlying cause.
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Blood in Urine (Hematuria):
- The presence of blood in urine without infection, alongside normal urological assessments, suggests other potential issues might be present, such as kidney stones or other anatomical anomalies often unappreciated on ultrasound.
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Back Pain and Flank Discomfort:
- Your lower back pain and flank discomfort can be complex. It's important to consider conditions that affect both the musculoskeletal system and urinary tract.
Next Steps:
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Nutrition and Supplements:
- Given your low calcium, ensure you're consuming enough calcium-rich foods (like dairy, leafy greens, and fortified products). Consider discussing the adequacy of your vitamin D supplementation with a healthcare professional, as vitamin D is essential for calcium absorption.
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Specialist Referral:
- Request a referral to an endocrinologist to evaluate your calcium metabolism and bone health, including potential parathyroid function checks.
- Additionally, consider consulting a rheumatologist for your chronic back pain, especially if ankylosing spondylitis remains a consideration, despite normal MRI results.
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Monitoring Symptoms:
- Keep a symptom diary: Note the frequency and severity of your flank pain, calcium levels, energy levels, and any other relevant symptoms.
- Document dietary intake to identify any potential deficiencies or patterns that correlate with your symptoms.
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Lifestyle Adjustments:
- Engage in regular, gentle exercise to support overall health and possibly alleviate musculoskeletal pain. Activities like swimming or yoga might be beneficial.
- Stay hydrated, particularly if you're experiencing any urinary symptoms.
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Follow-Up:
- Continue regular follow-ups with primary care to monitor your overall health and response to any treatments or dietary changes you implement.
It’s important to advocate for your health by communicating openly about your ongoing symptoms and concerns with your healthcare providers. You deserve thorough investigation and care. If you see changes in your symptoms or feel that new symptoms arise, seek medical advice promptly.
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