Suggest treatment for abdominal pain and weakness while having vitamin-d deficiency/hypotension
Patient: Hi my name is Katie. I am 22 years old. I have been in and out of doctors offices since my csection in Feb. of 2009.  I had my gallbladder removed in June of 2009 due to gallstones. My symptoms didn't subside after that/ I still felt the same. Fatigue, Abdominal Pain, weakness etc. I found out that I had vitamin d deficiency (18L). And Hypotension. (Get out of breath, fainting etc)The dr told me to increase my salt intake and exercise more. I did, and it hasn't worked.  During my pregnancy I developed ICP? (high liver enzymes)I had severe itching that didnt subside. Since I had no family history of it, I demanded a Ct scan of my abdomen to check everything visually. My results came back normal. As with all my bloodwork. I am at my wits end and don't know what to do. Do you have any suggestions? Doctor: Hello Katie!Welcome and thank you for asking on HCM!I passed carefully through your question and would recommend checking your adrenal gland function and also your thyroid gland function. Your symptoms could be caused by a hormonal disorder or an autoimmune disorder. For this reason, I would recommend performing some tests: - cortisol and aldosterone plasma levels for the adrenal gland function- ANA, ANCA to investigate for an autoimmune disorder- complete blood count, fibrinogen plasma levels and PCR for inflammation- thyroid hormone levels- a Head Up Tilt test for postural hypotension. A cardiac ultrasound is also necessary considering the shortness of breath when walking. In the meantime, I recommend continuing taking Vitamin D. Hope you will find this answer helpful!Kind regards, Dr. Iliri