استشارة الدكتور كاظمي

مرحبا دكتور . اشعر بارق وبخمول شديد بصفة مستمرة مع تقلص في الاكثاف و الواح الكتفين مع الشعور ببرد شديد في الرأس و الاكثاف و الواح الكتفين صداع مستمر في الرأس و خصوصا في مؤخرة الرأس مع قلة النوم

Salam Doctor Mohammed. The consultation for a girl, age, thirty four.It will be written in her word.
About seven months ago. Accidentally, my knees hit the table. I felt pain at the moment then I walked normally. After three days, I felt pain then the pain started increasing. I went to the hospital and did an X-ray. The result as he told me: “nothing, no damages, no breaking in the bones, no problem”. He gave me the following medication:
Diagnose: Sprain and strain of other and unspecified parts.

The doctor said, take these medications and after ten days, inshaalla it will be healed.
REPARIL GEL N FORTY G …….. ONCE EVERY EIGHT HOURS………. FOR TEN DAYS
TILAX TOW MG ……..ONCE EVERY TWENTY FOUR HOURS……… FOR TEN DAYS
VOLTIC -D FIFITY MG DISPERSIBLE….. ONCE EVERY TWELVE HOURS…….. FOR SIX DAYS

But I only took those medication for TOW days. Then I stopped after knowing that one of them affects thyroid.
In fact, I forgot to tell the doctor that I spent approximately one year having “Sub clincal hypothyroid” which means TSH was high, but T3 and T4 were always normal. And I didn’t have any symptoms and didn’t take any medication.

During that time, I noticed that my knee got better every several days, even after I stopped taking medication. So I decided to wait and just focus on nutritious food and eating fish.
I only used the Gel, and it had a positive effect. It continued for tow weeks or month but now. The pain returned back. My knee became much better in comparison to before but still there is pain came and some tiring when I rise my knee.

By the way, I did blood test and found out that even my TSH turned back to normal now. So I have NO sub clincal hypothyroid now.

I consulted another specialist online and told him about the condition. I told him that I don’t want a medication that affect thyroid although my thyroid hormone got back to normal now but I’m not comfortable to take that medication.
So he gave me the following:
Naproxin500 MG.

I went to pharmacy and the pharmacist told me: take one tablet a day, for five days OR seven days.
Now I took this medication, I completed five days but honestly, I don’t feel there is any difference.

There are times of the day where I feel there is no pain, then it comes back again at another time. I have no problem with praying on my knee. But if I try to rise my feet to up, I feel there is some tiring in it. When I sit on a chair, there is pain on my knee, When I let my feet straight and spend time that way, I have a pain too.
When I wash my knee with warm water for 3 minutes, I feel good, the pain vanish, But then it comes back after an hour or so.

My questions:
1) I don’t feel an effect of using naproxin once for 5 days, should I complete using it for further tow days?
2) I have Vitamin D deficiency , it’s 35.11 L nmol/L
I started taking vitmain D tablets right now. I’m taking (fifty thousand IU) one tablet for the whole week. Now I completed the second week. Is it the reason behind my situation? Should I wait until vitamin D get back normal?

3) there is a third doctor who asked me about vitamin B1, but I never made this test before. He said, take it even without doing blood test but I’m afraid of taking anything without making sure by doing a test. What do you think?
Do you recommend me to take Vitamin B1 without doing a blood test? If so, what’s the dose?

By the way, I have done vitamin B12 test and it’s normal.
B12 II = 445.2 pmol/L

I have a deficiency with hemoglobin, but it was just recently, because I kept thinking a lot. At that time, I had no problem. Now, I eat normally.
Please don’t response in Persian
Your response is highly appreciated

Thanks