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Weight loss,itching and left lower abdominal pain,so confused

Hi,please @stef2011 and others help me check into this.i was diagnosed for hbv in 2012 but didn't start any treatment because lft was normal,no idea about viral loads then, but used to have heartburn so i did endoscopy but nothing was found, was advised by gastro to eat healthy. So fast forward to last year Oct,I started having body pain with burping,and a particular lower left abdominal pain,and tingling on left leg with pain and back pain. I did several urinalysis,urine msc and ultrasound,protein was found in urine,sti and one out of all the ultrasound said renal parachema or so,family Dr said protein could be from not drinking enough water and did physical examination then said left abdominal pain from big colon,placed me on drugs for 2 weeks,asked me to stop eating some food,and dismissed the renal parachema. After 2 weeks my poo,started forming well and not watery as it used to be.but left lower pain persisted,he order ct abdominal pelvic scan,result came out nothing was found and no inflammation.pain persisted with serious body pain.later went to see a gastro,did colonoscopy,everything was normal,he said ibs change diet,I did but no changes still,went to see nephrologist, in December showed him all my past test results,ordered urinalysis,msc urine,creatinine and ct urogram with contrast.all came back fine with creatinine of 69.8 umol/L (62.0  to 106.0 range).from the scan he noticed my spine wasn't too curved so he said not normal and prescribed a muscle relaxant drugs,prior to that I had done hbv dna 7134 iu/ml  with normal lft
28/11/2020
Total bilirubin 0.5 mg/dl    range 0.1 to 1.2
Direct bilirubin 0.1 mg/dl      0 to 1.0
Total protein 6.2 mg/dl    6.0 to 8.7
Albumin 3.6 mg/dl    3.5  to 5.0
Alt   13 iu/l   0.1 to 39
Ast 06 iu/l  0.1 to 40

Alkaline phosphate 101 iu/l   98 to 279

Did fbc all normal with platelet of 235,lipid  profile normal too.

I asked if I can start taking drugs for hbv he said no. So went back to the gastro,he checked the ct urogram film and referred me to bone hospital, saw a spine Dr, he ordered Mri and did mri all spine ,was diagnosed with degenerative disc diseases,he said minor go do physiotherapy, I started that but with no drugs. Pain persisted,I was weighing 67kg,age 35,male. In February my weight dropped to 57kg. I met another gastro,presented my case,saw all the results and placed me on tenofovir immediately, and ordered tests Afp,thy,cea,calprotectin and pylori, all came back well
Afp  2.2 ku/l     0.0 to 5.8
Cea  1.4 ug/l   0.0 to 3.5
She also prescribed probiotics,dustpatalin  and anti depressant drug. She concluded that no inflammation ,but ibs,see in 3 months.

After 2 months, the left abdominal pain stopped and felt much better but I noticed  yellow urine sometimes, I was told livolin could be the cause too,but I drink lot of water. Into the 3rd month, I started having itching on my ankles , wrist, sometimes at night,it goes and comes,i asked around if this could be side effects of tdf but nobody knows really.plus i am not gaining weight still 57kg .Last week made it 3 months I started tdf and due for appointment,I did lft,urinalysis,ultrasound scan,hbv panel and dna/ surface antigen quantification.

26/04/2021
Total bilirubin 7 umol/L    range 3 to 26
Direct bilirubin  3 umol/L     2 to 7
Total protein   72 g/l    60 to 80
Albumin  49 g/l   35 to 50
Alt   42 iu/l  >40 H
Ast 30 iu/l  15 to 40
Sgt  53 iu/l  0 to 64

Kidney function test
Sodium  137 mol/l      135 to 150
Potassium  3.4 mol/l   3.5 to 5.1  L
Chloride  103 mol/l      98 to 107
Bicarbonate  25 mol/l   21 to 29
Creatinine  79 mol/l       80 to 115 L
Egfr   ckd kpi  >89 mil/min

Ph 6.0
Platelet 221

Hepatitis b cab  positive
Core value 7.98 s/Co
Hep b surface ag quantity  24280 iu/ml
Hepatitis  b sab  Non immune
Hepatitis b surface ab  value  0.58 miu/ml
Hepatitis b virus dna   Undetected  iu/ml
I started panicking when I got this results because everything was in range before I started tdf,Alt was raised and my Potassium level dropped,last week at the appointment i did vitals and noticed I dropped to 55kg again,itching continued. The gastro said I worry too much and probably not eating well that this could affect my weight as well.i asked about the itching she said not sure but would check the leaflet for tdf.she said with all the test results I am doing okay but I refused to believe that,why platelet dropped from 231 to 221,why Alt raised to 42 from being normal before tdf likewise Potassium?why weight loss like that?She said we should continue to monitor.

During these periods my left lower abdominal pain returned I started to panic really bad,she said since I don't believe I am okay that we should do fibroscan,scheduled for yesterday but was tensed since last week to yesterday not knowing what the findings could be,weighed myself at home about 4 days ago and still 55kg,getting to hospital yesterday did vitals and they said 53.5 kg,I almost broke down in tears what's going on really. I ended up doing the fibroscan,last food was dinner around 7pm the other night and did the test 11am yesterday morning.result below

Median stiffness 4.6 kpa
Iqr 1.4 kpa
Iqr/med 30 percent
Valid measures 20
Invalid 4
Success rate 83 percent
I asked about the cap number she said she's sure I don't have fatty liver but I also think the machine didn't have that feature.

I felt the fibration several times and she placed it diffrent areas during the test.she performed it in her office and she's a gastro and hepatologist.

She concluded that I should continue the tdf and livolin,check back in 3months with just lft and afp test.she said eat well and continue with dustpatalin and enterogermina for the abdominal pain.

My questions,I had tried all.possible best to get the answer to weight loss,left lower abdominal  pain and body cracking sound most times but no certain answer.what can I do regarding that ?could the itching be from tdf and weight loss ? Is the fibroscan a good result?I stopped eating many foods since last year and I don't drink nor smoke.what could be the cause for atl elevation and low Potassium? Can worrying too much affect weight and probably activate ibs?and lastly,with the left lower abdominal pain,I noticed I go to toilet every morning and once a day which stopped when I took the prescribed drugs but started again last week.. is it really ibs.

I am so sorry for the long story but I just want anyone trying to respond to understand my journey.i am new here please help my case thank you.
8 Responses
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Avatar universal
To add,she ordered vit d3 test and b12 but I don't have resources to get this done for now.i will do it soon.
Helpful - 0
Avatar universal
Hi Texcel

I am in similar position. I understand your pain and situation. Please don't panic. There is solution for every problem. Have faith in God.

My history as below :
I visited Dr for heart problem in Feb 2020. I was 67 kg.

Then during this covid 19 I started feeling pain in upper right abdomen. I saw family doctor. He prescribed me few medicine. Pain was little subsidized. It is disappearing with food.

I changed my diet avoiding suger completely. I was weighted 63 kg in October 2020

I visited gastrologists again in March 2021. I weigh 58 kg.
Did all blood work. Hep b detected. I was unware about it my whole life. I am 37 year old. TAF started. HBV DNA in millions 1.7 log unit. LFT on upper side.

I am feeling difference in body due to this loss. Cloths are baggy now. I am facing fatigue.

I again weigh Today it's 57 kg. After 2 and half month. Weight loss rate decreased by half.

I haven't did any other test. I will wait for one month if weight is constant then will increase diat else have to see specialists.

Helpful - 0
2 Comments
Also I was exercising during September to December daily. I was doing 12km cycling on road. Please keep us updated. Did you checked for thyorid and diabetes ?
Thank you for the feedback and sharing your condition with me. May we all see good help out of this.I did fasting blood sugar last month whicj came out fine. Also did thyroid function test in February all came back well. At this point I don't know any other things to do but to be hopeful.
Avatar universal
Hi texcel. Your fibroscan result is very good. It indicates there is no damage at your liver. Also it seems using TAF decreased your viral level to zero. So practically you don't need to worry about HBV. I think managing your stress level and trying to overcome your worries would be very helpful to you.
Helpful - 0
1 Comments
Thank you, its actually Tdf,which I started in February this year.i will work hard on managing my stress level and overcome my worries.
Avatar universal
I do not have all the answers to your questions but I do believe I have some insight into what is going on. I think taking vitamin D can help you alot. I think your low vitamin D could be causing many issues. You should get it tested right away.

I feel very strongly that your symptoms are from the HBV. The abdominal pain is probably from the HBV. Vitamin D will help lower the Hep b surface ag quantity. The medicine that they give usually only lowers the DNA.

One thing I noticed about your results is that your creatine level is high. A high creatine is either because your kidneys are not removing the creatine from your blood or your liver is excreting too much creating because it is damaged. This is another reason why I believe your HBV is the problem. This explains why you started feeling better on the HBV medicine. I also had high creatine and taking vitamin D made it go to a normal range. You have to keep taking vitamin D.

I can also see that your itching and bone issues could be because your vitamin D is low. The HepB medicine that you are taking is helping. But I am sure you are low on Vitamin D and it is probably causing many problems. Start taking 5000 IU vitamin D a day right away.



Helpful - 0
2 Comments
I truly appreciate your time for responding to my questions. I did ct urogram with contrast few months ago and it was stated that Kidney and other things were normal. Please I don't understand what you meant by high creatinine, but it was stated in the urinalysis result that Creatinine  79 mol/l       80 to 115 L, with the L saying low. In all honesty the vitd3  test is kind of expensive because this issue took most of my  finances,it might take like 3 weeks before I could get it done.Can I start taking the vitd3 without getting tested?if yes,which brand is okay and do I have to get other supplements to take with it or just the vitd3 daily ?
I made a mistake in reading your test results. The range that you reported for creatinine is different from the range that I am used to. I am guessing in your country they report a different range. So it seems your creatinine levels are normal. That was my mistake.

Yes, you can start taking it without the test. Just take vitamin D3 5000 IU once a day. The brand is not important. Just try to get the one that looks like gel capsules. Some people say it is good to take vitamin K2 with it. But you can get that later. Just take the vitamin D3. Don't worry about brand. Just get one. You will feel better in a few weeks. It will take time to work. But you have to keep taking it.

Avatar universal
I can see the potassium deficiency. As per internet search potassium deficiency can lead to weight and muscle loss.

Any other member has any opinion on it. I don't know my potassium level.
Helpful - 0
Avatar universal
texcel21  -  I understand your situation but what you're currently experiencing could be due to stress and anxiety giving the fact you had extensive workup.  Try to control your stress and see if there is any improvement. This is probably fueled by constantly searching for something that is not there. Trust me, we've all being there and still experience this time to time. I have learned a lot from this community and sometimes you must take things mentioned here with a grain of salt as we are not doctors, and our immune system will react differently to the virus. Stress can have a devastated impact on your health (I have been there and know it for sure).  Just relax and take it one day at a time. You can certainly take vitamin D if your level is low but always check with your doctor. Several nutrients our body needs can be found in superfood and cruciferous vegetables. Your issue is stress. you cannot eliminate stress, but you can certainly control it to some extent - stay away from google search for a while, daily walk - 30-60 minute, spend time with friends and family, well balanced diet, limit sugar and alcohol, be positive, etc. There are 370-400 millions of people in the world with Hep B and a lot of people grow old not knowing they have this virus. Be thankful you found out early and can take appropriate action to prevent adverse outcome. God bless....  
Helpful - 0
Avatar universal
Hi texcel.
Also my weight loss
Im start taking tenofovir since september 2020 and now i notice.my urine is foamy .
I dont know whats wrong.
Also my weight loss from 65 to 56 kg
Helpful - 0
Avatar universal
Hi texcel.
Also my weight loss
Im start taking tenofovir since september 2020 and now i notice.my urine is foamy .
I dont know whats wrong.
Also my weight loss from 65 to 56 kg
Helpful - 0
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