Patient : Female aged 74 years: Height about 5ft, Weight around 90Kgs

(1) Severe burning sensation in the feet (been there for 5-6 years but now has increased and becoming intolerable)
(2) Feels numbness in both the legs if she stands for few minutes (been there for few years, have consulted both Neurologist, Cardiologist – EEG, Brain MRI, Doppler of Carotid Arteries, Holter Tests done. (No significant issues identified)
(3) Cramps in both the legs
(4) IBS – Irritable bowel syndrome (for last 10 years, treated right from peppermint oil capsules to psychosomatic disorder, all of them only have very temporary relief). No clear solution to address this issue till date.

Patient History:

Hypertension – Was very mild until last couple of weeks (only 1/2 tablet of Prolomet XL 25 daily) for many years. Recently it became very high (now normal with medicines Telma 20mg & Amlong 5 mg daily).

Palmar Plantar Psoriasis – For last 4 years (Dermatologust treatment only external application ointments)

Treated for peripheral neuropathy with Maxgalin 75, etc. but no improvements.

Nerve conduction test, ECG, EEG – Normal
Venous & Arterial doppler of both the legs – No major issues
Blood tests, Thyroid, Renal, Hemogram, etc. – Normal
Vitamin D total (low, 9.02ng/ml, taking supplements now)
B12 high – 1258 pg/ml (high, may be because of supplement Nurokind OD she took for a week prior to blood test)
HbA1C – 6 and average blood sugar 125mg/dl

Total Knee replacement surgery for both knees done 6 years back.

Please advise.

Thanks

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