Q. I have severe pain in my fingertips and toes. What could this be?

Answered by
Dr. Prakash H Muddegowda
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 14, 2017

Hello doctor,

I have had chronic bloating, indigestion, stomach pain, nausea, and diarrhea for over a month. During that same time, I developed frequent shortness of breath and palpitations with exertion upon waking and after eating. Also, during the same time, I began having severe pain in my fingertips, toes, and elbows that come and go. I just feel very sick. Any idea what this could be? My father had polycythemia vera. My physician assistant did some bloodwork. Monocytes were 10.9, creatinine was 1.6, BUN was 20, and total protein was 8.5. Please provide your opinion.



Welcome to icliniq.com.

Based on your query, my opinion is as follows:

The serum protein and creatinine levels are a bit high possibly due to increased protein intake or associated dehydration in recent times.

Monocytes are mildly elevated and BUN (blood urea nitrogen) levels are in the upper normal range. Monocytes may indicate ongoing chronic inflammation. It is only mildly elevated and does not have much significance.

For polycythemia vera, hemoglobin levels or hematocrit levels are important. If they are normal, then there is nothing to worry.

If the pain is in the fingertips and toes and if there is any associated tingling or burning sensation, we can think of peripheral neuropathy. Vitamin B12 and folic acid supplements should be beneficial.

Looking at other symptoms like chronic bloating, indigestion, stomach pain, nausea, and diarrhea, gastritis, increased acidity in the stomach is a possibility.

You need to use antacids along with proton pump inhibitors like Pantoprazole to reduce the acidity. You also need to reduce stress, avoid spicy foods, and take regular meals.

There are no symptoms of polycythemia vera and more in relation to gastritis. If not checked, check once for hemoglobin levels. Maintain good hydration with at least six to eight liters of water per day.


For more information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

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