I am 50 years old woman with 74 kg weight and 5 feet height, having hypothyroidism, hypertension and diabetes. Taking arkamin once a day for hypertension, eltroxin 137 mcg once a day for thyroid replacement and metformin 1 g after breakfast and dinner plus dynaglipt 20 mg with 500 mg metformin before lunch for diabetes. My last hba1c was 6.7 but I am not feeling good most days and have very less energy. My body pains most of the time and since last few days, I am getting headache too sometimes. I get tired very easily with just two hours of house work and though I sleep lately, get up early at 5 or 6 am. Have an irritable bowel syndrome too it seems since I have to go to potty every time I eat or drink water. I.e.i have to go to toilet 5-7 times a day. My vitamins level are ok and iron is also ok when checked last time in may. What is the treatment for ibs and what might be the reason for body pain and getting tired with least amount of work. Energy levels are very low and I can't see and watch videos or films also since I can't be attentive enough to listen with focus due to lack of energy. My hands also pain so much that I don't feel like doing anything. Kindly give me the treatment plan which I am able to follow. Thanks.

Dr. Col V C GoyalGeneral Physician43yrs exp

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1.no alcohol 2. Reduce body wt 3. No smoking/ tobacco 4. Diet - no ghee/ butter, have mix of vegetable oils - mustard, til, ground nut, olive oil, have more green vegetables and fruits, have whole grain atta, no fried. Fast. Spicy / processed/ junk food. Less sugar, potato, rice 5. 30 mts brisk walk daily 6. Deep breathing exercise for 10 mts daily 7. Meditation daily for 10 mts. 6-8 hrs of sleep at night 8. Expose your body to sun for 15-20 mts daily after some oil massage to get vit d. 9. Take more water. U have to improve your food habits do 1. Take 2/ 3glass of warm water in the morning before brush 2. Take more water in day 3. Take meals at fixed hrs, chew food properly/ completely, no eating quickly 4. Take small amount of food at a time, take more frequent meals - may be five times a day. 5. No spicy/ fried/ fast/ junk/processed food. Caffeine, mints or mint-flavoured foods, pungent, sour things, tomato-based foods. 6. No smoking, chewing gum, and carbonated beverages. 6. No milk for few days, can take curd, no uncooked salad 7. Avoid constipation 8. Use nibupani (lemon water) 2/ 3 times a day 9. Do not drink/ store water in plastic bottles. 10 .relax and walk for 30 mts daily 11. Take enough rest- do not lie down immediately after eating. Take dinner 3 hrs before sleeping. No late nights 11. Keep your weight under control. 13. Avoid tea, coffee, alcohol 15. Reduce physical and mental stress. Maintain healthy life style. Do exercise regularly. 16. No unnecessary medicines medicine can not be advised for open question for medicine and further advise contact on private consultation good luck.  

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