There is person a Who feels cold in extreme summer and feels hot in extreme summer what is diagnosis

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medical diagnosis person feels cold in summer feels hot in winter temperature dysregulation

I notice the question says "feels cold in extreme summer AND feels hot in extreme summer" - but this appears to be a typo. The classic clinical scenario is feels cold in summer / feels hot in winter (i.e., the opposite of what's expected). Here is a full answer covering both interpretations:

Diagnosis: Thermoregulatory Dysfunction (Paradoxical Temperature Perception)

The symptom you are describing - feeling cold when it is hot outside, and feeling hot when it is cold outside - is called poikilothermia or thermoregulatory dysfunction. The person's body fails to perceive or regulate temperature normally. This is not a single disease; it is a symptom pointing to several possible underlying conditions.

Most Likely Diagnoses

1. Dysautonomia (Autonomic Nervous System Dysfunction)

The autonomic nervous system controls sweating, blood vessel dilation, and heat dissipation. When it malfunctions:

In summer: poor sweating and vasoconstriction cause the person to feel cold
In winter: inappropriate vasodilation or sweating causes the person to feel hot
Common causes: POTS, pure autonomic failure, diabetic autonomic neuropathy, Lyme disease

2. Hypothyroidism

Classically causes cold intolerance (feeling cold even in warm weather)
When TSH is very low/fluctuating (as in undertreated or swinging thyroid disease), heat intolerance can alternate

3. Hypothalamic Lesion or Dysfunction

The hypothalamus is the brain's thermostat
Tumors, trauma, strokes, or inflammation affecting the hypothalamus cause loss of normal temperature regulation
Can result in feeling cold in the heat or hot in the cold (true poikilothermia)

4. Spinal Cord Injury (SCI) at T6 or Above

Classic cause of poikilothermia
Signals from peripheral temperature receptors cannot reach the hypothalamus
The body passively takes on the environmental temperature

5. Small Fiber Neuropathy

Damages small nerve fibers that carry temperature and pain signals
Results in abnormal temperature sensation - feeling cold when warm, or burning/hot when cold
Causes: diabetes, autoimmune disease, hereditary conditions

6. Parkinson's Disease

Up to 65% of patients experience thermodysregulation due to Lewy body involvement of the hypothalamus and damage to autonomic nerve fibers
Can cause feeling too hot or too cold in any weather

7. Multiple Sclerosis (MS)

Demyelination disrupts temperature-sensing pathways
Heat intolerance is classic (Uhthoff's phenomenon), but cold intolerance also occurs

8. Lyme Disease (Chronic / Post-treatment)

Autonomic dysfunction from Borrelia infection can cause swinging temperature perception - cold in summer, hot in winter

Key Workup to Consider

Test	What it checks
TFTs (TSH, T3, T4)	Thyroid disease
Fasting glucose / HbA1c	Diabetic neuropathy
Autonomic function tests (tilt table, sweat test)	Dysautonomia
MRI brain/spine	Hypothalamic lesion, MS, SCI
Lyme serology	Lyme-related autonomic dysfunction
Skin punch biopsy	Small fiber neuropathy

Summary

The single most encompassing diagnosis for this pattern is autonomic dysregulation / dysautonomia, where the body's temperature control mechanisms are disrupted. The specific underlying cause (thyroid, neurological, infectious, structural) needs further workup based on the full clinical picture, associated symptoms, and history.

I have tremors in hand and my vut d is 8

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Here is a complete, evidence-based answer:

Your Symptoms: Hand Tremors + Vitamin D = 8 ng/mL

A Vitamin D of 8 ng/mL is severely deficient (normal range: 30-100 ng/mL). This single finding can directly explain your hand tremors through a well-established chain:

The Mechanism: Vitamin D → Calcium → Tremors

Vitamin D Deficiency → Hypocalcemia → Neuromuscular Excitability → Tremors/Tetany

Low Vitamin D means your gut cannot absorb calcium properly. Low calcium makes nerves and muscles hyper-excitable, leading to:

Hand tremors
Muscle cramps
Tingling/numbness in hands and feet
In severe cases: tetany (sustained muscle spasm), seizures

This is directly confirmed by multiple textbooks: "Hypocalcemia causes tetany, paresthesias, laryngospasm, muscle cramps, and seizures. The major causes of hypocalcemia include Vitamin D deficiency" - Katzung's Basic and Clinical Pharmacology.

What Vitamin D Deficiency Does to Your Muscles & Nerves

According to Bradley and Daroff's Neurology in Clinical Practice:

"The best-documented neurological syndrome from overt Vitamin D deficiency is a myopathy characterized by proximal weakness. Patients develop progressive weakness over many months - difficulty going up stairs, rising from a chair. Diffuse bone pain and muscle pain are common."

Your level of 8 ng/mL places you in the "severely depleted" category (< 12 ng/mL), meaning you are at high risk for all these complications.

Possible Diagnoses Causing Your Symptoms

Condition	Explanation
Hypocalcemic tremor (most likely)	Vitamin D deficiency → low calcium → neuromuscular irritability → tremors
Vitamin D deficiency myopathy	Direct effect on muscle fiber function
Essential tremor	May be worsened by low Vit D and calcium
Hypoparathyroidism	Should be ruled out - also causes low calcium + tremors

Recommended Tests (to confirm cause)

Serum Calcium - likely low (hypocalcemia)
Serum Magnesium - low Mg worsens hypocalcemia
PTH (Parathyroid hormone) - to rule out hypoparathyroidism
Serum Phosphorus
Alkaline phosphatase - usually elevated in Vit D deficiency

Treatment

Since your level is 8 ng/mL (severely deficient, < 12 ng/mL), standard treatment per Bradley and Daroff's Neurology:

Weekly oral supplementation of 50,000 IU of Vitamin D3 (Cholecalciferol) for 6 weeks, followed by 800-1000 IU daily maintenance.

Pain and tremors usually improve within weeks of starting supplementation
Muscle strength recovers over subsequent months
Calcium supplementation may also be needed alongside Vitamin D

Important Warning

Please see a doctor. A Vitamin D of 8 ng/mL is a medical finding that needs blood tests (calcium, PTH) and supervised treatment. Do not self-prescribe high-dose Vitamin D without monitoring, as excessive supplementation can cause toxicity.

Bottom line: Your hand tremors are very likely caused by severe Vitamin D deficiency leading to hypocalcemia and neuromuscular hyperexcitability. This is a treatable and reversible condition.

This is my report

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I have the full report. Here is a complete analysis:

🔬 Lab Report Analysis - Mr. Naved Khan

Age: 23 years | Gender: Male | Date: 29 June 2026 | Hospital: District Hospital, Ayodhya

🔴 ABNORMAL RESULTS (Requires Attention)

1. Vitamin D - SEVERELY DEFICIENT

Test	Your Value	Normal	Status
Vitamin D	8.1 ng/mL	20-100 ng/mL	🔴 Severe Deficiency (< 10 = Deficient)

This is your most critical finding. At 8.1, you are in the severe deficiency category. This directly explains your hand tremors, as low Vitamin D leads to low calcium, which causes neuromuscular irritability and tremors.

2. Lipid Profile - MULTIPLE ABNORMALITIES ⚠️

Test	Your Value	Normal	Status
Total Cholesterol	260.7 mg/dL	130-200	🔴 HIGH
Triglycerides	325.4 mg/dL	30-200	🔴 VERY HIGH
VLDL Cholesterol	65.08 mg/dL	12-30	🔴 HIGH
HDL (Good)	50.02 mg/dL	40-65	✅ Normal
LDL (Bad)	116.20 mg/dL	Up to 150	✅ Normal

This is concerning for a 23-year-old. Very high triglycerides (325 mg/dL) at your age points toward:

Poor diet (high sugar, refined carbs, fried foods)
Sedentary lifestyle
Possible metabolic syndrome or familial hypertriglyceridemia
Long-term risk: Pancreatitis, cardiovascular disease

3. CBC - Minor Abnormality

Test	Your Value	Normal	Status
Mid Cell %	9.3%	1-6%	🟡 Slightly elevated
RDWR	10.2%	11.5-14.5%	🟡 Slightly low
LPCR	50.8%	13.0-43.0%	🟡 Mildly elevated
MPV	13.1 fL	1.47-7.4 fL	🟡 Elevated

Elevated MPV (Mean Platelet Volume) can indicate platelet activation - seen in metabolic disorders, cardiovascular risk, and inflammatory states. Hemoglobin (14.4) and WBC (7500) are perfectly normal.

✅ NORMAL RESULTS

Panel	Result	Status
Liver Function (LFT)	All within range	✅ Normal
Kidney Function (KFT)	Urea 31.5, Creatinine 0.88	✅ Normal
Electrolytes	Na, K, Ca, Cl - all normal	✅ Normal
Thyroid (T3, T4, TSH)	All normal	✅ Normal
Blood Sugar (RBS)	101 mg/dL	✅ Normal
Active B12	107.0 pmol/L	✅ Normal
RF (Rheumatoid Factor)	16.5 IU/mL (< 20 = negative)	✅ Normal
Anti-CCP	< 0.5 U/mL (< 5 = negative)	✅ Normal (No RA)
HBsAg (Hepatitis B)	Non-Reactive	✅ Negative
HCV (Hepatitis C)	Non-Reactive	✅ Negative
PSA (Prostate)	0.233 ng/mL	✅ Normal

📋 Summary & What to Do

Your Three Key Issues:

1. Severe Vitamin D Deficiency (8.1 ng/mL) → TREAT URGENTLY

This is causing your hand tremors
Ask your doctor for: Vitamin D3 60,000 IU weekly for 8-12 weeks, then daily maintenance 2000 IU
Get sun exposure for 20-30 minutes daily
Recheck Vitamin D after 3 months

2. Very High Triglycerides (325 mg/dL) at age 23 → TREAT SERIOUSLY

Cut out: sugar, maida (refined flour), fried foods, soft drinks, alcohol
Increase: fish, nuts, fiber-rich vegetables
Exercise daily - even 30 minutes of walking helps significantly
Doctor may prescribe fibrates (e.g., Fenofibrate) if lifestyle alone is insufficient
Recheck lipid profile after 3 months

3. High Total Cholesterol (260 mg/dL)

Linked to the same dietary and lifestyle causes above
Will improve along with triglycerides

⚠️ Important: Please share this report with your doctor (Dr. Kuldeep Chaudhary or your GP). The triglyceride level of 325 at age 23 needs supervised management. The good news is your kidneys, liver, thyroid, blood sugar, B12, and infection markers are all completely normal.

So i also have sometime pain in left thoracic region

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Excellent - this is very important additional information. Combining your left thoracic pain with your report findings, here is a thorough analysis:

Left Thoracic (Chest) Pain - Analysis in Your Context

🔴 Most Important Connection: Triglycerides 325 mg/dL → Pancreatitis Risk

This is the most medically significant link. Your report shows Triglycerides at 325 mg/dL - and according to Harrison's Principles of Internal Medicine and Fuster & Hurst's The Heart:

"Hypertriglyceridemia is a direct cause of acute pancreatitis. Acute pancreatitis presents with upper abdominal/epigastric pain radiating to the back."

Pancreatitis pain can radiate upward into the left thoracic/chest region and is a real risk when triglycerides are this high. This is a serious concern you must not ignore.

Ranked Differential Diagnosis for Your Left Thoracic Pain

Given your age (23), gender, and lab findings, here are the likely causes from most to least probable:

Rank	Diagnosis	Why It Fits You
🥇 1	Musculoskeletal / Costochondritis	Most common cause in young males. Inflammation of rib-cartilage joints. Worsens on pressing the chest wall.
🥈 2	Vitamin D Deficiency / Osteomalacia	Vit D = 8.1 ng/mL causes diffuse bone and muscle pain, commonly felt in ribs, thoracic spine, and chest. This is highly likely in your case.
🥉 3	Referred pain from Hypertriglyceridemia / Pancreatic irritation	Triglycerides 325 mg/dL can cause sub-clinical pancreatic inflammation with left-sided abdominal/chest radiation.
4	Pleuritis / Pleural irritation	Pain sharp, worsens with deep breathing. May come from a mild lung infection or inflammation.
5	GERD / Esophageal pain	Acid reflux can cause left-sided chest pain mimicking cardiac pain. Common in young adults.
6	Intercostal muscle strain	From posture, heavy lifting, prolonged sitting. Very common in young men.
7	Cardiac (least likely at 23 with normal ECG)	Your lipid profile does increase long-term cardiovascular risk, but acute cardiac events at 23 are rare without other symptoms.

🦴 Vitamin D → Bone Pain Connection (Very Relevant to You)

Your Vitamin D of 8.1 ng/mL causes osteomalacia - softening and pain of bones. The ribs and thoracic spine are classic sites. Per Bradley & Daroff's Neurology:

"Diffuse bone pain and muscle pain are common [in Vitamin D deficiency]. Serum alkaline phosphatase is abnormally high."

Notice your Alkaline Phosphatase = 194.9 IU/L - while technically within the lab's reference range (< 270), at 23 years old this is on the higher side and consistent with bone metabolism being stressed by Vitamin D deficiency.

⚠️ Warning Signs - Go to ER Immediately if You Have:

Sudden, severe chest pain that doesn't go away
Pain spreading to your left arm, jaw, or back
Sweating, breathlessness with chest pain
Severe upper abdominal pain with vomiting (could be pancreatitis)

What Tests to Ask Your Doctor For

Test	Reason
ECG	Rule out any cardiac cause
Serum Amylase & Lipase	Rule out pancreatitis (given high triglycerides)
Chest X-ray	Rule out pleural or lung pathology
Serum Calcium	Already normal in your report - reassuring
Pressing on chest wall	If pain reproduces with pressure → costochondritis

Most Likely Conclusion

Your left thoracic pain is most probably a combination of:

Vitamin D deficiency bone/muscle pain (bone ache in ribs and thoracic spine - directly from Vit D = 8.1)
Musculoskeletal / costochondritis (common in young males)

Both will significantly improve once you start Vitamin D supplementation. However, given your triglycerides of 325 mg/dL, please get serum amylase and lipase checked urgently to rule out pancreatic involvement - this is the one cause that could become serious quickly.

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