<s>[INST] i m 31 yr old lady ,mother of 3 yr old twins. i had pain in my legs n finger swell when i  stand for 1 hour or more.sometimes my hand fingers also swell.but do't have pain in hand fingers. whn i consult to doctor after many test hediagnose that i have deficiency of Vit D,Ca,Fe. i took medicine for 6 month everything was fine but now i m facing same problem.what will be permanent solution for this problem. [/INST] hilooks like you have longstanding anaemia with related mineral deficiencyplease evaluate the cause  this,withcomplete haemogram,iron studies,ultrasound abdomen & pelvis,stool examination,ecg,2d-echo ,renal function testsyou can start with iv iron infusions under medical supervisiontake care </s>