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Multiple symptoms and no diagnosis

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Hi, I am a 22 year old female, I am petite..about 105 lbs, 5"2 and I have been having major issues with my health for 5 months now. It has been a nightmare and no doctor has been able to figure out what is going on with me. I have seen my PCP probably 30 times and I have seen two cardiologists, a neurologist,an ENT, and two Opthamologists…. I thought I'd give it a shot on here. I won't get into all of my symptoms because it is just too overwhelming. The good news is that I have been tested for many problems and all have come out normal. I have had many resting EKGs, an Echocardiogram Ultrasound, a stress test, a 30 day event monitor and a brain MRI. I also had two eye exams that have been normal. All of my blood work has been normal as well. I have a constant dizziness and lightheadedness that won't go away. I was afraid it was my heart but it doesn't seem to be the case. Also, I have developed a sensitivity to light, especially fluorescent/artificial light from the computer or in stores. My eyes feel like they are detached from my head. It is very odd. Most of the time I feel like I am about to faint too. I have also been having chest pains. I am worried and I hate feeling this way because up until 5 months ago I was feeling really good. I went to the gym every day and ran about 4 miles a day. Now, I can't even exercise because I get dizzy and lightheaded and my vision gets all messed up. My life is falling apart because I am constantly feeling ill. I have been fatigued as well. I an unable to function a normal life right now. I need answers ! Sorry if this is long but I really would appreciate some good thought. There is one specialist that I haven't seen yet and I do plan to see… an endocrinologist. I was wondering if any of my symptoms could be related to a hormonal imbalance. Because let me tell you…this all began 5 months ago when I started the birth control pill for the first time…microgestin fe. I was only on it for approx. 90 days but what happened was during the first month, when it was time for the placebo week, I started having dizzy spells each day. I was wondering if it was because of the drop of estrogen from taking a pill every day to not taking it at all. I asked the doctors and they all said nope..that wouldn't be the case. But It made sense to me. Then….I began having chest pains, and had an ocular migraine that was really scary because my vision became all warped. My doctor told me to immediately stop taking the oral contraceptive. I did and I stopped taking it but my symptoms didn't subside. So this all began when I started the pill and I haven't been better since, but I have NOT been on the pill since. Also…in July I got pregnant and I had to have an abortion. Hence, why I started the birth control pill. So, to me it seems like there is a possible hormonal imbalance from being pregnant, to not, to on the pill, to off. But I would have thought my body would be balanced by now? Hopefully this gives you enough information. Thank you!

Category: Endocrinologist

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Category: Diabetologist
 22 Doctors Online


Hello and thankyou for approaching DoctorSpring with your query.
I have gone through your case in detail and will try my best to help you.

Your symtoms of lightheadedness, dizziness, fatigue, sensitivity to light, feeling faint, chest pains and disturbed vision tend to point towards the diagnosis of a condition known as SLE (Systemic Lupus Erythematosus).

SLE is inflammatory condition and usually it manifests in young adults around the age of 20 -30 yrs. It is due an immunologic abnormality which results in production of a number of antinuclear antibodies. Patients usually will have multiple symptoms.
There will be a precipitating factor for its manifestation and in your cause the estrogen has precipitated it and it has persisted. I will like to know a few more details to see if you any other manifestations of the disease.
1) Do you have photosensitivity as in redness of your cheeks, nose on exposure to light, especially sunlight?
2) DO you have any rashes or hair loss?
3) Do you have any joint pains or muscle pains?
4) Do you have redness of eyes or irritation in the eyes?

In order to diagnose this condition you will require to do a few tests.
1) Complete Blood Count with ESR
2)Antinuclear antibodies (ANA)
3)Antibodies to double stranded DNA (Anti dsDNA)

Once you get your tests done, we will have a clearer picture and treatment can be started accordingly.

I hope this has helped, feel free to follow up with any other queries.

Thankyou.


Patient replied :

I have already been tested for autoimmune disorders such as lupus... However my grandmother has it. I had the ANA blood test that was negative. Is this enough information? I feel like my drs are kinda stubborn and they don't want to preform any additional testings

No I do not have any redness of the face. I do have these red patches above my eyelids that are very dry. I assume it is eczema. I do have muscle pain, mostly in the chest/biceps. No recognizable hair loss but I think my eyelashes have thinned a lot.

Eyes are sometimes red but not always. No physical eye irritation.


(With additional inputs from Dr.Deepu Sebin Sebastian, Internist and expert in Diagnostic Medicine)

Well, that rules out SLE.

To answer your first question - are these symptoms related to an endocrine problem ? Less likely. But endocrine dysfunction can present with atypical symptoms. Since you have recent onset symptoms that are troubling you, a set of investigations are recommended.

FSH
LH
Prolactin Level
Testosterone Levels
Ultrasound abdomen and pelvis.
Thyroid Function tests

Pheochromcytoma evaluation (after discussing with your Doctor)

Please not these are not usually recommend for the above mentioned kind of symptoms, but considering your special circumstance these may be done. As of now I symptoms are suggestive of diagnostic of any endocrine condition.

Do you have any stomach or intestinal complaints ?

Thank yiu


Patient replied :

Hi,

Thanks for the reply. I have had gastrointestinal issues since I have been a little kid. I suffer from IBS symptoms. Could any of my symptoms be related to an underlying gastrointestinal issue? I know you are an endocrinologist but I am just so confused at this point as to the direction I should take as my primary care doctors are left all confused. They are sending me to an endocrinologist, a neurophysiologist, another opthamologist and a neuropsychiatrist for futher evaluation. My doctor checked me again for ANA and did a sed rate. The ANA was again negative. Shes also checking my iron levels.


Hello,

Just as I expected, you do have IBS related symptoms. You might sound this cliché, but around 80% of your symptoms could be psychosomatic. That means the symptoms arise from your brain. I am glad that you are under evaluation. Once an involvement of any major organ systems are ruled out, if stress, anxiety and depressed mood is there it should be treated. From an Endocrine point of view you can get the above mentioned tests done.

Hope this helps
Thank you


Patient replied :

Yes it helps thank you. Some doctors have mentioned that it may be psychosomatic as well. I just feel that it is not 100% psychosomatic like you said and I do believe that I have developed a health anxiety due to my ongoing symptoms. It is possible that the symptoms have gotten worse due to anxiety. But yes I am being evaluated and I hope to find a cause to all this ! Thanks again for your help


Hello,

Yes you do seem to have anxiety. But the good thing is that you do realise this (called insight).

Another thing is that - when I say your symptoms are psychosomatic it does not mean that you are 'thinking up' the symptoms. The symptoms are indeed real. The only difference is that it originates from the brain (for neurohormonal interactions ) rather than from the body.

I am sure you will be able to to over come this
All the best
Thank you


Dr. J Muthukrishnan
Category: Diabetologist
Experience: 
Fellowships/Training: 
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
Dr. J Muthukrishnan and 4 other Medical Specialists are ready to help you

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