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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22882
Experience:  Over 20 yrs of Family Practice
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When I was a child, I could not sweat. I was told by specialists

Customer Question

When I was a child, I could not sweat. I was told by specialists that I did not have sweat glands, but that I would develop them in puberty. I was very athletic and often overheated and vomited. In puberty, I did develop sweat glands. I now sweat "normally" or not any more or less than anyone else.

I am 5'6" and weigh 140 lbs and exercise regularly. The only medication I take regularly is Jolessa (birth control).

I am extremely prone to heat exhaustion/intolerance/allergy/stroke. (I am not sure what to call it.) My heat issues an be brought on by sun exposure or physical exertion. I can be sitting in the sun doing nothing and have the same symptoms as if I worked out too hard indoors.

Symptoms are: I start to get weak and get a headache. I then smell ammonia (this is almost every time), I get a migraine headache accompanied by a sensitivity to light, nausea, and yawning. (Excessive yawning) If I do not lay down and go to sleep, I will then vomit.

This has happened as often as everyday to not very often depending on exposure. I have had a blood test and everything looks good in terms of the basics: thyroid, vitamins and minerals, etc.

This is very debilitating and going to doctors has left my frustrated, because I don't feel like anyone has any idea what I am talking about and then it seems like I am complaining about something that doesn't exist. None the less, it greatly affects my life and I would like to get to the bottom of it.

I have tried to find a doctor who specializes in heat related issues, but I have yet to find one. Is there someone on here that has this expertise and can offer some insight? I have browsed previous posts and looked at wrongdiagnosis.com for diseases associated with heat intolerance and nothing seems to fit the bill. Any thoughts?

Thanks for your help.
Submitted: 2 years ago.
Category: Health
Expert:  Karel1 replied 2 years ago.
Although Im a respiratory therapist it sounds to me that it might be a side effect from the birth control. The migraine you suffer is also a birth control side effect. I would look into the drug. Next I would see a neurologist headache specialist. If you suffer from chronic daily headache, migraine definitely causes vomiting. But first I would check out the birth control and see an endocrine doctor as they are ones for perspiration which definitely is hormonal, and since birth control controls hormones I tend to think it might be the birth control. see your gyn or call the drug company who makes the drug to see if others have had this side affect.
Customer: replied 2 years ago.
Hello:
Thank you for your reply. I have had these symptoms before I was on birth control. They started as a child and then after I went through puberty and had working sweat glands, but before I started taking birth control, I had the headaches, nausea, dizziness symptoms associated with sun and over exertion.

It doesn't make sense that it would be my birth control if the problem started prior to me taking it. Is it possible to have a response from an neurologist, endocrinologist, or someone who has direct experience in the field of heat issues?

Thanks,

Amy
Customer: replied 2 years ago.

You asked me to accept your answer, but you have not replied to my reply. Please reply.

 

Thank you,

 

Amy

Expert:  Karel1 replied 2 years ago.
s stated you should see an endocrine doctor and a neurologist.Endocrine doctors specialize in hormonal imbalances such as hot and cold.I do not know if any are on this site.
Customer: replied 2 years ago.
Relist: Incomplete answer.
Certified Respiratory Therapist answered question by saying I should speak with an edocrinologist. I am wondering why it wouldn't be more appropriate for an endocrinologist to answer the question and give me his or her opinion, rather than a doctor in a totally unrelated field telling me to go see a different specialist. I don't understand why the Respiratory Therapist responded to a question clearly so far afield from his ro her experience.
Expert:  Dr. Chip replied 2 years ago.
Hi--let me try to help here. To clarify this a bit, if you stay indoors without major exertion and a comfortable ambient temperature, none of this happens?
Customer: replied 2 years ago.
Thanks. Correct, if I am not exposed to sun or physically exerting myself, none of these things happen together in this way.

I look forward to your reply.

Thanks,

Amy
Expert:  Dr. Chip replied 2 years ago.
This takes direct exposure to the sun? How long after the "triggers" are there before the symptoms begin and what happens once the triggers are removed?
Customer: replied 2 years ago.
Direct exposure from the sun is the largest contributing factor. I have also had similar symptoms when my body temperature gets too hot indoors. It is typically about 1 hour after "trigger" that symptoms begin, whether it is sun or increasing physical activity. If I am able to seek shade and lower my temp, I can often stave off the symptoms, but if I can not, they will continue to grow. If I reach "the point of no return" where I start to get a headache, I smell ammonia, I get a little disoriented, removing the triggers has no affect. If I can remove the triggers before the "point of no return" I can avoid an episode sometimes. If I stay mobile after triggers (if I am working outside or am in the middle of a hike where I continue on), I will throw up and my symptoms will get worse. I usually go into a dark room and sleep/rest for 4 or more hours. By the next day, symptoms are gone. Although, sometimes I have what feels like a hangover afterwards. Thank you for your questions.
Expert:  Dr. Chip replied 2 years ago.
OK--sorry if I need to ask a lot of questions here, but so far what's been the extent of your workup for this, have you seen both an endocrinologist and a neurologist, and what diagnoses have been considered?
Customer: replied 2 years ago.
When I was a child I saw specialists about the lack of sweating. (Pediatric docs.) Since I have been an adult I have discussed the issue with a number of GP's with little success. I have not seen an endocrinologist or neurologist. It seems like such an odd problem that there has been little recommendation other than avoid exposure. I am an active person and I try and minimize exposure, but it is debilitating. I have stopped addressing it with docs, because I have frequently ended up frustrated with the lack of answers, but it continues to be a pervasive problem.

Also, it is a problem that comes and goes. When I go to the doctor, I am not symptomatic. It seems like that makes it more difficult to address.

I am in reasonably good shape (I just ran a half marathon) but I am not a star athlete.

What are your thoughts?
Expert:  Dr. Chip replied 2 years ago.
So you can run a marathon without the problem? Is it that only on certain occasions exertion brings it on?
Customer: replied 2 years ago.
No. I had A LOT of problems with running the half-marathon. Many episodes of heat exhaustion regardless of ambient temperatures. Combined with some serious digestive issues. (Beige bile. Etc.)

Customer: replied 2 years ago.
The issues with running the half-marathon (which I ran very slow (12 min miles) and was at night) are what prompted a deeper investigation into my problems, because they were more severe than ever before.
Expert:  Dr. Chip replied 2 years ago.
Do you have muscle pain with these episodes?
Customer: replied 2 years ago.
Not particularly. I would say no.
Expert:  Dr. Chip replied 2 years ago.
OK--so have the GP's done any workup at all?
Customer: replied 2 years ago.
Thyroid, mineral levels, and glycemic stuff is all fine.
Expert:  Dr. Chip replied 2 years ago.
What about autoimmune screen and cortisol levels? What about a brain MRI?
Customer: replied 2 years ago.
Nope. None of that.
Expert:  Dr. Chip replied 2 years ago.
Just one more question--your doctors didn't consider this perhaps a variant migraine problem and try to treat it that way?
Customer: replied 2 years ago.
No. I think because it is so accutely related to heat, that has always been the primary focus.
Expert:  Dr. Chip replied 2 years ago.
OK--I would have you see both a neurologist and an endocrinologist about this. Variant migraine would be my first suspicion. Then comes cortisol abnormalities, dysautonomia, and perhaps inherited mitochondrial disorders.
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22882
Experience: Over 20 yrs of Family Practice
Dr. Chip and other Health Specialists are ready to help you
Customer: replied 2 years ago.
Thank you very much for taking the time to understand and give your opinion.
Expert:  Dr. Chip replied 2 years ago.
Welcome--let me know how it goes

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