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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29576
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Ive posted before, each time thinking something else was possibly

Customer Question

I've posted before, each time thinking something else was possibly wrong with me, but now I'm scheduled to visit an endocrinologist in two weeks, and think that maybe a hormone imbalance may be to blame for all of my symptoms, which include -
Hair loss (all over for about ten years, but mostly on the top of my head, said to be female pattern baldness, which I don't buy)
Migraines (have had for twenty years)
Knee pain in my right knee (MRI shows nothing, was told I'm just chubby and getting older)
A fleshy-feeling lump in my throat (barium test showed nothing)
Several yeast infections in the past year, plus a UTI
Blurred vision at times
Trouble concentrating
Trouble losing weight (I went from doing nothing to exercising five hours a week and lost only 3 pounds in six weeks)
Anxiety attacks (worse recently, but have had them for about 10 years)


More recently (in the past couple of weeks, I've been now noticing -
Itchy skin (mostly at night, in the scalp, back, feet, arms, legs and groin, pretty unbearable)
Heart palpitations
Hand tremors
Light-headedness/dizziness, mostly after standing, but not always
I've had so many tests, but the only hormone tests I've had are for my thyroid, all of which came back normal. I'm a 35-year-old woman and have had one pregnancy (and hope to have another one once I figure this all out).

These things are really consuming my life and I really feel as though the doctors are trying to play everything off as coincidence, but I just know there's something wrong. If anyone has any advice or ideas on what might be going on, I would greatly appreciate the comments. I'm just at the end of my rope and don't know where to go from here if the endocrinologist doesn't find anything. Please help!

Jackie
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 1 year ago.
Hello Jackie,

I agree that hormonal issue like thyroid abnormality can explain all of your symptoms. So hormonal assessment would be the best as the first step. The other possibilites to look for your symptoms would be;

1) autoimmune disorders. A rheumatologist would be the specialist to consult.
2) fibromyalgia

Fibromyalgia is a chronic condition, which may have following of the manifestations;

 

1) widespread muscle pain, "myalgia,"

2) excessive tenderness in many areas of the body

3) fatigue,

4) sleep disturbances,

5) headaches,

6) mood disturbances, such as depression and anxiety.

 

Laboratory studies and investigative work up like following are done to help rule out diseases with similar manifestations and to assist in diagnosis of certain inflammatory diseases that frequently coexist with fibromyalgia;

 

1) Complete blood cell (CBC) count and differential count,

2) Basic metabolic panel,

3) Urinalysis,

4) Thyroid-stimulating hormone: Hypothyroidism has many similar clinical features with fibromyalgia.

5) Creatinine phosphokinase (CPK) to rule out inflammatory myopathies

6) Erythrocyte sedimentation rate (ESR)

7) Antinuclear antibodies (ANAs): Many patients with SLE have comorbid fibromyalgia.

8) Rheumatoid factor

9) Sleep studies

 

If fibromyalgia, lupus, sleep disorders etc can be ruled out; other consideration would be;

 

1) chronic fatigue syndrome; unexplained, persistent or relapsing fatigue with unrefreshing sleep, muscle pain, concentration problems, headache, sore throat etc.

 

2) idiopathic fatigue; it does not meet the above criteria.

 

A consultation with either a rheumatologist or a clinical immunologist would be prudent for an evaluation.


Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

 

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Customer: replied 1 year ago.

Thank you so very much. I am so obsessed with all of this and have been labeled (I think) a hypochondriac by my primary care provider. A few more follow-up questions for you -


 


So, I'm not crazy and should keep pushing this to get the answer?


 


On first glance, would you think it's most likely hormonal over the other options you note? Of everything I've read, I'd thought for sure it was my thyroid, but my T3 and T4 were both normal. Now, I see I have a lot of symptoms for estrogen, testosterone, etc. issues.


 


What kinds of autoimmune issues are you thinking? Would that also explain my hair loss?


 


If it were to end up being something like fybromaylsia, would that also explain my hair loss?


 


Thanks again! And thanks for being so quick!


 


Jackie

Expert:  Dr. Arun Phophalia replied 1 year ago.
You are very welcome, Jackie.

Yes, your symptoms need answer. It is inadequacies of the doctor to not detect the diagnosis. These should be pursued. The TSH is most sensitive investigation for thyroid. You may need to than get the adrenal function tests. It is difficult to pin point a type of autoimmune disorder but mild polymyositis can be a possibility. Fibromyalgia do not have hair loss but there can be a local scalp condition which a dermatologist can diagnose (so concomitant conditions are possibility).

It is privilege assisting you.
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29576
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Dr. Arun Phophalia and 6 other Health Specialists are ready to help you
Customer: replied 1 year ago.

One more question, I appreciate you listening to me.


 


Now that I've taken a full inventory of my problems, since I'm feeling pretty sick today, I also have pain during sex (for about six months), for which I received an ultrasound that found nothing. I'd been told that sometimes it happens and usually resolves itself. I also have a very, very low libido.


 


Anyway, in doing some research prior to this, I'd considered a possible celiac response (test came back negative) and aspartame sensitivity. Do you think it's possible that perhaps some of these symptoms may also be caused by a food allergy?


 


Thanks again for listening, I'm at my wits end and this is consuming my life. Please know how grateful I am. :)


 


Jackie

Customer: replied 1 year ago.

One more question, I appreciate you listening to me.


 


Now that I've taken a full inventory of my problems, since I'm feeling pretty sick today, I also have pain during sex (for about six months), for which I received an ultrasound that found nothing. I'd been told that sometimes it happens and usually resolves itself. I also have a very, very low libido.


 


And I have severe bruising of my legs at times, with no reason.


 


Anyway, in doing some research prior to this, I'd considered a possible celiac response (test came back negative) and aspartame sensitivity. Do you think it's possible that perhaps some of these symptoms may also be caused by a food allergy?


 


Thanks again for listening, I'm at my wits end and this is consuming my life. Please know how grateful I am. :)


 


Jackie

Expert:  Dr. Arun Phophalia replied 1 year ago.
Hello Jackie,

Food allergy does not seem to be a plausible explanation for your manifestations. But still, all investigative avenue should be kept open and it is not be bad ideal to get the allergy tests.

It is a great privilege and pleasure interacting with you.
Customer: replied 1 year ago.
Hi! I just wanted to get back to you with an update and thank you for your help! The endocrinologist was no help - I was told had I pre-diabetes and that I should see a psychiatrist. I was lucky enough to be turned on to a local internist who's worked with people looking for answers and not getting any. After giving thirty vials of blood for tests and getting a catscan, we've discovered I have PCO and my rheumatoid factor was very high. So, a lot of my problem WAS hormones! He put me on Metformin and an anti-inflammatory and will see me again in four months. SO relieved. Of course, I have a few choice words for the endocrinologist! Just wanted to let you know I've gotten somewhere!
Expert:  Dr. Arun Phophalia replied 1 year ago.
Thanks Jackie for the update. I am so happy for you.

Wishing you a very fast resolution of your symptoms.

Best wishes and kindest regards

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