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Experience:  Physician with 8 years of experience.
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My symptoms: tachycardia, around the mouth and fingers tinglying, throat tightness, verti

Customer Question

My symptoms: tachycardia, around the mouth and fingers tinglying, throat tightness, vertigo
Submitted: 4 years ago.
Category: Medical
Expert:  Dr Su S replied 4 years ago.
Hello,

Greetings,

Sorry for the problem.
Please let me know a little more about the symptoms so that I can try.Since how long? How frequent ? How long do the symptom last? Any past illness? Any test ? Any medication /treatment taken?

Regards.
Customer: replied 4 years ago.

Thanks for your concern. I've had these problems for about 3 wks now. The dizziness is periodic throughout the day - happens when I get up or pick up something - happened after some of my workout moves today - sometimes just standing - its over in a few seconds. The tingling of my fingers happens at night. Around my mouth tingling periodically throughout the day like the dizziness. The tightness of the throat a few times a day lasts longer. (throat and mouth can be a few hrs) The tachycardia has improved with the medicine - which had been periodic - but I woke up with it a little while ago.(see below)

 

Normally my blood pressure is about 114/70 but this morning around 3 - I woke up with 133/78 with a pulse of 109. I am 5'4" weight 125. I do strength training twice a week and have been told my pulse should be in the 70's.

 

I have been hypothyroid since 1983 (and have been taking for quite some time Synthroid 50mcg and T3 L-thyronin 112.5mcg. )

 

but current blood tests show my t4 is .66 low (0.82-1.77)

TSH <0.006 low (0.450 - 4.500

I have the reverse t3 problem - but it was ok at 153 (90-350)

Aldosterone was 7.8 in the normal range

Triiodothyronine, free, serum was high at 4.8 (2.0-4.4)

 

so a little less than a wk ago I was prescribed bio-thyroid 50:85mcg

 

I also have adrenal fatique and just took a saliva test. My grandmother died of Addisons disease. My female hormone levels are low and the dr wants to start me on the bio-identical hormones but wants to get the thyroid and adrenal problem taken care of first.

 

Many thanks!

Expert:  Dr Su S replied 4 years ago.
Thank you for the input.

I shall try my best to explain the condition. There can be different causes for tachycardia. Among the extracardiac causes anemia, high thyroid hormone, anxiety or tension states are common factors.There are different causes of vertigo. It can be due to inner ear cause like inflammation or labyrinthitis, acoustic neuroma, Meniere's disease, decreased blood supply to certain part of brain,cerebellar disease , multiple sclerosis etc. However dizziness can also be due to variation of blood pressure, glucose level, heart rhythm or rate abnormalities etc.Tingling around the mouth can be due to alkalosis from hyperventilation. Tingling can also come from calcium , or electrolyte abnormalities, nerve disorders , low thyroid states etc. When all these are going on for long , it will be prudent to get a consultation with doctor for a review, investigations to get the precise diagnosis and intervention if necessary.

Hope this information will help you.
Wish your healthy life.
Any query, please feel free to ask.
It will be my privilege to assist you.
Regards.
Customer: replied 4 years ago.
Relist: Answer quality.
Expert:  Dr. B. replied 4 years ago.
can you mention on what all medications are you on?
has any tests been done for your symptoms?
Customer: replied 4 years ago.
yes please see above- I replied to the other dr's request for more information - can you see this?
Expert:  Dr. B. replied 4 years ago.
Dear jacustomer,

I am sorry to know about your symptoms,

Based on what you mentioned,there is a possibility that your symptoms are due to low thyroid hormone as that may cause similar paresthesias(numbness and tingling) but may not lead to tachycardia as low thyroid leads to bradycardia(low heart rate).I will advise that you ask your physician to do complete metabolic panel as imbalance of electrolytes like serum calcium,sodium,potassium may cause similar vertigo(dizziness),paresthesias,throat symptoms and tachycardia,so this has to be ruled out.I am also mentioning this as adrenal problems can lead to electrolyte disturbances.Throat and mouth tightness could be due to underlying reflux disease or anxiety,so both these possibilities should be discussed with your physician.
Other possible causes like middle ear infection,benign positonal vertigo seems less likely as they may not present with tingling or numbness,but still a ear exam should be done ,to be sure.
CNS causes seems less likely as there is no morning headache,nausea but after ruling other possibilities a mri may be indicated to rule out multiple sclerosis.

Thanks


Customer: replied 4 years ago.
I was in the emergency room for this problem with crazier blood pressure - 157/43 2 wks ago. I had a ct scan then and that was fine. Could this problem be pernicious (sp!) anemia as well as the adrenal/thyroid issue? Your answer is much more thorough -thanks!
Expert:  Dr. B. replied 4 years ago.
Do you know your recent hemoglobin levels?

Thanks for your patience
Customer: replied 4 years ago.

don't know if this is what you want - but from the er I have the following: wbc 6.22bil/L, rbc 4.92 tri/L Hgb 14.3 g/dl Hct 41.1% MCV 83.5fl MCH 29.1pg MCHC 34.8g/dl Plts 202 bil/L MPV 10.2 fl RDW 13.3% ANC 3.1bil/L Neut% 49.5% Lymphs, abs 2.7 bil/L Lymphocyte 42.6% Mono# XXXXX bil/L

Mono% 6.6% Eosin # XXXXX Eosin % 0.8% Baso# XXXXX Baso % 0.5%

 

Is this what you mean?

Expert:  Dr. B. replied 4 years ago.
Thanks for extra vital information.

Now looking at your hemoglobin count of 14.3 ,it does not seem that your symptoms like tachycardia,dizziness are due to pernicious anemia,still you may get vitamin b12 levels too,to be sure.
From what you have mentioned,it seems that your symptoms are related to underlying electolyte disturbance ,could be due to adrenal pathology.

Thanks

Customer: replied 4 years ago.

What can I do for electolyte disturbance????

You are awesome - thank you so much! I will give you the highest rating:)

Expert:  Dr. B. replied 4 years ago.
Your welcome,
Thanks for mentioning that.

At present ,unfortunately there is not much you can do,as firstly we need to know which electrolyte level is impaired(most likely serum calcium ).Then that will be needed to be taken care off.We also need to do other test later,not to miss any other underlying undiagnosed problem too,as I mentioned in one of previous post.Meanwhile I will advise that you keep your self hydrated with fluids like water or gatorade as this always helps.

Thanks

Customer: replied 4 years ago.
I have osteopenia as well and am very concerned about the calcium levels - should I drink more milk??????? - is there something that helps the calcium levels
Expert:  Dr. B. replied 4 years ago.
Now as you mentioned that you have osteopenia,so then vitamin d and oral calcium supplements should be taken.If possible ask your physician to monitor your t score by getting dexa scans as regular interval.
You may take milk,but do not overdo it,as nothing in excess is advised.Healthy diet like banana,meat products have enough calcium,which a person can supplement in the diet.

Thanks

Customer: replied 4 years ago.
Do you have advise regarding the dosage of vit d and calcium? Shouldn't this be D3? Sorry but important questions! Again - you are amazing:)
Expert:  Dr. B. replied 4 years ago.
The normal dosage for vitamin d(calcitrol) is .25mcg capsule a day .It comes with trade name of rocaltrol.Calcium can be taken as form of normal multivitamins,taken a single tablet a day.But before starting any of these,please do discuss with your physician.

Please click on accept if satisfied with my answer,so that I may get credit for my work.

Thanks

Dr. B., Doctor
Category: Medical
Satisfied Customers: 7826
Experience: Physician with 8 years of experience.
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