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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
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Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I am a 47 year old female athlete. I eat a healthy diet, weigh

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I am a 47 year old female athlete. I eat a healthy diet, weigh 112 lbs, and feel energetic. I take no meds except spironolactone for acne. My issue is that every night I awake repeatedly. I do not wake up sweating. The sweating starts predictably one to two minutes after awakening. Concurrently, my breathing becomes shallow. I do NOT feel anxious when this happens. I become so hot that I take my clothes off and sweat all over. It does not start in my face, and I do not appear flushed. It subsides in 5 minutes. I do not believe I am having nightsweats associated with perimenopause. I have multiple blood tests. My doctor put me on 90 mg of armour thyroid a few months ago, but this issue has been occurring for about 2 years and the armour thyroid has not improved my sleep and sweating problem. My recent bloodwork was normal except for low TSH (.045). My only other symptom is hairloss. My neurologist and endocrinologist have nothing else to offer.
I had typed out an answer to your other post, but you opted me out, and no other expert has picked up the post.

Is there a particular reason that you opted me out?

Customer: replied 3 years ago.

No I misunderstood. I'm sorry. I did not mean to opt you out. Can I still see your response?

I had saved it on my computer, so it didn't take long to regenerate it.

There are many possible causes of night sweats, including several that are not endocrinologic or neurologic in nature. Also, some people have excessive sweating (either at night or during the day) for which no explanation can be found, so is called idiopathic (the medical term for when no underlying cause can be identified).

It is true that menopause is a common cause of night sweats, but the Endocrinologist would certainly have considered this possibility.

If there is a fever along with the night sweats, then that would increase the possibility of certain causes, primarily chronic infections. There are a variety of chronic infections that can cause night sweats, with or without fever, such as tuberculosis, endocarditis (an infection of the valves of the heart), or osteomyelitis (an infection of the bone)

Night sweats can also occur with a low blood sugar, and the blood sugar can be normal at other times, so it is good that the blood sugar was checked and was normal during an episode, as that would exclude this possibility.

It is also possible to develop night sweats associated with a variety of inflammatory conditions. The most common inflammatory conditions that cause night sweats are inflammatory conditions that primarily affect the musculoskeletal system. However, it is also possible to get night sweats associated with inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis. Since you are also having diarrhea, it would be appropriate to consider this as a possibility.

Lastly, there are certain cancers that can cause night sweats, such as lymphoma, although there would usually be other symptoms or findings on exam if a cancer is present.

It would require an appropriate evaluation to consider each of these possibilities. Yes, checking the temperature during an episode would be the correct next step, but further testing would need to be done by a physician. If there is no fever, then pursuing the cause of the diarrhea would be the next direction to consider, and consulting a Gastroenterologist would be appropriate.

My goal is to provide you with excellent service and a complete answer. If I have completely answered your question, please remember to provide a positive rating so that I can be compensated for my time. If you have any further questions or need clarification, please let me know.

Customer: replied 3 years ago.

Thank you Dr Love. Does it make a difference that night sweats are usually described as "waking up sweating" whereas I wake up first and then start sweating after a couple of minutes?


 


As for the stools. It's not diarrhea, just unformed (sorry for the visual, but like pudding). What are the other symptoms of Crohn's or ulcerative colitis? I have no pain (and a great appetite).


 


Finally, if I had any of the other infections (heart, bone) or musculoskeletal inflammation, wouldn't I have other symptoms?

It is not really a difference. You are probably feeling something that is associated with the impending sweating, such as a chill, which wakes you up and then you start sweating after you are awake. Symptoms that occur to wake someone up may not be remembered once the person is awake if the symptom does not persist.

Unformed stool would still be considered diarrhea. Inflammatory bowel diseases can also cause abdominal pain, cramping, blood in the stool, or systemic symptoms, such as fatigue or weight loss. Although inflammatory bowel diseases will usually cause more symptoms than just diarrhea, it can present with any of these symptoms alone.

The infections that I mentioned can present with fever or night sweats alone. They certainly can cause other symptoms, but may present only with fever or night sweats.

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