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Neuro Doctor
Neuro Doctor, Neurologist (MD)
Category: Neurology
Satisfied Customers: 3516
Experience:  American Board Certified Neurologist, Internal Medicine
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Making sense of cognitive lapses, nosebleeds, and headaches

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Hello, I am a 29 year old female, married with a toddler. I'm generally in good health, but have struggled to make sense of a few subtle but troubling symptoms that have presented in the last few weeks. My daughter is now sleeping on her own through the night and I have been able to get better sleep than I had in the year and a half prior. Despite this improvement in my quantity and quality of sleep, I have had an increase in funny slips of the tongue and general forgetfulness. What seems most odd is that, where I used to catch the mistake, it now goes completely unnoticed by me. The other day, I was signing the bill at a restaurant and after calculating the tip, I forgot to sign the check. The waitress had to bring it back and ask me to sign it. Today, I forgot to lock my daughter's stroller while I opened the gate to the playground and she went rolling down the sidewalk (all is fine, not to worry). Earlier today, I wrote my daughter's name on the name tag intended for my husband at a nursery school open house. I've also felt localized pressure in certain parts of my head, particularly across the top of the front of my head and on the back right side. It's not painful, but it persists for about 10-20 minutes and then goes away. I came down with the first nosebleed I've ever had--in my entire life--last week. The bleeding definitely originated high up in my nasal cavity. I could feel blood in my throat and in the ear on the side of the offending nostril. I'm not sure how to make sense of these symptoms and, naturally, have begun to fear the worst. I'm concerned that I may have a brain tumor and am afraid I'll be laughed out of a doctor's office if I seek medical council. Can you please help me figure out if these symptoms are cause for concern or further evaluation? If so, whom do I reach out to?

Submitted: 5 months ago.
Category: Neurology
Expert:  Neuro Doctor replied 5 months ago.
Hi, I am Neuro Doctor, an American Board Certified Neurologist with vast clinical experience.

None of your symptoms are actually pointing towards a brain tumor. And also the possibility of a brain tumor is extremely low around your age of 29. Brain tumors typically occur during childhood or old ages and brain tumors are very uncommon for your age. And also the type of symptoms you are having in no way point the finger towards any brain tumor. There are so many medical & neurological conditions that can cause your symptoms including thyroid issues, vitamin b 12 or folate deficiency, certain types of infections or inflammations etc and sometimes even some stress too can cause such symptoms. I do see that your overall stress has come down recently but there may be some unrecognized residual stress too. Of course the stress may not be able to explain the nose bleeding and for the nose bleeding there may be some ENT (ear or nose) causes, but there is absolutely no reason to suspect any brain or ENT tumors in you because such tumors are extremely unusual for your age, and there are myriad non-tumor causes to explain these symptoms including bleeding, pressure feeling in the head, cognitive issues etc.

While I am definitely not suspecting any tumors however this needs to be evaluated further. You may see your clinical doctors preferably a neurologist who will conduct a thorough examination followed by certain relevant investigations including a Brain and ENT scan and certain blood tests too to find out the exact cause for your new symptoms and once the exact cause is identified it will be treated appropriately.

Once again I strongly reassure that the type of symptoms you are having (pressure feeling in the head, nose bleeding, cognitive issues etc) in no way automatically mean that there is an underlying serious condition like a tumor etc, in fact on most occasions such symptoms are commonly related to some non-serious benign conditions which can be treated and cured. You may see your clinic doctors, preferably a neurologist as soon as possible for a thorough clinical evaluation/examination & investigations as pointed above and then treated appropriately. An early diagnosis and treatment gives the best chance for quick and complete cure so try to see your clinic doctors including a neurologist as soon as possible. All the best!

Please let me know if you have any further questions. And if you feel you have received the answer to your question please rate me Excellent to compensate me for the time and effort put by me in answering your question.

Best regards,

Neuro Doctor
Neuro Doctor, Neurologist (MD)
Category: Neurology
Satisfied Customers: 3516
Experience: American Board Certified Neurologist, Internal Medicine
Neuro Doctor and other Neurology Specialists are ready to help you
Customer: replied 5 months ago.

Thank you, XXXXX XXXXX I am very reassured by your thorough and thoughtful answer.


 


My interest was piqued when you mentioned thyroid issues as a possible explanation for my forgetfulness. As it turns out, I have hashimoto's thyroiditis, but was recently advised to lower my dose of levothyroxine after a blood test revealed my TSH to be 0.845. Could this lower TSH account for some of my forgetfulness?

Expert:  Neuro Doctor replied 5 months ago.
You are very welcome.

Yes, the thyroid conditions could explain at least some of your symptoms, but to tell more confidently whether thyroid is indeed related to your symptoms I would require your all thyroid numbers including TSH (which you have already provided), T4, T3 etc. Levothyroxine dose is usually reduced when it provides more thyroid hormones (T4 or T3) than necessary in the blood, and this excessive T4 & T3 blood levels try to reduce TSH blood level as part of a reflex mechanism. Just based on TSH numbers it will be difficult to tell exactly whether your thyroid condition or TSH value is related to your new symptoms, if you give me all the thyroid numbers (results of TSH, T3, T4 numbers etc) then I will be in a better position to comment upon whether thyroid issues really contributing to your symptoms or not. If recently all you had was TSH and they have not done T4 and T3 then you need these tests now to find out exactly what is the current status of your thyroid.

One or otherway I once again strongly reassure you that the possibility of serious conditions like brain tumors etc are indeed very unlikely in you based on your symptoms.

Please let me know if you have any further questions. And if you feel you have received the answer to your question please rate me Excellent to compensate me for the time and effort put by me in answering your question.
Neuro Doctor, Neurologist (MD)
Category: Neurology
Satisfied Customers: 3516
Experience: American Board Certified Neurologist, Internal Medicine
Neuro Doctor and other Neurology Specialists are ready to help you

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