Hello and thankyou for approaching DoctorSpring with your query.
I have gone through your case in detail and will try my best to help you.
Your symtoms of lightheadedness, dizziness, fatigue, sensitivity to light, feeling faint, chest pains and disturbed vision tend to point towards the diagnosis of a condition known as SLE (Systemic Lupus Erythematosus).
SLE is inflammatory condition and usually it manifests in young adults around the age of 20 -30 yrs. It is due an immunologic abnormality which results in production of a number of antinuclear antibodies. Patients usually will have multiple symptoms.
There will be a precipitating factor for its manifestation and in your cause the estrogen has precipitated it and it has persisted. I will like to know a few more details to see if you any other manifestations of the disease.
1) Do you have photosensitivity as in redness of your cheeks, nose on exposure to light, especially sunlight?
2) DO you have any rashes or hair loss?
3) Do you have any joint pains or muscle pains?
4) Do you have redness of eyes or irritation in the eyes?
In order to diagnose this condition you will require to do a few tests.
1) Complete Blood Count with ESR
2)Antinuclear antibodies (ANA)
3)Antibodies to double stranded DNA (Anti dsDNA)
Once you get your tests done, we will have a clearer picture and treatment can be started accordingly.
I hope this has helped, feel free to follow up with any other queries.
Thankyou.
Patient replied :
I have already been tested for autoimmune disorders such as lupus... However my grandmother has it. I had the ANA blood test that was negative. Is this enough information? I feel like my drs are kinda stubborn and they don't want to preform any additional testings
No I do not have any redness of the face. I do have these red patches above my eyelids that are very dry. I assume it is eczema. I do have muscle pain, mostly in the chest/biceps. No recognizable hair loss but I think my eyelashes have thinned a lot.
Eyes are sometimes red but not always. No physical eye irritation.
(With additional inputs from Dr.Deepu Sebin Sebastian, Internist and expert in Diagnostic Medicine)
Well, that rules out SLE.
To answer your first question - are these symptoms related to an endocrine problem ? Less likely. But endocrine dysfunction can present with atypical symptoms. Since you have recent onset symptoms that are troubling you, a set of investigations are recommended.
FSH
LH
Prolactin Level
Testosterone Levels
Ultrasound abdomen and pelvis.
Thyroid Function tests
Pheochromcytoma evaluation (after discussing with your Doctor)
Please not these are not usually recommend for the above mentioned kind of symptoms, but considering your special circumstance these may be done. As of now I symptoms are suggestive of diagnostic of any endocrine condition.
Do you have any stomach or intestinal complaints ?
Thank yiu
Patient replied :
Hi,
Thanks for the reply. I have had gastrointestinal issues since I have been a little kid. I suffer from IBS symptoms. Could any of my symptoms be related to an underlying gastrointestinal issue? I know you are an endocrinologist but I am just so confused at this point as to the direction I should take as my primary care doctors are left all confused. They are sending me to an endocrinologist, a neurophysiologist, another opthamologist and a neuropsychiatrist for futher evaluation. My doctor checked me again for ANA and did a sed rate. The ANA was again negative. Shes also checking my iron levels.
Hello,
Just as I expected, you do have IBS related symptoms. You might sound this cliché, but around 80% of your symptoms could be psychosomatic. That means the symptoms arise from your brain. I am glad that you are under evaluation. Once an involvement of any major organ systems are ruled out, if stress, anxiety and depressed mood is there it should be treated. From an Endocrine point of view you can get the above mentioned tests done.
Hope this helps
Thank you
Patient replied :
Yes it helps thank you. Some doctors have mentioned that it may be psychosomatic as well. I just feel that it is not 100% psychosomatic like you said and I do believe that I have developed a health anxiety due to my ongoing symptoms. It is possible that the symptoms have gotten worse due to anxiety. But yes I am being evaluated and I hope to find a cause to all this ! Thanks again for your help
Hello,
Yes you do seem to have anxiety. But the good thing is that you do realise this (called insight).
Another thing is that - when I say your symptoms are psychosomatic it does not mean that you are 'thinking up' the symptoms. The symptoms are indeed real. The only difference is that it originates from the brain (for neurohormonal interactions ) rather than from the body.
I am sure you will be able to to over come this
All the best
Thank you