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Decrease in energy level, vertigo, dizziness, gagging after eating. Blood tests normal. Thyroid?

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Internal Medicine Specialist
Practicing since : 1996
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do i have a thyroid issue? would it be hypo thyorid or hyper thyroid?

over the past month, i've noticed a decrease and energy level and sort of "out of it" feeling. this ranges from slight dizziness, to feeling off balanced at times. or just out of touch with reality.

1 month ago i had nearly passed out while running in intense heat. note i train about 4-5 times a week but had not been in the heat for nearly 7 months.

since that episode one month ago, the symptoms seem to be what i feel on and off. its difficult to describe but could be a mix between vertigo and dizziness. i went to the ENT, who did a full VNG test on me. fortunately everything was normal.

at one point, i decided to go to the ER. they did an EKG, heart ultra sound, and additional blood work & urine analysis to confirm. i even stayed overnight on their suggestion. everything looked fine, including my thyroid.

further, i've had a full physical with additional blood work and they havent found anything wrong.

lastly, i've noticed a feeling to gag about 3 of the last 5 days after eating. i feel as if i need to gag, sometimes i do and others i dont. then the feeling goes away. this only came up after doing acupunture last week.

im going back to the doctor monday as he ran further tests on my thyroid.

your thoughts are appreciated. my doctor belives its anxiety or a thyroid issue. thank you,
XXXXXX

Posted Sun, 2 Jun 2013 in Thyroid Problem and Hormonal Problems
 
 
Answered by Dr. Prasad Akole 2 hours later
Dear friend, welcome to Healthcaremagic!
I am Dr. Prasad Akole (Critical Care Expert- http://bit.ly/Dr-Prasad-Akole) and am glad to address to your query here.


You have extreme weakness and dizziness, imbalance and gag on swallowing sometimes.
This is despite extensive check up.
Did you mean that thyroid function tests from the lab were normal?
These are not typical thyroid symptoms. But we need to check up the profile.

Do you have any tremors, diarrhea, palpitations?
Do you have difficulty in swallowing (solids or liquids)? Is there pain or cough on swallowing?
Is there any weight loss/ gain?
Do you get any double vision, visual symptoms, headache, nausea?

The picture has many causes possible.

You need to ask about vitamin deficiencies (Vitamin D, B12 and others), thyroid diseases, low BP or heart arrhythmias (one testing may miss it), disorders like early myasthenia or myopathies.
Endocrine (hormonal) causes may be considered and lastly anxiety can be present.

Try to relax and get evaluated.
If you can answer and add details to the information, I may additionally help you out.


I hope to have answered your query satisfactorily. I would be glad to answer any further queries. Take care and please keep me informed of your progress at http://bit.ly/Dr-Prasad-Akole
Good Luck!
Above answer was peer-reviewed by
 
Follow-up: Decrease in energy level, vertigo, dizziness, gagging after eating. Blood tests normal. Thyroid? 16 minutes later
Hi:

very minimal if any diaarhea. i've lost about 5lbs in the last month but i also quit drinking alcohol and was drinking very often before so not too surprised there.

no tremors although i've had my heart race a couple different times but then go back to normal soon after. my resting heart rate is around 60bpm. i've very active athlete.

BP has acutally been a bit high during the day but comes down to normal in the evening and is normal in morning.

yes, the thyroid blood test showed everything to be normal. however, after going back to the doctor, he wanted to do an additional thyroid tests. testing all t3s, t4, tsh etc. he saidhe would call if anything serious in results but has not. this was on monday.

i've not had any double vision, or visual symptoms. just affected when the vertigo comes around. it seems as if im very sensitive to movement...i.e, computer desk. or coffee table moving.

the doctor did confirm heart arrhythimas but it was not a huge concern for him as he said its normal.

ENT did the VNG test and ruled out an inner ear disorder whether it be peripheal or central.

i will ask him if he checked b12 and vitamin d. a year ago i had a physical and was low on vitamin d.

any other thoughts?? thanks,
XXXXXX
also, it is not extreme fatigue or weakness. the energy level is probably a 7 of 10. ive still been able to exercise and even hit golf balls for 2 hours.

thanks aggain!
 
 
Answered by Dr. Prasad Akole 23 minutes later
Thanks for the update.
Additionally we need to look at liver disease and alcohol withdrawal effects or vitamin B1 deficiencies.
Neck spine and posterior brain circulation problems are other less likely possibilities.
These need physical exam and scans/xrays.

Things do not look serious.

Please keep me posted on your progress.

It would greatly help if you could upload reports here using the uploading service available on this site just below the text box. You can email the reports / scans to
YYYY@YYYY      with subject- (Attn: Dr. Prasad Akole)
Above answer was peer-reviewed by
 
Follow-up: Decrease in energy level, vertigo, dizziness, gagging after eating. Blood tests normal. Thyroid? 1 hour later
Thank you Dr. XXXXXXX

I had a physical where liver blood tests confirmed healthy, also did cholesterol which was great.

Its a very hard feeling to describe. As I said, somewhere between a mix of vertigo and dizziness.

My ENT and GP both confirmed I had no balance issue stemming from a central nervous problem. This is also what the VNG confirmed.

Is it possible this is a mental issue? It seems that at times it totally disappears if I get wrapped up in a work project. However, when I'm out i seem to constantly have it on my mind. It has also stopped me from my usual social activities.

I did have a good amount of ear wax removed from my ear on monday which had been blocking the canal. Could this of been a problem as well? I seem to feel better since having it removed althought I do have some lingering systems.

One more issue, I did notice this need to "gag" about 2 months ago. It occurred a few times when I had left a building and gone out into cold weather. However, it was very random and didn't seem serious as it was rare to happen and I felt fine. Is this a thyroid issue? or is it my body's natural response to cold weather at times?



Thanks again sir,

Cheers.
XXXXXXX
 
 
Answered by Dr. Prasad Akole 23 hours later
Dear XXXXXXX it could be a mental issue- anxiety etc.

It does not look like a thyroid problem -does not cause gag-feeling. Wax in the ear is not a cause too.

Check Vitamin D, B12, B1 levels. Consider alcohol as cause.

Keep occupied and free from worries.
Most of your tests are negative and the condition does not appear serious.

Enjoy life !!

I hope to have answered your query satisfactorily. I would be glad to answer any further queries. Take care and please keep me informed of your progress at http://bit.ly/Dr-Prasad-Akole
Good Luck!

As it helps us to improve continuously, may I request you to write a rating review before you ‘accept’ and ‘close’ the query anytime.
Thank you!!
Above answer was peer-reviewed by
 
Follow-up: Decrease in energy level, vertigo, dizziness, gagging after eating. Blood tests normal. Thyroid? 4 minutes later
thank you very much! yes very well answered. i appreciate it.

-XXXXXX
 
 
Answered by Dr. Prasad Akole 8 hours later
Thanks and hope you keep me posted on the outcome/ progress.

Above answer was peer-reviewed by
 
Follow-up: Decrease in energy level, vertigo, dizziness, gagging after eating. Blood tests normal. Thyroid? 2 days later
Hi Dr. Prasad:

I just checked with my doctor and he said everything with my thyroid appears ok. He did mention that my albumin levels in my blood are elevated and slightly out of the reference range but not by much.

Would you have any thoughts behind what may cause this? Please let me know when you can. Thank you,

XXXXXXX
 
 
Answered by Dr. Prasad Akole 3 hours later
Ok.
I see no immediate concerns. I need to know the total proteins and albumin and globulin values to comment on its importance.
Mild high with preserved ratio is OK.

Pl. consider other possibilities in my first reply.

Let me know any additional test reports. watch if fatigue, vertigo improves on rest. VERY EARLY MYOPATHY, MYASTHENIA CAN CAUSE WEAKNESS, GAG PROBLEMS.
recheck vitamin levels.




Above answer was peer-reviewed by
 
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