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Suggest Treatment For Flushed Red Palms, Chronic Insomnia, Cold Hands And Feet

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Posted on Wed, 2 Sep 2015
Question: I am 47 years old and for the last year have flushed red palms as well as other symptoms which acted like rheumatoid arthritis (but with my tendons) which has been rule out by blood tests. Can this be pre menopause or menopause symptoms. Otherwise hypothyroid? Have had insomnia for 10 years. Dry skin (not terrible), poor circulation for 20 years cold hands and feet, dry hair because I die it ~ again maybe age?
THS is 3.47 T4=7, T3 Free is 2.59, T4F is 1.05. In trying to read my blood results I don't think total T3 test and antibody test were taken. Should they be?
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Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Read below.

Detailed Answer:
I read your question carefully and I am sorry about those symptoms you are experiencing.

The manifestation of flushed red palms could be a manifestation of connective tissue disease as you mention, not only rheumatoid arthritis but other ones such as lupus as well. I am assuming a routine complete blood count to exclude policythemia, infection or liver function tests have been done as well, as those conditions could manifest with red flushed hands too.

The thyroid dysfunction would be a hypothesis as well. However the symptoms would be contradictory in that sense because red flushed palms, insomnia are manifestations of increased thyroid function, while cold hand and feet, dry hair at the opposite would be a manifestation of low thyroid function (hypothyroid), so you don't fit either of the two possibilities. Furthermore the test results are completely normal,not even threshold, so I do not think there is need for antibody or total T3 test.

The menopause possibility you mention is to be considered once women have reached their forties, as estrogen level variability begins to happen even before the menstrual cycle begins to change. These variations are known to cause vasomotor instability which can cause the flushing, or problems with the joints as well. Typically it does include the upper body and the face as well though, so if that is not the case it would be unusual, only if all the rest is excluded.

The fact of having spontaneous rupture of tendons is puzzling. It generally happens in connective tissue disease but you say you have thoroughly tested in that sense.
Other causes could include some drugs like steroids or antibiotics of fluoroquinolone group, hormonal treatments like anastrazol but I assume that has been considered as well.
One hormonal issue which also could cause tendin rupture is hyperparathyroidism (parathyroid hormone, not to be confused with thyroid), so that is a test which is to be added if not already done.

I remain at your disposal for other questions.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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Suggest Treatment For Flushed Red Palms, Chronic Insomnia, Cold Hands And Feet

Brief Answer: Read below. Detailed Answer: I read your question carefully and I am sorry about those symptoms you are experiencing. The manifestation of flushed red palms could be a manifestation of connective tissue disease as you mention, not only rheumatoid arthritis but other ones such as lupus as well. I am assuming a routine complete blood count to exclude policythemia, infection or liver function tests have been done as well, as those conditions could manifest with red flushed hands too. The thyroid dysfunction would be a hypothesis as well. However the symptoms would be contradictory in that sense because red flushed palms, insomnia are manifestations of increased thyroid function, while cold hand and feet, dry hair at the opposite would be a manifestation of low thyroid function (hypothyroid), so you don't fit either of the two possibilities. Furthermore the test results are completely normal,not even threshold, so I do not think there is need for antibody or total T3 test. The menopause possibility you mention is to be considered once women have reached their forties, as estrogen level variability begins to happen even before the menstrual cycle begins to change. These variations are known to cause vasomotor instability which can cause the flushing, or problems with the joints as well. Typically it does include the upper body and the face as well though, so if that is not the case it would be unusual, only if all the rest is excluded. The fact of having spontaneous rupture of tendons is puzzling. It generally happens in connective tissue disease but you say you have thoroughly tested in that sense. Other causes could include some drugs like steroids or antibiotics of fluoroquinolone group, hormonal treatments like anastrazol but I assume that has been considered as well. One hormonal issue which also could cause tendin rupture is hyperparathyroidism (parathyroid hormone, not to be confused with thyroid), so that is a test which is to be added if not already done. I remain at your disposal for other questions.