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What Causes Tingling In Hands And Feet, Brain Fog Along With High BP?
Question: Is it possible that after a brain MRI and scan of the arteries in my temples that a serious condition was overlooked?
I have had tingling in hands and feet, brain fog, lightheaded on standing and high blood pressure for 3-4 years.
I now have had aching index fingers( arthritis now I think), also wrist and shoulder joints ache intermittently.
I urinate often, mainly at home though. For some reason it's not as often when I'm out.
My hand shake sometimes, I have high anxiety levels generally. My muscles feel weak most days, and every few days I get short of breath though I'm actually quite fit when I do exercise.
I've been a smoker for 30 years and drink 5 standard beers per night. This has been for 5 years.
Could the neurologist have overlooked something? My bloods were normal and I was tested for diabetes, apparently negative. Could the fact I drink alcohol and this could severely lower my blood sugar by the morning, could the glucose test have been incorrect also and I do have diabetes??
Thank you in advance.
XXXX
I have had tingling in hands and feet, brain fog, lightheaded on standing and high blood pressure for 3-4 years.
I now have had aching index fingers( arthritis now I think), also wrist and shoulder joints ache intermittently.
I urinate often, mainly at home though. For some reason it's not as often when I'm out.
My hand shake sometimes, I have high anxiety levels generally. My muscles feel weak most days, and every few days I get short of breath though I'm actually quite fit when I do exercise.
I've been a smoker for 30 years and drink 5 standard beers per night. This has been for 5 years.
Could the neurologist have overlooked something? My bloods were normal and I was tested for diabetes, apparently negative. Could the fact I drink alcohol and this could severely lower my blood sugar by the morning, could the glucose test have been incorrect also and I do have diabetes??
Thank you in advance.
XXXX
Brief Answer:
No serious neurological condition has been overlooked from description
Detailed Answer:
In my opinion and as a neurologist who sees many patients with similar symptoms I can tell you that your presentation is not suggestive of a neurological condition since most of the time in a 47 year old a neurological condition would be expected to cause what is known as a FOCAL DEFICIT somewhere over the body which then, either resolves completely, resolves partially, or stays fixed.
MRI of the brain and pain in the temples sounds as if someone were worried about something like aneursym or giant cell arteritis. However, symptoms in either of those conditions generally get WORSE...not better. Your symptoms suggest the presence of a neuropathy which could very well due to the 35 standard beers you drinks per week.
Tests for diabetes are rather sensitive and specific for the condition and it is one of the easiest to diagnose from limited data. In your case, it seems that you are no longer suffering from that element of coming back from your duty station. Of course, you could check the labs that were ordered for you and see what the HEMOGLOBIN C measured.
I would make sure I did a complete base line set of labs such as thyroid hormones, cortisol levels, serum Vit. B12, and serum Vit. D
http://www.YYYY.org/YYYY-lesson-213-YYYY-one-word-or-two/
No serious neurological condition has been overlooked from description
Detailed Answer:
In my opinion and as a neurologist who sees many patients with similar symptoms I can tell you that your presentation is not suggestive of a neurological condition since most of the time in a 47 year old a neurological condition would be expected to cause what is known as a FOCAL DEFICIT somewhere over the body which then, either resolves completely, resolves partially, or stays fixed.
MRI of the brain and pain in the temples sounds as if someone were worried about something like aneursym or giant cell arteritis. However, symptoms in either of those conditions generally get WORSE...not better. Your symptoms suggest the presence of a neuropathy which could very well due to the 35 standard beers you drinks per week.
Tests for diabetes are rather sensitive and specific for the condition and it is one of the easiest to diagnose from limited data. In your case, it seems that you are no longer suffering from that element of coming back from your duty station. Of course, you could check the labs that were ordered for you and see what the HEMOGLOBIN C measured.
I would make sure I did a complete base line set of labs such as thyroid hormones, cortisol levels, serum Vit. B12, and serum Vit. D
http://www.YYYY.org/YYYY-lesson-213-YYYY-one-word-or-two/
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello, all bloods were normal but sodium was slightly raised. The neurologist put my symptoms down to anxiety and the need to cut down alcohol and quit cigarettes.
I did forget to tell him about my blurry vision, bloating and gas.
I was diagnosed with IBS 7 years ago.
Also, sudden changes in my toe and finger nails this year. I have vertical ridges on 4 finger nails and toe nails are flattening and changing shape. Is this just aging?
I guess i worry about my liver. I had another ultrsound 2 years ago for the ongoing RUQ pain. Its a particular spot when pressed is very painful. Ive been told by GP and bowel specialist this is a point in the intestine that turns a corner and food gets stuck there. Im recommended to have more fibre and relaxation, plus a probiotic.
If Liver Function test is normal( which it was, and also kidney function), does that rule out Liver Disease?
Thanks in advance.
XXXX
I did forget to tell him about my blurry vision, bloating and gas.
I was diagnosed with IBS 7 years ago.
Also, sudden changes in my toe and finger nails this year. I have vertical ridges on 4 finger nails and toe nails are flattening and changing shape. Is this just aging?
I guess i worry about my liver. I had another ultrsound 2 years ago for the ongoing RUQ pain. Its a particular spot when pressed is very painful. Ive been told by GP and bowel specialist this is a point in the intestine that turns a corner and food gets stuck there. Im recommended to have more fibre and relaxation, plus a probiotic.
If Liver Function test is normal( which it was, and also kidney function), does that rule out Liver Disease?
Thanks in advance.
XXXX
Brief Answer:
Cutting back on alcohol and quitting cigarettes is a good thing, no?
Detailed Answer:
Thank you for your clarifications and other information.
With all your bloodwork normal then, that certainly does allow one to say with more confidence that no serious illness, neurological or otherwise was missed. I am in agreement with your neurologist that there are several indicators in your story that point to anxiety as a very possible cause to how you're feeling. Have you had the opportunity to speak with anybody well versed in relaxation techniques? You may be surprised to find out how easy and effective such techniques can be when treating symptoms that appear to have an organic basis but cannot be ascribed to any after thorough testing.
As far as any changes to your fingernails and toenails there are conditions where certain vitamins and minerals that are lacking such as calcium, iron, magnesium, manganese, and other trace elements can cause these sorts of changes. In my first answer to you I had asked about things such as Vitamin B12, Vitamin D, and thyroid hormones. With these symptoms that you're describing perhaps a full iron panel would be worthwhile to get as well to rule out any anemic condition.
I'm not a bowel specialist, however, I am pressed to explain how pain in the right upper quadrant of the abdomen could be due to the colonic flexure at that point. Boluses that are being passed through peristaltic wave activity tend to reshape and reform the intestinal trajectory such that flexure points don't become obstructions. Therefore, I don't quite feel compelled to endorse that particular explanation of your pain. Having said that it is certainly possible and the prerogative of a GI specialist to disagree.
But again the ultimate recommendations of increased fiber and relaxation seem to be once again resonate well with me with respect to your GI symptoms. Liver and renal function enzymes which are normal in context with the balance of your tests and examination results which are coming out spic and span, in my opinion makes your chances very good indeed at not suffering from any liver or kidney disease.
Also, I noted that you posed a question regarding time to response of questions. While it is always the intentions of most doctors on this network to answer questions and followups as quickly as possible most also have other clinical duties and responsibilities which can keep us from getting back to these questions except until later than what we generally would like. At the same time Healthcaremagic (as most telemedicine networks do) allows its staff up to 24 hrs. to respond to followups. I do appreciate your patience and look forward to hearing more updates from you in the future.
I did not see any values for your B12, Vit. D, thyroid hormones, and cortisol levels. If you'd like to secure those and post them I'd be happy to comment on them in any future post.
If I can be of service to you in the future please do not hesitate to contact me at:
bit.ly/drdariushsaghafi
If you have no further questions or comments then, I'd appreciate your closing the query and providing some feedback on the responses I've provided.
This query has taken a total 86 minutes to review, analyze, and research in preparation for the response and envoy to the patient.
Cutting back on alcohol and quitting cigarettes is a good thing, no?
Detailed Answer:
Thank you for your clarifications and other information.
With all your bloodwork normal then, that certainly does allow one to say with more confidence that no serious illness, neurological or otherwise was missed. I am in agreement with your neurologist that there are several indicators in your story that point to anxiety as a very possible cause to how you're feeling. Have you had the opportunity to speak with anybody well versed in relaxation techniques? You may be surprised to find out how easy and effective such techniques can be when treating symptoms that appear to have an organic basis but cannot be ascribed to any after thorough testing.
As far as any changes to your fingernails and toenails there are conditions where certain vitamins and minerals that are lacking such as calcium, iron, magnesium, manganese, and other trace elements can cause these sorts of changes. In my first answer to you I had asked about things such as Vitamin B12, Vitamin D, and thyroid hormones. With these symptoms that you're describing perhaps a full iron panel would be worthwhile to get as well to rule out any anemic condition.
I'm not a bowel specialist, however, I am pressed to explain how pain in the right upper quadrant of the abdomen could be due to the colonic flexure at that point. Boluses that are being passed through peristaltic wave activity tend to reshape and reform the intestinal trajectory such that flexure points don't become obstructions. Therefore, I don't quite feel compelled to endorse that particular explanation of your pain. Having said that it is certainly possible and the prerogative of a GI specialist to disagree.
But again the ultimate recommendations of increased fiber and relaxation seem to be once again resonate well with me with respect to your GI symptoms. Liver and renal function enzymes which are normal in context with the balance of your tests and examination results which are coming out spic and span, in my opinion makes your chances very good indeed at not suffering from any liver or kidney disease.
Also, I noted that you posed a question regarding time to response of questions. While it is always the intentions of most doctors on this network to answer questions and followups as quickly as possible most also have other clinical duties and responsibilities which can keep us from getting back to these questions except until later than what we generally would like. At the same time Healthcaremagic (as most telemedicine networks do) allows its staff up to 24 hrs. to respond to followups. I do appreciate your patience and look forward to hearing more updates from you in the future.
I did not see any values for your B12, Vit. D, thyroid hormones, and cortisol levels. If you'd like to secure those and post them I'd be happy to comment on them in any future post.
If I can be of service to you in the future please do not hesitate to contact me at:
bit.ly/drdariushsaghafi
If you have no further questions or comments then, I'd appreciate your closing the query and providing some feedback on the responses I've provided.
This query has taken a total 86 minutes to review, analyze, and research in preparation for the response and envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thankyou so much for this information!
You are very thorugh and very kind.
Yes i will follow up on what youve said, cut back alcohol firstly as i forgot to note that sometimes i get pain around my liver area.
I was told once by an ultrsound administrator this could be spasms.
I dont have a copy of my bloods but will try to get one for you though B12 i know was fine.
I will begin to take vitamins also. Do you have any idea then what the RUQ pain would be and do you think my nail changes are from a less functioning liver, hence inability to absorb these minerals etc?
Thank you again. You are very kind
XXXX
You are very thorugh and very kind.
Yes i will follow up on what youve said, cut back alcohol firstly as i forgot to note that sometimes i get pain around my liver area.
I was told once by an ultrsound administrator this could be spasms.
I dont have a copy of my bloods but will try to get one for you though B12 i know was fine.
I will begin to take vitamins also. Do you have any idea then what the RUQ pain would be and do you think my nail changes are from a less functioning liver, hence inability to absorb these minerals etc?
Thank you again. You are very kind
XXXX
Brief Answer:
Alcoholic hepatitis- Fatty Liver could be the pain you are feeling
Detailed Answer:
Good morning once again. Thank you for your patience and understanding with how our system operates in terms of the time frames necessary to answer questions. The other thing that makes answering your questions just a bit lengthy is the fact that since you are in Australia our time zones are about as far apart as possible and therefore, during the entire day that you're awake...we're asleep over here....or trying to at least! LOL.
The RUQ pain may be a sign of what is termed alcoholic hepatitis which is a swelling of tenderness of the liver (usually the right lobe area to begin with) resulting in fatty deposition. This is based upon the excessive consumption of alcohol. If you were to stop that consumption then, over a period of time (varies from person to person, but if you really leave the stuff alone) there's likely going to be a healing process and regression of the swelling that in several months time will noticeably result in your RUQ feeling much better. But you must give your liver a break.....it's working too hard trying to process all the alcohol and if you don't suspend that activity that pain at some point may also go away....but the fatty deposition will especially lead to a shrinking and hardening of the liver called cirrhosis....and from there the prognosis is very bad. Please consider those consequences when making a decision on what to do.
I also wouldn't doubt that your nail changes are related to some type of nutritional deficiencies based on the history of alcohol consumption. Those 2 things commonly go together but then, again I don't know what your nail looks like to say for sure. It could also be a fungal infection. You could upload pictures of your nails to this system in a separate question to me or any other doctor and see what the opinion is....
All the best to you and I hope things work out.
Cheers....I raise a glass full of my favorite beverage when I'm with friends (Conga....a very tasty Mexican Fruit drink)....I don't drink alcohol at all....but when I have the barman make me a Conga, he does it up with the umbrella, lemon slices, and Maraschino cherries and it's the best looking drink in the toast! LOL!!
If I can be of service to you in the future please do not hesitate to contact me at:
bit.ly/drdariushsaghafi
If you have no further questions or comments then, I'd appreciate your closing the query and providing some feedback on the responses I've provided.
This query has taken a total 99 minutes to review, analyze, and research in preparation for the response and envoy to the patient.
Alcoholic hepatitis- Fatty Liver could be the pain you are feeling
Detailed Answer:
Good morning once again. Thank you for your patience and understanding with how our system operates in terms of the time frames necessary to answer questions. The other thing that makes answering your questions just a bit lengthy is the fact that since you are in Australia our time zones are about as far apart as possible and therefore, during the entire day that you're awake...we're asleep over here....or trying to at least! LOL.
The RUQ pain may be a sign of what is termed alcoholic hepatitis which is a swelling of tenderness of the liver (usually the right lobe area to begin with) resulting in fatty deposition. This is based upon the excessive consumption of alcohol. If you were to stop that consumption then, over a period of time (varies from person to person, but if you really leave the stuff alone) there's likely going to be a healing process and regression of the swelling that in several months time will noticeably result in your RUQ feeling much better. But you must give your liver a break.....it's working too hard trying to process all the alcohol and if you don't suspend that activity that pain at some point may also go away....but the fatty deposition will especially lead to a shrinking and hardening of the liver called cirrhosis....and from there the prognosis is very bad. Please consider those consequences when making a decision on what to do.
I also wouldn't doubt that your nail changes are related to some type of nutritional deficiencies based on the history of alcohol consumption. Those 2 things commonly go together but then, again I don't know what your nail looks like to say for sure. It could also be a fungal infection. You could upload pictures of your nails to this system in a separate question to me or any other doctor and see what the opinion is....
All the best to you and I hope things work out.
Cheers....I raise a glass full of my favorite beverage when I'm with friends (Conga....a very tasty Mexican Fruit drink)....I don't drink alcohol at all....but when I have the barman make me a Conga, he does it up with the umbrella, lemon slices, and Maraschino cherries and it's the best looking drink in the toast! LOL!!
If I can be of service to you in the future please do not hesitate to contact me at:
bit.ly/drdariushsaghafi
If you have no further questions or comments then, I'd appreciate your closing the query and providing some feedback on the responses I've provided.
This query has taken a total 99 minutes to review, analyze, and research in preparation for the response and envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you pnce again and for your sense of humour!
Sorry to go back again, but you previously said if the liver function and blood tests were normal, then this more than rules out liver disease. I have read the liver can function at 25% so in yhat case it would still dhow normal function. Am i correct?
I also read from liver disease ppatients that their liver function tests had come out normal only to find out after biopsy that they were unwell.
I know i have to quit drinking, i am finding this very hard as its been a part of life for so long!
In regard to nails, it could be just aging and a photo would not show these changes. I know its not fungal.
Sorry for so many questions, but the liver functiontest i guess is what im questioning most.
Thanks in advance!
Sorry to go back again, but you previously said if the liver function and blood tests were normal, then this more than rules out liver disease. I have read the liver can function at 25% so in yhat case it would still dhow normal function. Am i correct?
I also read from liver disease ppatients that their liver function tests had come out normal only to find out after biopsy that they were unwell.
I know i have to quit drinking, i am finding this very hard as its been a part of life for so long!
In regard to nails, it could be just aging and a photo would not show these changes. I know its not fungal.
Sorry for so many questions, but the liver functiontest i guess is what im questioning most.
Thanks in advance!
Brief Answer:
Normal liver enzymes
Detailed Answer:
It is certainly true that organs and systems in the body can have problems without the classic markers or warning signs (such as LIVER enzymes elevations, etc.) showing up as abnormal. However, if the only thing I, as a physician speaking to you over a long distant internet connection, have to go on is your report that the labs are NORMAL....then, I would be hard pressed to say that you had liver disease. Right?
I looked again very carefully at what I wrote and how you interpreted it and please take another look to see if you don't agree....I didn't write that normal labs "more than rules out liver disease."
What I said was the following:
"Liver and renal function enzymes which are normal in context with the balance of your tests and examination results which are coming out spic and span, in my opinion makes your chances VERY GOOD INDEED at not suffering from any liver or kidney disease."
To me that's a different statement than yours which virtually rules out any disease process.
The pain you report in the abdomen is quite possibly related to (as I said earlier), some type of alcoholic hepatitis or pancreatitis secondary to alcohol ingestion excess. It's a common complaint in such situations. Furthermore, liver and kidney enzymes happen to be normal.
But there is good news.
If you were to GIVE UP DRINKING alcohol (i.e. give your system a TOTAL BREAK from having to process and detoxify this substance from your bloodstream) then, healing can begin to occur. Perhaps, there is some damage to those organs and perhaps that's what the pain is all about.
You would need to see either a GI specialist or liver specialist to make that sort of call. They will undoubtedly get an U/S or CT scan of your liver/kidneys and there are other blood tests which can be run to see if any abnormalities exist.
If you DO NOT STOP drinking then, sooner or later your enzymes will begin to show abnormal responses and at that point it's going to get complicated. If it's that hard for you to do this on your own and believe me, YOU ARE NOT ALONE then, I believe either joining a detox center or AA group would be in your best interest.
As I said, I'm happy to look at your nails in a photograph but if that's the case then, please open up another question at this point. I very much appreciate your time in asking the questions. This will be the final answer in this thread of questions. If there are more questions please consider writing me under separate cover after closing this series of responses.
I would also appreciate a few words of feedback and a high star rating for our conversation if you are so compelled.
Here is my URL for future reference: bit.ly/drdariushsaghafi
Cheers!
This query has taken a total 116 minutes to review, analyze, and research in preparation for the response and envoy to the patient.
Normal liver enzymes
Detailed Answer:
It is certainly true that organs and systems in the body can have problems without the classic markers or warning signs (such as LIVER enzymes elevations, etc.) showing up as abnormal. However, if the only thing I, as a physician speaking to you over a long distant internet connection, have to go on is your report that the labs are NORMAL....then, I would be hard pressed to say that you had liver disease. Right?
I looked again very carefully at what I wrote and how you interpreted it and please take another look to see if you don't agree....I didn't write that normal labs "more than rules out liver disease."
What I said was the following:
"Liver and renal function enzymes which are normal in context with the balance of your tests and examination results which are coming out spic and span, in my opinion makes your chances VERY GOOD INDEED at not suffering from any liver or kidney disease."
To me that's a different statement than yours which virtually rules out any disease process.
The pain you report in the abdomen is quite possibly related to (as I said earlier), some type of alcoholic hepatitis or pancreatitis secondary to alcohol ingestion excess. It's a common complaint in such situations. Furthermore, liver and kidney enzymes happen to be normal.
But there is good news.
If you were to GIVE UP DRINKING alcohol (i.e. give your system a TOTAL BREAK from having to process and detoxify this substance from your bloodstream) then, healing can begin to occur. Perhaps, there is some damage to those organs and perhaps that's what the pain is all about.
You would need to see either a GI specialist or liver specialist to make that sort of call. They will undoubtedly get an U/S or CT scan of your liver/kidneys and there are other blood tests which can be run to see if any abnormalities exist.
If you DO NOT STOP drinking then, sooner or later your enzymes will begin to show abnormal responses and at that point it's going to get complicated. If it's that hard for you to do this on your own and believe me, YOU ARE NOT ALONE then, I believe either joining a detox center or AA group would be in your best interest.
As I said, I'm happy to look at your nails in a photograph but if that's the case then, please open up another question at this point. I very much appreciate your time in asking the questions. This will be the final answer in this thread of questions. If there are more questions please consider writing me under separate cover after closing this series of responses.
I would also appreciate a few words of feedback and a high star rating for our conversation if you are so compelled.
Here is my URL for future reference: bit.ly/drdariushsaghafi
Cheers!
This query has taken a total 116 minutes to review, analyze, and research in preparation for the response and envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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