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What Does My Blood Work Report Indicate?

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Posted on Wed, 18 Mar 2015
Question: Hi, I have been having some strange health problems since 2003 (I was 23 years old then, I am now 35). I got hit in the head with a frozen basketball and a cascade of strange symptoms occurred shortly after. Besides the dizziness and feelings of passing out, I vomited and had severe diarrhea a few days after the ball hit me. I thought I had the flu. For 10 days I rested at home (because it was Christmas break from school) and when I went to go back I felt this strange nervousness (like drinking WAY too much coffee) - like my body was nervous but my mind wasn't. I then had this strange feeling that something bad was about to happen - even though nothing bad was happening. My heart rate then began to beat really fast, my resting heart rate was 125bpm upon waking in the morning. When I stood up it jumped to 160bpm and my blood pressure dropped. My blood pressure was low and I felt like passing out all the time. I had these adrenaline/panic rushes that flushed over me in waves. It felt like my blood pressure would drop over and over like falling in an elevator. I became so tired and so weak and had these episodes that felt like I was going into shock (would turn cold and white like I wasn't getting enough blood to every part of my body). It felt like my body was stuck in flight or fight plus making me incredibly weak and tired (I was a 23 year old teacher). I could no longer work and could barely take care of myself. Having a shower would exhaust me for the day. I could not tolerate stress at all. Even laughing, or that small excitement when the phone rang was too much to handle. I would get these chest pains while trying to deal with the stress. The pains were almost like a muscle was spasming just under my rib cage just below the sternum. My short term memory also was suffering. I had fasiculations running down my body (mostly on my left side as this was the injured side) and could feel them in my tongue at times and even in my genitals at times as well. I felt spacey and dizzy almost all the time. I had an upset stomach and a lot of diarrhea. My ears were ringing. It was like all my muscles were breaking down. I even had an episode where the left side of my body went weak and even the left side of my face sort of drooped. I felt hungry for air at times. All neurological tests came back normal and they concluded I wasn't having a stroke. I had pain at the site of the injury as well as at the back of my neck where the skull meets the neck. I also had a lot of pain in my left shoulder where the neck meets the shoulder. My jaw also began to crack all the time. I became extremely sensitive to medications to the point where I can barely tolerate anything stronger than Tylenol. Medications made things so much worse. It was like I was a baby on adult doses. At one point I was given IV fluids and it made me feel almost normal.

I also experienced episodes when I was falling asleep where my body would forget to breathe. I would wake up feeling like I was drowning, gasping for air. This wasn't like the typical obstructive sleep apnea, it was like my body would just stop breathing. I would also get weird sensations as I was drifting off to sleep - forgive my description but you know when you lay down and sink down into your bed and feel gravity pull all your tired muscles down...I couldn't feel that in my body and had to move my arms and legs to make sure I could still feel them (I could).

I was diagnosed with neurocardiogenic syncope after a tilt table test and several ECG's and an ultrasound and 24 hour holter monitor of my heart. I was given (over the course of the illness) propranolol, metoprolol, Effexor, Paxil, Nexium, Tegretol, Naproxen, Flexeril and many more, none of which had any effect on what was happening to me. I had 2 MRI's (one with DTI and SWI) and a CT scan of my head and neck which showed nothing except for an incidental finding of a disc buldge at c5/c6 and moderate-severe spinal stenosis as well as kyphosis of the neck (military neck).

I eventually saw a chiropractor and was relieved of some of my symptoms allowing me to function better throughout the day (but still very sick). it seemed as though my 1996 whiplash from a car accident (was stopped and was hit by a driver going 70km/hr) was playing a role in my problems. After 6 months of treatment nothing was changing so I learned about NUCCA chiropractic (which is a chiro specialty dealing with the atlas/c1 only). I continued treatment for 2 years noticing things were improving. The longer I held my alignment the more things would improve. I was only holding adjustments for a month at a time when I had to get adjusted on my previously injured (left side) and all my symptoms came flooding back and I was as sick as I was in the beginning - feeling of something bad happening, terrible nervousness, panic rushes over and over, fasiculations, etc. When x-rayed it was noted that my neck that previously measured 17 degrees to the left was now 19 degrees to the right (optimal is zero, but it is very strange to have the neck 'flip flop' like this). Holding my alignment didn't help get rid of my symptoms immediately and it seemed as though the cascade of muscle breakdown, anxiety, intolerance to stress etc (just like in the beginning) was happening again. This time as my health declined I went off all medications and ramped up my vitamin c which seemed to help. Things started to improve and I began to go uphill with my health. It took almost a year after that episode but I ended up getting well enough to work.

I held my alignment for 4 years (something that most people can't do) and was able to go back to work and resume my life as normal. The only thing I dealt with was feelings of lightheadedness (especially at noon hour time) and this anxiety. I was never the same again, always having this underlying nervous feeling which is frustrating because I was a very confident person. I even had a baby via c section in 2008 and still held my alignment. Between 2006-2014 I lost my alignment 5 times - and each time I lost my alignment I would get this nervousness in my body (but not anxious in my mind) and was adjusted, on the right side (non injured side). I had 2 more children via c section in 2011 and in 2014. In September 2014 I required an adjustment again but this time on my left (previously injured) side and the cascade of symptoms started again. X rays showed a neck "flip flop" again from 17 degrees out of line to the left to 20 degress out of line to the right. The inflammation that I had in my head behind my eyes, at the base of my skull was so intense that at times it felt like I was seizing up both in body and mind.

Over the course of weeks the feeling of impending doom, terrible nervousness, adrenaline rushes, fasiculations, weakness, intolerance to stress. This time my blood pressure wasn't low. In fact I was seeing numbers like 135/96 which is high for me. This time I was also having a headache between my eyes that intensified as all the other symptoms intensified. I was sweating so much in the night I'd wake up with wet clothes. I could hardly sleep, suffered from insomnia (because I couldn't calm myself down from this nervousness for no reason) and if I did fall asleep I was consistently up at 4am. I would also have to eat in the middle of the night or else I felt like passing out. I was having episodes again of feeling like I was going into shock and going to die. I also was losing weight (about 5-10 pounds) and had not changed my eating and my activity level in fact got lower. I acquired a new symptom that was very scary. If I would do some cognitive work (like reading on my phone, or addressing envelopes for Christmas cards) it was like my brain was over worked and would shut down, even the thoughts in my head were jumbled and I probably wouldn't have been able to tell you my name. I would have to go and lie down in a dark room and wait for the feelings to pass. It would take hours. My ability to handle stress became so non-existent that I had to leave my house and my children because they were too stimulating. I could not miss a meal ever or even be late for a meal or a snack or else my symptoms would intensify. Hearing my baby cry or my children speak was too much for my nerves/body to tolerate. I was taking 400g of Advil every 4 hours and ended up doing so for about 2 months.

I also experienced a lot of pain in my body, mostly on my left side. My muscles were so sore, sometimes it felt like I had a deep ache to the bone. The muscle behind my left ear felt like it was ripping away from the bone. I would feel sensations (as the fasiculations worked their way down my body) of muscles weakening and then releasing. It would feel like my esophagus was S-shaped or like I had whiplash in the front of my neck muscles. Even one time it felt like my tongue was shifting at the back of my throat. Even stranger was that night I didn't snore for the first time (I have also been diagnosed with sleep apnea and Oral allergy Syndrome but I can't use my cpap machine because I was prescribed the machine right after I gave birth to my 3rd son and I have lost 65 pounds since then and am on a wait list to see a respirologist to get my air pressure prescription changed since it fills me up with too much air now). I would also get pain over my body that felt like pins and needles. My skin behind my eyes and nose felt sunburned and I got little white bumps (milia) on my eyelids. My butt muscles also felt sunburnt.

I consulted with another physiatrist and neurologist who diagnosed me with post concussion syndrome with atypical migrainous symptoms. They gave me amitriptyline. I tried it, and it helped with my symptoms on the first day but because I am so sensitive to everything I felt suicidal by day 2. So I tried Atenolol, also the side effects were too strong. So I went off everything and seemed to turn a corner in December and my health is going up hill again.
At this point I am about 80% back to normal except I still have so much of this nervousness/anxiety (although not as severe as when the episodes first begin), headaches (although I am getting breaks from them now, they are not continuous) and my period is super heavy for 5 straight days and then I bleed lightly for the next 2 weeks or more. This is a new symptom for me also but is distressing as my PMS seems to be hard to handle and interferes with the functioning of my life. The anxiety and headache increase exponentially during PMS and the first few days of menstruation. I have had a pelvic ultrasound that showed little fibres on my ovaries but they were very small. Interesting to note; in 2013 I was put on the birth control pill, Marvelon, and my body experienced severe anxiety with chest pains - similar to the nervousness I feel during my "episodes". I only took the pill for a week but the anxiety was so terrible I had to stop and then it took almost a month before I felt back to normal.

I consulted with a neuropsychologist who thinks the brain injury I have is in the brain stem because I was hit in the head on the left side and when you're injured on the left side of your brain your symptoms should be on your right side of your body. She also put me on a diet that eliminated all dairy, gluten, foods that make alcohol (corn, potatoes, vinegar, grapes, plums, pears, peaches, etc). I eliminated the foods for 2 weeks and then reintroduced them slowly to see if I had a reaction. Vinegar gave me a headache and that was all. I easily lost another 10 pounds and even with adding more breads and some sugars back into my diet my weight continues to slowly decline which is a major change from what I'm used to - having my weight never budge even with big efforts! I have not had caffeine since 2003 and have about 3 alcoholic beverages each year as well. My body cannot tolerate caffeine.

Since my case is considered "non urgent" and we have only 1 endocrinologist in my city it could be 2 years before I see her. She ordered blood work and now I wait to see her. The blood work results are as follows:
TSH - 1.38 mIU/L (ref range0.27-4.20)
Free T3 4.34 pmol/L (ref range 3.90-6.70)
Free T4 17.1 pmol/L (ref range 12.0-22.0)
Vitamin D 48.23 nmol/L (ref range 70-250)
FSH 4.9 IU/L (ref range: Follicular Phase 2.5-10.2; Midcycle Peak 3.4-33.4; Luteal 1.5-9.1......Period was Oct 15-23 and test was taken Oct 24)
LH 3.7 IU/L (ref range: Follicular Phase 1.9-12.5; Midcycle Peak 8.7-76.3.4; Luteal 0.5-16.9......Period was Oct 15-23 and test was taken Oct 24)
Estradiol 219 pmol/L (ref range: Follicular Phase 46-607; Ovulation phase 315-1828; Luteal 161-774......Period was Oct 15-23 and test was taken Oct 24)
Prolactin 8.1 ug/L (ref range 3.0-20.0)
DHEA-S 5.06 umol/L (ref range 1.65-9.23)
Cortisol 752.1 nmol/L (ref range 138-635)
Anti Thyroid Peroxidase 16 IU/ml (ref range 0-34)
Anti Thyroglobulin 20 IU/ml (ref range 0-115)
ACTH 7.90 pmol/L (ref range 0.00-11.00)
Human Growth Hormone <0.05ug/L (ref range 0.00-8.00)
Cortisol Free 24 hour Urine 134 nmol/d (ref range 25-146)

The patterns I notice with this illness are:
Daily - if I wake in the night it's at 4am consistently. Symptoms are always bad in the morning, get a little better and then between 11am-1pm they are worse again (that new symptoms of my brain shutting down and having to lay down in a dark room consistently happened during this time frame and no other time) after this they get better and in the evening I feel my best, sometimes even feeling completely normal.

Monthly - Symptoms always worse during PMS and the first few days of my period.

Episodically - feels like the illness follows a bell curve. Symptoms go downhill (get worse and worse) and eventually turn around and go up hill.

I seem to be hypersensitive to everything happening in my body, and to medications.

I consistently have this pain in my upper abdomen/lower chest on my left side just below the rib cage that appears when I am symptomatic with headache and nervousness. Feels like heart strain or a muscle pulling or spasming or something. Sometimes the feeling is in back straight back from the pain at the front (at the same height).

Things that have helped : Loads of Vitamin C, walking lightly (I am very slow to recover from exercise), NUCCA and being in alignment, sometimes IV fluids, advil but not long term.

Things that make it worse: Losing my alignment or being adjusted on the left side, massage, medications (both natural and pharmaceutical), acupuncture, stress, lack of sleep, hunger, exercise causes symptoms as well as takes a long time to recover.

I have been seeing a psychologist. She wants to know what my adrenals are doing.

I realize this was a very long story. Thank you for reading it and I appreciate any insight you might have. It has been such a long journey and in the place I live (Saskatchewan Canada) there are not many specialists and if we get referred it takes years to see them making this process hard to endure. Any ideas of what could be happening? I feel the diagnosis of atypical migrainous symptoms doesn't fit what is happening to me.




doctor
Answered by Dr. Noble Zachariah (32 hours later)
Brief Answer:
Organic and functional problems are involved

Detailed Answer:
Hello,
Welcome to HCM and thanks for your query.
Reading through your account, I can imagine what you have been going through in the last 12 years. Human body is very complex with various systems in the body and mind function in symphony like a well performing orchestra. Little problems upset the quality of the melodious music.
From your account and the tests available , I am glad that I don't find any serious or life threatening health problems. There are a few problems which are making your life difficult at times.
My approach to your problems is as follows.
You have vitamin D deficiency. This has a significant role in your musculoskeletal problems and your general health. The other major problem is the panic attacks and stress related disorders like the atypical vascular headache and the feeling of anxiety
Blood cortisol levels vary with the time of the day. The 24-hour urine cortisol is normal and a serious adrenal disease is unlikely.
I think you should get your vitamin D deficiency corrected. This is easily done by monthly injections or weekly high dose tablets.
You should also have a wholesome diet, exercise at least 30 minutes a day and practice stress relieving measures like yoga, meditation or relaxation techniques.
If your headache is very troublesome, there are medicines to prevent the headache in addition to those to relieve it.
I shall be happy to answer any further queries.
Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Noble Zachariah (38 hours later)
Hi, I also asked this question to an endocrinologist and it disappeared, why would that be?
doctor
Answered by Dr. Noble Zachariah (3 hours later)
Brief Answer:
Did you make two payments or one?

Detailed Answer:
Welcome back.
No endocrinologist was interested in answering the question.
So it was put for specialists who have experience in endocrinology to answer.
If you want a specific doctor to answer , you may address it to the concerned doctor and pay his/ her special fees for a direct question. The fee would be more than the specialist fee.
If you have further queries, you are welcome.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Noble Zachariah

Internal Medicine Specialist

Practicing since :1974

Answered : 2319 Questions

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What Does My Blood Work Report Indicate?

Brief Answer: Organic and functional problems are involved Detailed Answer: Hello, Welcome to HCM and thanks for your query. Reading through your account, I can imagine what you have been going through in the last 12 years. Human body is very complex with various systems in the body and mind function in symphony like a well performing orchestra. Little problems upset the quality of the melodious music. From your account and the tests available , I am glad that I don't find any serious or life threatening health problems. There are a few problems which are making your life difficult at times. My approach to your problems is as follows. You have vitamin D deficiency. This has a significant role in your musculoskeletal problems and your general health. The other major problem is the panic attacks and stress related disorders like the atypical vascular headache and the feeling of anxiety Blood cortisol levels vary with the time of the day. The 24-hour urine cortisol is normal and a serious adrenal disease is unlikely. I think you should get your vitamin D deficiency corrected. This is easily done by monthly injections or weekly high dose tablets. You should also have a wholesome diet, exercise at least 30 minutes a day and practice stress relieving measures like yoga, meditation or relaxation techniques. If your headache is very troublesome, there are medicines to prevent the headache in addition to those to relieve it. I shall be happy to answer any further queries. Take care