Brief Answer:
Would recommend a neurological examination and possible MRI of brain

Detailed Answer:
Good evening and I'm very sorry for the symptoms that are obviously at least a BOTHER to you for the past couple of weeks. I've read other consults that you submitted back in 2016 which seem to be unrelated. Seems like everything since 2016 to the present has been A-OK, right?

And so these symptoms seem to be a bit odd. You say they've been present for about 2 weeks to this point and that at least preliminary screening bloodwork seems normal. There are probably a couple of additional tests I would've considered ordering AFTER THOROUGHLY EXAMINING HIM from a neurological perspective, however, if nothing else showed up then, it's not likely that any of these additional tests would should anything.

However, I believe that if the test results did not reveal anything to the doctor who ordered the tests AND the doctor who ordered them is not a NEUROLOGIST himself who conducted a solid examination that it would be to your advantage to see a specialist who can then, look and check into things to determine whether or not any sort of DIAGNOSTIC TESTING is worth ordering such as an MRI of the brain as well as the spinal cord. In fact, if I ordered an MRI of the brain I would also go with GADOLINIUM CONTRAST. Please remember that if you do get the GADOLINIUM CONTRAST for this situation that you should also have your kidneys cleared FIRST by having both an EGFR and BUN performed. The EGFR should be >=60 though slightly lower numbers can be acceptable given the circumstance.

Your question as to "what this POSSIBLY be" is a bit open ended since the word POSSIBLY really gives us a lot of latitude to throw in everything under the sun...and I'm sure you'll agree that such a prolific and and endless list of possibilities doesn't really help answer your question either.... But literally, given the symptoms and the fact that many of the relevant tests are NEGATIVE....the differential still remains a bit wide.

But I would still entertain the possibility of a metabolic process although it drops a little lower on the list since so many of the preliminary tests are negative. I will tell you that I really YEARN to hear the results of a NEUROLOGIST who has examined you....Doctors and patients should not be tricked into believing that the answer definitely or MUST lie in the "numbers"....because that is not the way we practice GOOD MEDICINE.

The answer that should be given first and premier dibs as to what's going on is the result of a solid HISTORY of your symptoms and what your NEUROLOGICAL EXAMINATION showed when performed by a knowledgeable and experienced clinician who believes that "the body talks to us by way of our coaxing it with a GREAT NEUROLOGICAL examination." Tests, beyond that type of examination and HISTORY....are merely supportive and rarely if ever rule a disease process IN or OUT...... I've seen far too many doctors as well as MILLENIALS satisfied with DIAGNOSIS "by lab result" and in my opinion that is absolutely not the way to go about diagnosing what you've got going with respect to the symptoms.

What needs to be done FIRST is a thorough examination. Perhaps, some additional lab tests could be added but maybe it's not necessary either...the examination may dictate this detail. I might suggest something on the order of Vitamin D, Free T4, Vitamin D, and I may've also thrown in parathormone levels with IONIZED CALCIUM. And there might've been just a couple more tests....but for the most part we REALLY, REALLY, REALLY need that NEUROLOGICAL EXAMINATION by a good and careful neurologist who is looking to test all the major (and minor) components of your CNS (motor, sensory, reflexes, cognitive domains, and CRANIAL NERVES).

Your case may be anything from an as of yet undiscovered metabolic/hormonal derangement (you've not really provided the lab values for the tests that you say are normal....you could attach the copies of the tests in PDF format on this website) or it could be something not working properly in the INTRACRANIAL VAULT affecting the brain, or it could theoretically be something emanating from the spinal cord and the brain.

This could also be a physical manifestation of stress, anxiety, or other psychological stressors which may or may not have risen to the level of your consciousness....but honestly, we save this rationale for the very last set of choices after we have systematically and methodically ruled out all reasonable organic causes.

If I've provided useful or helpful information to your questions could you do me the utmost of favors by CLOSING THE QUERY along with a few positive words of feedback and maybe even a 5-star rating if you feel it is deserving? I am definitely interested in getting updated information on your condition if you'd care to drop me a line at:

www.bit.ly/drdariushsaghafi

and let me know how things turned out.

You can always reach me at the above address for this and other questions. I wish you the best in everything and hope this discussion has aided to your understanding of your concerns.

CHEERS!

This query required 58 minutes of professional time to research, assimilate, and file a response.

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