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What causes anxiety, facial flashes, cystic acne, joint pain with a positive AAA blood test?

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Practicing since : 2001
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hello. For the past year i have had a lot of weird symptoms. It all started with facial flushing that started around the same time every night it is also brought on with exercise, heat , anxiety and sex. i am also getting cystic acne on my shoulders and back which started out of no where a couple of years ago and i am still getting them to this day, they are leaving nasty scars and take a long time to heal. I am also getting joint pains in my chest and my left knee. Also noticed increased hair growth on my upper back and chest. lastly i am getting white hair on my head and in my facial hair. I also find myself waking up in the middle of the night 2 or 3 times to use the washroom. So my question is could this be something hormonal in my body creating all these strange symptoms, my doctor cant seem to figure out what is going on. The only thing i have tested postive for is the ANA blood test and have high kidney function.
Posted Wed, 15 Jan 2014 in Thyroid Problem and Hormonal Problems
Answered by Dr. Shehzad Topiwala 4 hours later
Brief Answer: Endocrine Detailed Answer: I see the symptoms are varied and unusual. We can rule out a few endocrine conditions by doing the following tests: CBC CMP TSH Free T4 Plasma fractionated metanephrines The above are blood tests. Further, I recommend a 24 hour urine test for 5HIAA. Essentially, we are looking for endocrine problems like thyroid and adrenal. Specifically some of the above tests are meant for rare conditions like Pheochromocytoma and Carcinoid syndrome
Above answer was peer-reviewed by
Follow-up: What causes anxiety, facial flashes, cystic acne, joint pain with a positive AAA blood test? 31 minutes later
thanks for your answer, i have done the 5hiaa test and it came back negative i also did a 24 hour urine test for cortisol also negative my thyroid also seems to be ok according to my blood work. Yes my symptoms are unusual, my main concern is the joint pain flushing and the acne on my shoulders which all arrived at the same time. After all the research i have done it keeps coming up with either cushings syndrome or carcinoid. Now i have done a some of the test for them but they came back negative but i also heard that the 24 urine test are not 100% accurate is this correct and are there any other additional test i can take? Thanks again
Answered by Dr. Shehzad Topiwala 26 minutes later
Brief Answer: Follow up Detailed Answer: I suggest you do a 24 hour urine test for fractionated catecholamines and metanephrines to evaluate for the possibility of pheochromocytoma. Also add calcitonin to the blood tests. See a dermatologist to assess the skin lesions for the possibility of 'Mastocytosis'
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