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What causes muscle tightness, excessive hair growth and unbalanced periods when suffering from PCOS?

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General & Family Physician
Practicing since : 2005
Answered : 2568 Questions
27 year old female, 5'6, 160lbs, diagnosed with PCOS 3 years ago & it went untreated, diagnosed with reactive hypoglycemia in July, diagnosed with generalized anxiety disorder with panic attacks at 18 but they started at age 15, on & off flare ups of gastritis since 17. Current tests & results - low vitamin d, low b12, high testosterone 11.1, high dhea, last catscan of head November 2012 = clear For 5 years I had always complained of headaches, stress headaches, sinus headaches, feelings of unbalanced, feeling "drunk", upon standing sometimes the pressure would be pounding in my head & almost feeling faint .. I have had over 3 head cat scans & been in the ER once for headaches .. I have had an eeg 3 years ago and it was normal, i had a vng and it revealed the crystals in my right ear were off, 2 years ago i had a nerve conduction test on my arms/hands, had numerous ear tests due to ringing in my ears and nothing was found .. Last November, i had tingling & numbness in hands and feet and went for the CT but was clear .. Doctors have said anxiety anxiety anxiety .. It has gotten worse .. In April i was walking in my apartment and kind of felt weird i felt stationary and stiff - my heart started racing and i started panicking .. ever since that moment i havent felt myself .. my neck started feeling like it wanted to jerk forward on and off up until may but that went away and i was ok all of may and XXXXXXX .. middle of july i started getting this inner shakiness and started feeling like my muscles would tighten up to a point that it would make me nervous .. while i drove, sitting down, doing chores .. my DR said it was stress and anxiety and I asked him about MS, ALS, parkinsons .. he said no he didnt feel it was that - he did a pshyical exam, made me do exercises, reflexes, looked in my eyes etc .. He told me since i didnt move around and was a stay at home wife with limited activity it was my muscles going into atrophy .. I disagreed .. I got a personal trainer and didnt last long with her because i didnt feel it was helping .. some said it could be a hormonal imbalance and sugar messing with me .. since the levels are so off .. I had been a little bit better in the recent 2 months and it started again last week .. i need help as to what direction i should be pointed in .. i spoke with 2 other drs on this site to get their opinion & 1 said do a whole bunch of different blood tests and then a muscle biopsy and nerve conduction test and another dr said maybe partial seizures which totally made me frightened. Please give me some insight and ask me any questions you think would be helpful. Also, with the pcos i have gained 40 lbs and cant control my appetite .. I am always hungry, excessive hair growth, unbalanced periods, mood swings .. I am wondering if this all ties in with everything .. I just dont know. i am more concerned with the muscle tightness as it makes me uncomfortable not painful but more annoying and scary
Posted Tue, 4 Feb 2014 in Medicines and Side Effects
Answered by Dr. Prasad 16 hours later
Brief Answer: Muscle tightness may be related to anxiety... Detailed Answer: Hi, I went through the details you provided and for sake of simplicity let me group your symptoms and concerns: a) You been diagnosed with PCOD, gastritis, reactive hypoglycemia and generalised anxiety. b) Vitamin deficiency, high testosterone and DHEA levels found on lab tests. c) Recurrent episodes of headache - stress and tension related / sinus issues d) Off balance especially upon standing - incidentally it also causes headache e) Ringing ear - probably related to inner ear crystals - seems to be better now. f) Tingling and numbness in your peripheries. g) Lastly the most concerning recurring episodes of generalised muscle tightness in a back ground of normal (multiple) brain scans and EEG. As I analyse these symptoms I see few complex interlinks between those symptoms while some are incidental. I would need some help from you to understand those links. 1. Anxiety presents with myriad of complex symptoms. Headache, palpitation, nervousness and episodes of muscle tightness may be part of anxiety syndrome. Are you being treated for anxiety? You have not mentioned about it. If you are on treatment, I think you might need treatment revision. 2. Posture change can induce autonomic changes in few individuals which can make a person off balance. Headache that becomes worse upon standing may also be related to autonomic disturbance. Posture related autonomic disturbances is associated with postural blood pressure drop. Have you checked your blood pressures in standing, sitting and lying down position? 3. Vitamin deficiency may be secondary to nutritional causes and environmental reasons (lack of enough sun exposure). Low vitamin levels can be the cause of peripheral numbness and tingling. Are you on vitamin supplements? 4. High DHEA and testosterone most probably is related to PCOD. However other endocrine functions especially that of adrenal gland need to be evaluated. I would recommend endocrine evaluation if you also have those autonomic disturbance. 5. As your EEG is normal, I do not feel you suffer from complex partial seizure. However it would be worthwhile to take a second neurology opinion about the EEG report, if seizure is being suspected strongly. 6. Muscle tightness don't seem to be related to motor neurone disease (ALS) or multiple sclerosis if your neurologist are convinced you don't have clinical signs of it. Perhaps a second neurology consult would convince you. 7. If there are no proper explanation for muscle tightness, then perhaps it is anxiety related. Treating anxiety with appropriate medicines should be able to take care of it. In a nut shell, I have three suggestions to you. - Consult an endocrinologist who can evaluate for adrenal gland functions. He/she should also be able to evaluate for reactive hypoglycemia and blood pressure changes related to position. - Take a second neurologist opinion about your EEG. EMG (nerve conduction test) and muscle biopsy may be considered as discussed by the other doctor. - Anxiety treatment need to be revised by your psychiatrist. Hope this helps. Let me know if you need clarifications. Regards
Above answer was peer-reviewed by
Follow-up: What causes muscle tightness, excessive hair growth and unbalanced periods when suffering from PCOS? 7 hours later
Can you give me more info as to why partial seizure should and would be considered ?
Answered by Dr. Prasad 16 hours later
Brief Answer: In view of sudden recurring episodes... Detailed Answer: Hi, Seizure is a condition diagnosed clinically. A person is suspected to have seizure when a neurological event such as yours (muscle stiffness / jerking) happens abruptly and involuntarily. When supported with enough evidence we confirm the diagnosis. Evidences to confirm seizure are: 1. A live recording of the event. If you are able to record the events when it happens again, you can show it to your treating doctor. This will able him to arrive at a conclusion. If needed you could use your friends/family members help to record the event. 2. If these events are very frequent, say it occurs almost every day, then a video EEG is a useful diagnostic tool. 3. If a live record is unavailable, EEG recording of your brain's activities is helpful. 4. Lastly, if a second person has witness the events, his or her description can be helpful. In your case, apart from your description - that the muscle stiffness is involuntary and abrupt, I do not find any other evidence to convince that they are seizures. Moreover your doctor has reported the EEG as normal. Hence I requested for a second neurologist opinion. If you know of any second person who had witnessed those events live, you could ask him to describe it to the doctor. Or if those episodes are very frequent - say more than once in day, you could ask for video EEG to confirm / exclude seizure. Hope this answers your question. Let me know if you need any more clarifications. Regards
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