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Arthritis (Expert Forum)
Lupus, ALS, or unrelated symptoms?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions and support regarding arthritis issues such as: Arthritis, Autoimmune Disease, Bursitis, Fibromyalgia, Gout, Juvenile Rheumatoid Arthritis, Lupus, Myositis, Neuralgia, Osteoarthritis, Polymyalgia Rheumatica, Rheumatoid Arthritis, Sciatica, Tendinitis, Vasculitis.
Lupus, ALS, or unrelated symptoms?
by TotallyLost, Oct 09, 2005 12:00AM
Hi -
I apologize for the length. Hopefully someone can help, because I'm totally confused, and consumed by fear. My doctor suggested I may have Lupus, and I have even worse fears of ALS. I'm 24, and I recently started having fascilations absolutely everywhere. Arms, legs, face, stomach, toes, bottom, you name it. They are continual. Even my eyes feel jumpy sometimes, and my head feels like it's hard to hold up while sitting still. My left arm/hand feels kinda heavy and weak/without coordination. I frequently drop things I'm holding in my left hand, they just slip right out before I realize I've let go, and left foot causes me to trip now and then. Strength and coordination tests are normal, but on reflex tests I'm 2/4 - no reflex reaction in my arms, normal in legs.
Recently I'm having trouble swallowing, and have a continual "full" feeling in my throat. Have also had a few laryngospasms in the last year, and several bouts with tonsilitis - but my throat and mouth are constantly sore, and irritated by allergies (constant PSD) - sometimes causing thrush, and the Dr. says I could even have GERD. I am currently taking Anaprox (for extreme pain during menstruation), Singulair, Flonaise, Advair, and Alavert, and something for GERD, I forget the name.
Some history -- I have had Raynauds - lousy general circulation - and mild signs of Carpul Tunnel and swelling/achey joints in my hands for for over ten years. I have very tight muslces and a lot of stress in general. I also suffer from asthma like symptoms (though I have pigeon breast, and that may cause the breathing difficulties), and recently - intermittent heart palpitations. Recently I even had a brief spell of high blood pressure and dehydration - I'm still overly thirsty. My memory and mental organization are absolutely lousy, and I go in phases of being disoriented, slurring/mixing/forgetting words, and experiencing no symptoms at all. This is so frequent that it actually causes my IQ to vary, and it has happened for as long as I can remember. I also get ill and vomit sometimes just before menstruation, so it's suspected I have a hormonal imbalance. There is also incidence of gout in my family, and I have had leg joint pain since I was very young.
Had full metabolic testing, all normal. Now my doctor suggested that I might have some sort of autoimmune disorder, and suspects Lupus. From what I've read, my neurological symptoms sound more like ALS. Does anyone have any input? Could these things be ALS, Lupus, or a coincidence - the weakness from a pinched nerve maybe? Hormonally induced, or something else entirely? Please help, if you can.
I apologize for the length. Hopefully someone can help, because I'm totally confused, and consumed by fear. My doctor suggested I may have Lupus, and I have even worse fears of ALS. I'm 24, and I recently started having fascilations absolutely everywhere. Arms, legs, face, stomach, toes, bottom, you name it. They are continual. Even my eyes feel jumpy sometimes, and my head feels like it's hard to hold up while sitting still. My left arm/hand feels kinda heavy and weak/without coordination. I frequently drop things I'm holding in my left hand, they just slip right out before I realize I've let go, and left foot causes me to trip now and then. Strength and coordination tests are normal, but on reflex tests I'm 2/4 - no reflex reaction in my arms, normal in legs.
Recently I'm having trouble swallowing, and have a continual "full" feeling in my throat. Have also had a few laryngospasms in the last year, and several bouts with tonsilitis - but my throat and mouth are constantly sore, and irritated by allergies (constant PSD) - sometimes causing thrush, and the Dr. says I could even have GERD. I am currently taking Anaprox (for extreme pain during menstruation), Singulair, Flonaise, Advair, and Alavert, and something for GERD, I forget the name.
Some history -- I have had Raynauds - lousy general circulation - and mild signs of Carpul Tunnel and swelling/achey joints in my hands for for over ten years. I have very tight muslces and a lot of stress in general. I also suffer from asthma like symptoms (though I have pigeon breast, and that may cause the breathing difficulties), and recently - intermittent heart palpitations. Recently I even had a brief spell of high blood pressure and dehydration - I'm still overly thirsty. My memory and mental organization are absolutely lousy, and I go in phases of being disoriented, slurring/mixing/forgetting words, and experiencing no symptoms at all. This is so frequent that it actually causes my IQ to vary, and it has happened for as long as I can remember. I also get ill and vomit sometimes just before menstruation, so it's suspected I have a hormonal imbalance. There is also incidence of gout in my family, and I have had leg joint pain since I was very young.
Had full metabolic testing, all normal. Now my doctor suggested that I might have some sort of autoimmune disorder, and suspects Lupus. From what I've read, my neurological symptoms sound more like ALS. Does anyone have any input? Could these things be ALS, Lupus, or a coincidence - the weakness from a pinched nerve maybe? Hormonally induced, or something else entirely? Please help, if you can.
Doctor's Answer
by Kevin Pho, MD, Oct 11, 2005 12:00AM
, Oct 11, 2005 12:00AM
Fasciculations, problems swallowing, cramps, fatigue, and problems breathing can all be caused by ALS. Of course, there are many more common illnesses that can lead to these symptoms as well.
However, if there is concern about ALS, you can discuss being tested for this disease to give some peace of mind since this is obviously concerning you.
Testing can include electrodiagnostic testing as well as a cranial and spinal MRI.
These options can be discussed in conjunction with a neurology evaluation.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
However, if there is concern about ALS, you can discuss being tested for this disease to give some peace of mind since this is obviously concerning you.
Testing can include electrodiagnostic testing as well as a cranial and spinal MRI.
These options can be discussed in conjunction with a neurology evaluation.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
Loss or coordination, poor reflexes, especially the trouble swallowing (that's a big Hashimoto's sign), frequent infections, allergies, menstrual irregularities, carpel tunnel, aching joints, cold extremities, cognitive difficulty - yep, everything you mentioned is a hypo symptom. I also
had the asthma like symptoms - which is from weak breathing muscles and hypo fluid build up.
To check for sure, you should ask for the following tests:
TSH (thyroid stimulating hormone - new top end of range is 3)
Free T4 (storage thyroid hormone)
Free T3 (active thyroid hormone)
TPO - (thyroid peroxidase - thyroid antibodies)
The docs usually just like to do the TSH, but it is really important to have all the tests, especially in your case, the thyroid antibodies.
Best of luck to you.
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You may want to investigate Lyme Disease.
The Canadian Lyme Disease Foundation has a good list of symptoms:
http://www.canlyme.com/
(click on symptoms)
* Head, Face, Neck
1. Unexplained hair loss
2. Headache, mild or severe, Seizures
3. Pressure in Head, White Matter Lesions in Head (MRI)
4. Twitching of facial or other muscles
5. Facial paralysis (Bell's Palsy)
6. Tingling of nose, (tip of) tongue, cheek or facial flushing
7. Stiff or painful neck
8. Jaw pain or stiffness
9. Dental problems (unexplained)
10. Sore throat, clearing throat a lot, phlegm ( flem ), hoarseness