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Running out of Possibilities
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Running out of Possibilities

21 year old Male, 6 foot, 165lb. I have been experiencing a wide-range of unspecific and seemingly confusing (as my doctors tell me) symptoms for 7 months now.  My symptoms include: Ear Ringing, Neck Pain, Joint/Muscle Pain/Tenderness, Abdominal Cramping/Nausea, Dizziness/Ataxia/Confusion, Palpitations, Shortness of Breath, Throat Tightness & Congestion, and Balance Problems -- (posted in no specific order of severity).  These can occur simultaneously or all at once.. varying from the tolerable to the almost unbearable levels.  These are the tests I have had so far:

- CBC Blood Panel ------(clean)
- 2 Thyroid Tests ------(clean)
- TSH Test -------------(clean)
- Basic Metabolic Panel (**elevated calcium)
- Brain MRI ------------(clean)
- 2 Chest X-Rays -------(clean)
- Parathyroid Test -----(clean)
- Heart Monitor --------(clean)
- Echocardiogram -------(clean)
- EKG ------------------(clean)
- Treadmill EKG --------(clean)
- Blood Oxygen Levels --(clean)
- Blood Pressure -------(125/70)
- STD's ----------------(clean)

  As you can see the only slight abnormality was the blood **calcium.. which measured an 11 with a normal range being 8.4-10.2.  I am running out of possible answers as more and more doctors seem to think I am fine.  My Primary Doc wants to meet with me and talk about anxiety, but I don't know what I'll say -- I'm a very calm person most of the time.. im not stressed.. and these symptoms are SO severe sometimes I'm amazed Im not in a hospital.  I eat healthy, too.

  Any input on possible causes or directions to pursue are appreciated.
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Avatar_f_tn
Did the basic metabolic include "hepatic functioning"  (liver functions)?  That would be SGOT/SGPT/GGT, or they are also called the AST/ALT (see any of those?)   It would also include bilirubin, albumin, alkaline phosphatase, and a few others.  

You say that you are OK on the STDs.

I'll give you my personal experience with "normal labs after normal labs after normal labs" (for years).  I began feeling awful  (had those symptoms you described -- ringing in my ears, joint pain, stomach pain, cramping, dizziness, unbalanced gait, awful fatigue)  but no doctor could attribute any of my symptoms to any "specific disease" (other than "mental") because the symptoms so closely mimicked chronic anxiety / chronic depression AND because ALL of my labs, including my liver function tests, were consistently "all normal - all clear"  (and had been normal for several years in a row.)  

I got referred to a psychiatrist at my GP's recommendation because it was thought I had an anxiety disorder / depression disorder.   After about my third year under the care of psychiatrist (with symptoms only worsening) I was finally tested for Hepatitis C.  It was positive.   And here's the "kicker" -- all my lab work that entire time (in ALL departments including liver function tests) was completely within normal limits  (but I still had Hep C - 30 years worth.)  

The only way to know if you have Hep C is to get tested.  With the dizziness and ataxia you are describing  (and the other symptoms), you surely deserve to have EVERY possible liver problem ruled out  (especially Hep C), and so -if you've been tested for Hepatitis C, pardon me for trying to pound the importance of "testing" home.  A very high percentage of people who are chronic carries (many years of the infection)  have completely normal labs  (but they have the virus, and it's slowly destroying their liver.)  The ONLY way a doctor will know is by doing a Hepatitis C panel.  People with Hep C usually begin having strange symptoms in about the 20th year  (some sooner).  Far too many with Hep C are not diagnosed and instead are referred to psychiatrists.

Not trying to scare you -- just trying to give you some facts.  

My advice: Get tested for Hep C if you haven't been. If the regular doctor tells you your liver function tests are fine and that you don't need to be tested, tell him you want to be tested anyhow.  

Best of luck.
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Avatar_n_tn
Thank you for the advice, I'll inquire about the tests with my doc.
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Avatar_n_tn
It's a possibility, but I'll be honest when I say I really am not a very stressed person.  Most of the time there is no warning and no trigger for the unset of my symptoms.. which is why it is so difficult to discern the cause(s).  But yes, I have considered the possibility of my brain in influencing all of this.  If that IS the case, boy do I hope to get over it soon.  =o)
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Avatar_f_tn
Hi Ed.  Yes, lol - I am very focused on liver function tests with respect to the Hep C virus because in most cases liver function tests will not be the reason people with Hep C are diagnosed with Hep C (even though the virus is destroying their liver, their liver function tests are normal.) So, diagnosis often comes very late and only after severe liver damage has occurred.  

With respect to the hepatitis C virus, yes - it can cause cognitive changes (meaning it can cause fatigue, depression, anxiety, nervousness, insominia, hypersomnolence, sleepy, drowzy, etc.)  The reason why patients with Hep C have "mental status changes"  (even personality changes)  has stymied researchers, but it's a big area of research, and it's believed that it's because the Hep C virus interferes with serotonin and dopamine.  Some patients (I think it's up to 60%) who have little liver damage from Hep C experience mental status changes (some disabling).

With respect to liver disease (not caused by Hep C), those with advanced liver disease for any reason (such as cirrhosis from... many causes, including Hep C but not limited to)  can most assuredy experience mental status changes (profound changes - to the point of disorientation and coma). But in those cases, the liver function tests are WAY out of whack - very abnormal. But that is at the end stage of liver disease (unlike the Hep C mental status changes that a patient can experience with little damage).  

Here are a few good links that might help explain the Hep C connection and mental status changes.

The original poster had "ataxia", too, listed as a symptom, which very frequently is seen with liver disease.

http://www.hcvadvocate.org/hcsp/articles/cognitive_impairment.html

http://gut.bmj.com/cgi/content/abstract/55/11/1624

Hope this helped.
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Avatar_n_tn
I thought I would share that another part of my testing came back.  My Albumin levels were elevated.  However, my Vitamin D (the one you mentioned), was in the normal range.  With this new elevated albumin (in addition to my elevated calcium), is there anything that still sticks out?
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Avatar_n_tn
What else is going on in your life? I am 55, but when I was 21 I got married and had a child.  In a short time I experienced ringing ears, dizzyness, and all of the symptoms you have described.  I tried bio-feedback, valium, and a lot of other things.  After a few years it all went away.  I think at age 21 you often have a lot of responsibilities forced on you that you didn't have a few years before, and you system reacts to that.
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Avatar_n_tn
chcnme,

   I have a curious question that maybe you may be able to answer..? You seem very focused on the liver functions and Hepatitis..?  Can liver damage or liver problems create Anxiety symptoms...?


  peace... ED
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Avatar_n_tn
I am not a doctor, but I have a lot of experience.  Stress and nervous disorders almost always go away with time.  We have to try to keep our mind on other things that interest us, although I know that is easier said than done.  It's like saying "Don't think about a pink elephant"  The more you try not to think about it, the more you do. Moderate exercise and getting out alos seem to help.  Anything that takes your mind somewhere other than dwelling on your problems.

Good Luck and hang in there
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Avatar_n_tn
Oh yeah, when I first experienced the things you are, I thought I was the most laid back relaxed person in the world.  I would have never thought it possible for me to have anxiety problems.  Anxiety is not a sign of weakness, and it manifests itself in many ways.
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Avatar_f_tn
Hi, an abnormal albumin alone and an "off" calcium would not necessarily indicate anything  (not unless it was totally off the scale, and that would be for your doc to zero in on, and -- since they haven't, I'm assuming the doc doesn't think it's abnormal enough to be concerned, which would be totally appropriate for the doc to do).  

An abnormal albumin, though, (with ANY other abnormal liver tests such as your SGPT , SGOT, or on your lab work it might be called AST / ALT) could mean liver problems.   Did you have any of those labs drawn, and if so - do you know what the results were?  

Has a doctor diagnosed you with "ataxia"?  

Do you know if you have any risk factors that would predispose you to contracting a virus, such as hepatitis C.  Does anyone in your family have any risk factors?  Do you know what the risk factors are?

Certainly, all of the symptoms you have stated could be anxiety, but with the ataxia - well.... that one made me stop and write a note to you about making sure you are aware of the virus called Hepatitis C and the testing done.
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Avatar_n_tn
the only person in my family who had liver issues was my uncle.  he died I believe in his 40's from liver problems... he was a bit of a drinker as I understand but he had some other problem.  I contacted my doctor about a liver test AND a hepC test, actually.. and I am waiting to hear back about them.
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Avatar_f_tn
Good.  I'm glad you did.  I hope the other liver tests are OK.  If you have anymore questions, feel free to ask.  I'll try my best to help you.
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Avatar_n_tn
much appreciated =)
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