Variety of symptoms

I am 57 and I feel fine right now, however I have intermittent periods of odd symptoms and I want to make sure they don't add up to something scary. First, 12 years ago I stayed in a beach community where deer were prevalent and lyme disease occasionally popped up. I do not recall having a rash. 7 years ago I started having intermittent periods of unexplained hair loss. I have thick long hair and it was literally falling out - in no pattern - just all over. My family noticed it. After about 2 months, it gradually went back to normal and grew back as thick as ever. This has happened 4 times since, most recently 2 months ago. This last time was minor and it lasted only 2 weeks. 12 months ago, I had tendonitis in both wrists and right forearm for about 5 months - I am no tennis player and do no repetitive activities, except work at a computer. I am getting pretty stiff all over, particularly legs and knees, which I realize may be normal for my age. I generally wince a little when I walk down the stairs in the morning and every time I get up from my desk chair during the day. For years I have had a sore or stiff neck that never really goes away. I also have a fair amount of numbness in my back and left shoulder blade and lately my left ear occasionally feels like it has pins and needles. 2 years ago I had no problem whatsoever getting into any yoga position - now it's hard to get into most positions and hurts to get out, so I'm not even doing that any more. A friend of mine said check out lupus and lyme disease. Better safe than sorry. What do you think? Could these things have a relationship? Could they just be "stuff" and mean nothing?

[Kevin Pho, MD]

It is a possibility that the hair loss and back/shoulder discomfort may be related.

Regarding the hair loss - you may want to be evaluated by a dermatologist.  Any abnormalities in androgen can cause hair loss.  Laboratory tests in those with suspected androgen excess should include total testosterone, dehydroepiandrosterone sulfate (DHEAS), and prolactin levels.  

Hair loss can also be associated with a variety of autoimmune disorders, including lupus.  A dermatologist may consider a scalp biopsy for further evaluation.

For the joint symptoms, I would consider a thyroid test, blood count, ANA (anti-nuclear antibody), rheumatoid factor and sedimentation rate (a marker of inflammation).  Any positive value should lead to an evaluation by a rheumatologist.

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.

Thanks,
Kevin, M.D.

[slappy]

I forgot to say that I also have occasional sharp pain in my neck and skin sensitivity to clothing labels on my neck -- feels like a pin is sticking me and I have to remove most of them. --Slappy

[merotte]

I am suffering from the exact same symptoms described in your letter.  I too was exposed to deer three and a half years ago, and, unlike you, had a bull's eye rash on my leg.  I immediately went to the doctor.  Unfortunately the doctors in the Los Angeles area refuse to acknowledge Lyme disease.  It is now three and a half years later and the Lyme test has turned positive and they all say I should be treated for a disease that had become chronic when a course of antibiotics at the time would probably have knocked it out.  Get a Lyme test, just in case.

Good luck

[totalmuggle]

lupus