idiopathic condition

[DeLouis]

First off I'm not female, I'm male (sign up error I guess)

Basically I am having several symptoms that don't seem to tie into a diagnosis.

Fever at 100.3 (core temp 97.5 thermometer temp 99.2) not consistent.

Borderline to tachycardia (90-125 bpm) HR can jump from sitting to standing or from standing to sitting.

Blood pressure avg. 110-135 systolic while diastolic in between 100-110 (lightheadedness is sometimes felt)

Tachycardia doesn't need to maintained for BP to sustain.

Tachycardia happens mostly through the day and may or may not be present with a panic or GAD without reason.

Sweating (especially at night is present)

Feeling generally run down, tired, lethargic, poor concentration)

Watery diarrhea has been present for at least 1 month.

Upper right quadrant pain comes and goes underneath right rib cage.

Chest pain or slight tightness may sometimes present. With a palpable pain on the left side of the heart as it's beating.

Dehydration has been noticed in urine color (dark amber) but not always consistent.

Poor circulation to extremities. A tourniquet can be placed on the arm but no veins are produced. Also losing feeling in legs while using the toilet or after praying on knees.

Dehydration is likely to come through excessive urine output. Though it doesn't continually produce excessive amounts of urine and tapers off at about 3L output with 2L intake returning to normal values. What is noticed is (because there is a chronic state of dehydration) that when well hydrated my output is the same as my intake in 40 minutes. (Diabetes,  or problems with vasopressin have not been linked)

There was a rash on both elbows, bumpy, clustered, same skin color, semi itchy

Diagnostic testing done of known problems.

PVC'S
gastroparesis
hiatal hernia
diverticulosis
acid reflux disease
GERD
Restricted blood flood both kidneys at 50%
creatinine 1.5 (Bun and electrolytes normal)
triglycerides 200 to 400 w/in a year.
Endoscopy also discovered a small area of irritation in the stomach.

psychiatric diagnosis

GAD, Depression

Medications

seroquel
trazodone
klonopin
omeprazole
Tylenol or Advil as needed for pain.

Background

31 yr old male, smoker (1.5 packs a day) There has been significant weight gain over the past year (possibly due to medication) in stomach, buttocks,  thighs,  and face.

Other symptoms

Muscle twinges (sections of muscle groups will start pulsating as if being electrocuted) infrequent.
Abdominal cramping in morning until a bowel movement is made (not always consistent)

Clinical examination by PCP

examination revealed a goiter in on the thyroid. Though I can't feel it. I have however noticed swelling in that area from time to time.

Pending tests

Pulmonary function studies.
EKG
Thyroid ultrasound.

Past work ups

Suspicion of celiac disease. Scalping of the villi was present, 2 nodules non cancerous, barrettes esophagus, ando food in the stomach indicating delayed gastric emptying. In 2005 (IGA was negative)

Suspicion of celiac due to rash on elbows (IGA again negative) in 2014

Any ideas as to what's going on?

[Red_Star]

I meant baking soda! :)  Anyway, my mother and I both have Hashimoto's thyroiditis.  There is a long list of possible symptoms of hypothyroidism and I found one article listing many but not all of them called: 300+ Hypothyroidism Symptoms...Yes REALLY.

[Red_Star]

My mother was told she had too much stomach acid for many years without a single pH test to confirm it.  She was taking 40mg of nexium (more powerful than the prilosec you are taking) and it wasn't working. When I found the too much stomach acid is rare and not enough stomach acid is very common, I thought I'd trial the easy baking soda test. She didn't burp for an hour~! The long list of health problems she suffered with for years due to nexium went away one by one increasing stomach acid.

The official test for stomach acid pH is the The Heidelberg Stomach Acid Test. This test below costs nothing if you have baking powder in your cupboard. :)

Baking soda (sodium bicarbonate, not baking powder) test...

The following steps help to determine your stomach's acidity:

1. Perform this test first thing in the morning on an empty stomach (before
eating or drinking)

2. Dissolve ¼ teaspoon of baking soda into an 8 oz glass of cold water

3. Drink the solution and start timing

4. Record the time until you first burp up gas

5. Perform this test for 5 consecutive days (or longer) at the same time each day to give a better estimation of your stomach’s acidity

Time until first burp:

If you burp immediately and excessively your stomach acid level is probably too high

Under 2 min: indicates normal acidity

2 - 5 min: low normal acidity

Over 5 min: possible hypochlorhydria (low stomach acid)

No burping indicates possible achlorhydria (no stomach acid).

[DeLouis]

Thank you for your comment. After the diagnosis of Gastroparesis the Dr believed it was caused by a super infection. Of which I had an extreme infection in 2003 though a workup for the infection type nor antibiotics were given. They discovered a critically low potassium and gave me an IV replacement (which made me feel hung over) and diagnosed the condition as a primary panic attack. At that time I was urinating fluid well beyond my intake, had these painful sores on my fingers. Some petechiae and hemorrhages confined to my fingers and chest, stinging in lungs when smoking, shortness of breath, palpitations, and unusually high blood pressure even when calm. That was in 2003. There was also a dental proceedure done 10 days prior to me being sick and a suspicion of sub acute endocarditis not tested until 2005. Both blood and echocardiogram were normal.

My acid stomach acid is hyper acidic. Despite being on 40mg of omeprazole it does not completely relieve the issue.

I was diagnosed with thyroid antibodies in 2005 and the consensus was that the thyroid would probably start malfunctioning within a year. 11 years later and every test for it has been normal. There is now another pending test for TSH levels and a thyroid sonogram to determine if this has changed. So a malfunctioning thyroid may be found that would help to tie in these current symptoms. I have also found it possible and even likely (based on symptoms) that periodic mild to moderate thyrotoxis may be present. Also pain in the thyroid and swelling have been noticed from time to time.

I have also suspected adrenal complications (specifically cortisol) which a workup for that hormone done in 2003 was elevated. Though after a cortisol suppression test was administered it did fall.

I do speculate at this point if there is some type of adrenal malfunction. Though what has lead me away from that is that electrolytes are normal, there hasn't been steady excessive urination, nor are there any hallmark signs with skin (such as hyperpigmentation) present. That would be linked to something like Addison's Disease.

Though I do acknowledge the restricted bloodflow to my kidneys @ 50%. An elevated creatinine @ 1.5 and a moderate excessive urine output. It has brought me to speculate (being that there's poor blood circulation to the extremities) if there might be poor circulation to the kidneys or other organs. With the kidneys I could say that if a poorer blood flow is now present it might kick off an excessive adrenal output from time to time leading to some of the symptoms I'm feeling today.

As for cardiac output. I have not been able to conclude if any type of infection or SVT is present. I only know the symptoms presenting. Either there is tachycardia present with a BP AVG of 120/100 and a weak pulse to where lightheadedness or faintness may present. Or no tachycardia present with a BP AVG of 135/115 with a weak pulse to where lightheadedness or faintness may present. Sometimes there is a small drop in systolic pressure of 10 points taking a blood pressure from a sitting to standing position where lightheadedness or faintness may or may not present. Sometimes tachycardia will present from a standing to sitting position (unusual). Also there has been at times a feeling of panic which usually appears during episodes of tachycardia with high diastolic BP. Though I can administer 3 mg of Klonopin to break that feeling but tachycardia and BP stays the same regardless of the medication being administered (so it's not a primary panic attack). There has also been chest pain, pressure that is localized to the left side, shoulder or neck. Shortness of breath may be present at these times too. Shaking of the body has also been noticed at times. Sometimes all these symptoms won't be present together and sometimes they will.

I've also noticed that with stresses such as anger or frustration the symptoms of lightheadedness or faintness seem to be more pronounced. This may or may not lead to an increase in primarily diastolic blood pressure. Also short walks may increase diastolic blood pressure (120 +) and chestpain, pressure, shortness of breath, lightheadedness or faintness may present.

Just based on the evidence I have. I suspect that the heart is not fully relaxing and blood flow to it is decreased. It seems unable to fill itself with the proper amount of blood to maintain normal pressures, not just in itself, but though out the body. I also suspect that primary dehydration may be contributing to the hearts weak performance

What's causing the condition is the unknown (Bad valve, SVT, hormonal imbalance, hardness of veins and arteries, ect...) for all could be possible.

I have also questioned some rarer causes for these disorders such as Cushing's Disease or pheochromocytoma. Where symptoms do match the conditions (in part) to where I feel a workup for these conditions may be warrented if other testing pending comes back negative.

[Red_Star]

The most common cause of gastroparesis is diabetes. I had this condition from hypothyroidism. Acid reflux is rarely due to high stomach acid just to add. My mother's severe GERD was due to very low stomach acid. She also has a hiatus hernia just to add. She takes betaine HCL with pepsin supplements and digestive enzyme supplements an no longer suffers GERD or LPR.

Excerpt from Mayo Clinic...

"Factors that can make it difficult for your stomach to empty properly include:

Diabetes
Abdominal surgery
Infection
Certain medications that slow the rate of stomach emptying, such as narcotic pain medications and antidepressants
Certain cancer treatments
Anorexia
Bulimia
Scleroderma
Parkinson's disease
Hypothyroidism"

***

Excerpt from Gallbladder Attack - Stomach Acid..

"Risk Factors and Causes of Low Stomach Acid

Allergies
Anemia
Adrenal fatigue
Alcohol
Atrophic gastritis
Heartburn
Gerd
IBS
Rheumatoid Arthritis
Hives
Candida and other Yeast
Bacterial Dysbiosis or infections in the Gut
Adult acne
Eczema
Alcohol consumption
H. pylori infection
Stress even in children
Age. HCl production decreases wtih age

Diseases Associated with Low HCl

Asthma
Diabetes
Osteoporosis
Arthritis
Hepatitis
Eczema
Acne rosacea
Dry Skin
Psoriasis
Parasites
Gallbladder disease
Herpes
Hives
Hypothyroid
Hyperthyroid
Thyrotoxicosis
Autoimmune disorders
Lupus erythematosus
Myasthenia gravis
Pernicious anemia
Celiac disease
Sjogren 's Syndrome"