Several unexplained symptoms

[D-05]

I have had several unexplained symptoms since February:
(in the order they appeared)

-- first symptoms --

-Headaches (mostly gone, but I suffer one from time to time)
-Fatigue
-Petechiae on hands and chest
-Flushed skin on the forearms
-Weight loss (have lost 30lbs)

-Several moles and freckles appearing on the whole body and enlargement of one mole (was worried it might be melanoma but was told it was normal and not to worry)
-Seizures, which I now believe were panic attacks
(fast heartbeat, shaking, etc, EKG and Holter were normal, did not have any since March)

-- Then I had --

-Jaw and teeth pain (had it evaluated by my dentist, who did not see anything)
-Joint pain (in all joints, on and off)
-Back pain and a very stiff neck
-Diarrhea, constipation, abdominal pain (mostly gone, but I still often have loose stool and abdominal tenderness)
-Shortness of breath with occasional chest pain (almost all the time, last symptom, since 2 weeks, no cough)

-- Tests performed --

Many lab tests (CBC, kidneys, liver, tsh, t4, ana, sed. rate, blood glucose, ck, urine cathecolamines)
all normal except slightly elevated white count (12000) which went down on my last test, and elevated CK (256)

Thyroid scintiscan - normal
Upper GI series, barium enema, ultrasound - normal
EEG - normal

My GP thinks it might be all caused by anxiety and/or depression. I am obviously anxious about my health, but I do not feel quite depressed. I've been on Effexor XR for a month and followed by a psychiatrist, but it doesn't seem to help me much. I have less difficulty concentrating, and have gained some weight.

Just wanted a second advice -- BTW I'm a 20 years old male and was previously healthy with no previous history of psychological or physical disorders

[Kevin Pho, MD]

You have already been through a pretty comprehensive evaluation.  Here are some considerations:

1) A dermatology referral to evaluate the moles.  To obtain a definitive diagnosis, you may want to consider a biopsy for further evaluation.  

2) A GI evaluation for the diarrhea/constipation.  A colonoscopy can be considered since this would be more comprehensive than the barium enema.  If the GI tests are negative, you may want to be considered for irritable bowel syndrome - the first steps to treating this would be increasing fiber intake.  

3) A rheumatology consult to further evaluate the joint pain.  With the negative blood tests, it would be less likely that there is a significant rheumatological disorder going on, but it may not hurt to have a specialist evaluate you.  

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.
Medical Weblog:
kevinmd_b

[D-05]

I also forgot to mention muscle aches, morning stiffness. Could Fibromyalgia be a possibility?

[mymomissick]

Unfortunately you only get to ask the question once. The Dr. will not reply to your follow up post. You have to pay another 15 bucks and make a whole new post altogether. That's what I've done three times now.