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Family Medicine (Expert Forum)
32 yr old with many symptoms- could it be hormone related?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
32 yr old with many symptoms- could it be hormone related?
by PatK, Feb 20, 2004 12:00AM
I am a 32 yr old women with a history of HLAB27 spondyloarthropothy ( which is very mild and almost non-exsistent), and a recent weight loss of 50-60 lbs (by diet). I do not take any medication, except for daily multivitamins.
About 6 weeks ago I started feeling fatigued and had urninary symptoms. I had a UTI that was daignosed by frequent urination, burning, and elveated WBC in urine. But there was no culture sent out. I was treated with 2 rounds of antiboitics. Symptoms continued. Went to a Urologist. He found micro hemoturia but no bacteria. Did an IVP- it was normal. Symptoms have ceased. He says that it may have never been a true UTI. He says that women my age sometimes have this problem. Meanwhile, I am experiencing a tight, warm feeling in my face. It comes and goes in severity but is almost always there. My doctor ran a CBC and Basic metabolic panel. All was normal except the glucose. My fasting glucose was 158. So she ran a 3 hr glucose tolerance test. That test came back in normal range. She claims that she can diagnose diabetes based on the 1st elevated lab alone. I am also feeling itchy thigh skin and burning muscles in both thighs, anxiety upon awakening from sleep, facial hair grows back quick and more coarse , irritability/mood swings, spotting, acne, body warmth without fever and a general fatigue. Friends have said that it may be perimenopause. My doctor says it is not likely because I have not missed a full period for 3 months. The facial "flushing" feeling, muscle burning, and anxiety are most troublesome. My rheumotologist says that the thigh burning is not related to my autoimmune arthritis. And she is basically at a loss. I am confused and really want to know which direction I should continue searching for some answers and if anyone else knows what this might be related to. Thanks
About 6 weeks ago I started feeling fatigued and had urninary symptoms. I had a UTI that was daignosed by frequent urination, burning, and elveated WBC in urine. But there was no culture sent out. I was treated with 2 rounds of antiboitics. Symptoms continued. Went to a Urologist. He found micro hemoturia but no bacteria. Did an IVP- it was normal. Symptoms have ceased. He says that it may have never been a true UTI. He says that women my age sometimes have this problem. Meanwhile, I am experiencing a tight, warm feeling in my face. It comes and goes in severity but is almost always there. My doctor ran a CBC and Basic metabolic panel. All was normal except the glucose. My fasting glucose was 158. So she ran a 3 hr glucose tolerance test. That test came back in normal range. She claims that she can diagnose diabetes based on the 1st elevated lab alone. I am also feeling itchy thigh skin and burning muscles in both thighs, anxiety upon awakening from sleep, facial hair grows back quick and more coarse , irritability/mood swings, spotting, acne, body warmth without fever and a general fatigue. Friends have said that it may be perimenopause. My doctor says it is not likely because I have not missed a full period for 3 months. The facial "flushing" feeling, muscle burning, and anxiety are most troublesome. My rheumotologist says that the thigh burning is not related to my autoimmune arthritis. And she is basically at a loss. I am confused and really want to know which direction I should continue searching for some answers and if anyone else knows what this might be related to. Thanks
Doctor's Answer
by Kevin Pho, MD, Feb 21, 2004 12:00AM
, Feb 21, 2004 12:00AM
One quick point - your physician is right. A fasting glucose level of greater than 126 is diagnostic of diabetes. You can repeat this test for confirmation.
As for your symptoms, there is no clear cut answer. For the flushing, perimenopause is certainly a possibility, but less likely given your age and normal periods. For confirmation, you can obtain a FSH level which can suggest menopause.
Regarding the facial hair and acne, you may want to be tested for polycystic ovarian syndrome. This is associated with diabetes. To diagnose this, you may want to consider a pelvic ultrasound to evaluate the ovaries as well as tests to measure the free testosterone. An elevation in this level is suggestive of this disease.
You may want to consider an endocrinology consult.
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.
As for your symptoms, there is no clear cut answer. For the flushing, perimenopause is certainly a possibility, but less likely given your age and normal periods. For confirmation, you can obtain a FSH level which can suggest menopause.
Regarding the facial hair and acne, you may want to be tested for polycystic ovarian syndrome. This is associated with diabetes. To diagnose this, you may want to consider a pelvic ultrasound to evaluate the ovaries as well as tests to measure the free testosterone. An elevation in this level is suggestive of this disease.
You may want to consider an endocrinology consult.
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.
Member Comments (2)
by ozark, Feb 20, 2004 12:00AM
have you been tested for any thyroid problems?
by PatK, Feb 21, 2004 12:00AM
Thanks for the feedback- yes, I did have a TSH blood test- it came back normal. I am going to an endrocrinologist in 2 weeks and hope to get some more answers.
