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[Drew1024]

I am 40 yr old male 6ft4in 205 lbs.  I had been diagnosed with SVT on a routine treadmill test in Jan.  I was put on toprol, no good for me, fatigue.  Switched to Cardizem, no problems. During this time I was having faster heartrates in bed, not real fast but in the 100 range.  This put me under serious stress and anxiety worrying about it.  Anyway, EP doc did blood work, catecholamines, vma, epinephrine, metaphrines, and 5-hiaa.  Well, 5-hiaa came back slightly elevated at 6.8 (ref range 6.0).  My ep doc didn't even mention it to me until I got a copy of the report.  He said you're a big guy and I would only pursue it if it was 15 and above.  Anyway,  I wanted closure so spoke to PCP and he said for kicks, let's repeat.  It came back 7.4 this time.  Referred me to endocrinologist who basically said the same thing as my ep guy.  But he decided to do blood serotonin tests which came back normal.  He closed the case and said we can do another 5-hiaa in year for "completeness".  In the meantime, I now know all the symptoms of carcinoid  (the internet is a powerful tool) and now feel like my face blushes or flushes.  I keep looking in the mirror to see if I have flushing and sometimes I think I do.  Can I put this to bed once and for all?  Oh yes, I almost forgot,  now it seems my stomach has been gurgling much more lately.

[Drew1024]

DR:

In my previous post regarding the 5-hiaa, I told you my initial tests were blood work when in fact they were the 24 hr urine test.  The second test by the endocrinilogist was blood serotonin.  Sorry for any confusion.  Looking forward to your response.

[help req]

I am 29 years old. and I do not have any children yet. I have been having this lower abdominal pain on one spot only which then spreads to a area but still concentrated on one spot just to the right, over my pelvic bone just above the hair line. It is on and off comes and goes. I didnt notice it being there always at the time of ovulation or periods, it can vary. but it just makes be very stressed and i cannot think of anything else when it is there. It goes away with some muscle relaxants like "mobic". The pain sometimes even goes till the right groin area. I have observed that it is significant if I am sitting down for a long time but not always it can even start when I have enough rest. I have had several ultrasounds all normal. i had an MRI in dec, 06 also normal. and I had a colonoscopy done in jan 07 also normal. Please advice me. None of my gynacs or my doctors have been able to tell me what it is. It had gone away for two months in between but had come back now.

Please help. you can also reply to me at ***@****
thank you

[Kevin Pho, MD]

I can't make specific recommendations without examining you.

If carcinoid continues to be suspected, further testing can be done.  This can include provocation of flushing using epinephrine or pentagastrin as well as blood serotonin tests.

Imaging with a CT scan and indium-111 octreotide imaging can be considered if tumor is suspected and you want to localize the lesion.

These options can be discussed with your personal physician.

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.
kevinmd_