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DrGodofredoMD could you look at this for me please?

I have posted twice on this forum, but I'm not sure how to link you to them both, so I will post one of them here.  Any help would be greatly appreciated.  Thanks!

28 year old male, not sure what to do at this point.  I had a CT scan in 12/05' that showed mild chronic sinusitus.  Since this time I have felt it becoming harder to walk, talk, think and see.  I can barely drive, sometimes see spots, cannot think at all, concentrate, eyes feel off, stiff feeling and feel like I'm going through menopause (from what I've heard).  My most recent MRI on 06/07' showed scattered foci of deep white matter T2 hyperintensity which are nonspecific, although somewhat atypical in this age group.  It was noted on a recent CT scan that I had a deviated septum, polyps, chronic sinusitus and a possible mucus pocket.  The neurologist ruled out anything from the white matter stating "I think it's from a previous injury."  ENT said he doesn't believe my deviated septum would cause me to feel like this.  I am at a complete loss.  I have this feeling of my face almost being lopsided.  I sometimes wake up or throughout the course of the day notice my right eye is smaller and that is exactly the way I feel, like my left side sits up higher than my right.  Not sure what to think of this.

Not sure if this is relevant but my homocysteine level came back at 45.4 when it should not have been higher than 11.8.  I had to postpone a gallbladder surgery twice (they put me out) as my P02 levels were sky high.

I have seen 11 doctors, ENT, neurologist, chiropractor, CT scan's, MRI's, 2 optometrist's, sleep apnea test, EEG, every blood test known to man and still no answers besides anxiety and depression.  I understand I might have those, but I believe it's because of what I'm dealing with.

Would a CT scan have picked up on the white matter back in 2005'?  Could a deviated septum cause any of this?  Any comments, suggestions or ideas would be greatly appreciated.  Thanks!
4 Responses
Avatar universal
Hi.

The CT scan probably did not pick up any findings related to white matter lesions in 2005 because the only finding then, as you mentioned, was chronic sinusitis. However, there is no certainty whether white matter lesions were present or not during that time just based on the CT findings.

A deviated septum would unlikely be the cause of your symptoms.

Have you suffered from anemia? Were any tests done to measure vitamin B6, B12 and folic acid levels?

Your homocysteine levels are intermediately elevated. Hyperhomocysteinemia could be genetic or can be caused by vitamin B6, B12 and folic acid deficiency. These vitamin deficiencies, especially when in combination, could present with some of your symptoms such as cognitive abnormalities and  neurologic and psychiatric abnormalities. You should probably have your vitamin levels checked out as well.

You mentioned something about your physician saying the findings might be from a previous injury. Did you experience any brain injury or head trauma which might correlated with the MRI findings?

Hope this information helps.

Avatar universal
Thanks for your help!  My B12 came back at 253 so they started me on B12 injections.  After 4 or 5 my B12 was up to 1667 so they stopped.  I have never suffered from anemia.

I had a few concussions about 10-15 years ago and broke my nose in 2004.  I am at a complete loss.  

I feel like I'm becoming dumber and slower everyday, like my head isn't getting enough oxygen.  I get quite a bit of pain behind my eyes, headaches, feel off balance, weak, sometimes shaky, clumsy during everyday activities.  My eyes barely adjust to light changes and everyday living is becoming almost impossible.

I had to postpone a gallbladder surgery twice (they put me out) as my P02 levels were sky high.  After seeing a cardiologist and being cleared they did the gallbladder surgery, but no answers as to why the high P02 levels.  Eoseniphils (sp) came back in 10/04' elevated at 601 and in 10/05' elevated at 908.   Here are my results from recent saliva and blood tests.  

Here are the saliva test results;

fTSH 57 Normal
fT4 0.25 Normal Normal: 0.17-0.42 ng/dl
fT3 0.27 Borderline Low 0.21-0.27
TPO Positive
E2 (Estradiol) 9 Male (20-49 yrs): 1-3 pg/ml, Male (50-85 yrs): 1-5 pg/ml
P1 (Progesterone) 30 Male (adult): 5-95 pg/ml
TTF (Free Testosterone) 34 Male (20-30 yrs): 60-110 pg/ml

Cortisol

7:00-8:00 a.m. 6 Depressed 13-24 nM
11:00-Noon 4 Depressed 5-10 nM
4:00-5:00 p.m. 3 Normal 3-8 nM
11:00-Midnight 5 Elevated 1-4 nM
Cortisol Burden 18 23-42

DHEA 4 Normal 3-10 ng/ml

My morning Cortisol blood test was 19.3 (Range: 4-22 MCG/DL). Antibodies test was negative.

Prior tests:

May 2007:

TSH 0.86 (Range .34-4.82 uIU/mL)
Free T4 0.75 (Range .59-1.31 ng/dL)
T-3, Total 114 (Range 60-181 NG/DL)
Iron 215 (Range 25-156 ug/dL)
%SAT 87.0 (Range 13.0-45.0)
Ferritin 179 (Range 5-244 ng/mL)

October 2005:

TSH .94

May 2006:

TSH 1.20 (Range .35-4.82)
Free T4 .91 (Range .59-1.17)
T4-Total 6.4 (Range 4.5-12.0)
T-3 Uptake 34.6 (Range 25.0-35.0)
Free Thyroxine Index 2.21 (Range 1.12-4.20)

August 2006:

TSH 1.11

Here are my latest lab results.
Results: Reference Range/Units:

Glucose 80
Bun 4 L 6-24 mg/dL
Creatinine 0.8 .6-1.3 mg/dL
Sodium 138 136-145 mmol/L
Potassium 3.8 3.5-5.0 mmol/L
Chloride 105 98-107 mmol/L
CO2 30 21-30 mmol/L
Anion Gap 7 3-12
Calcium 9.3 8.4-10.3 mg/dL
Total Protein 6.8 6.1-8.1 g/dL
Albumin 4.3 3.1-4.7 g/dL
Globulin 2.5 L 2.7-3.9
A/G Ratio 1.7 .8-1.8
Alkaline Phos 112 50-136
ALT/SGPT 52 30-65 U/L
AST/SGOT 23 15-40 U/L
Total BILI 1.2 H .0-1.1 mg/dL
Iron 215 H 25-156 ug/dL
IBCT 247 L 250-450 ug/dL
%SAT 87.0 H 13.0-45.0

GLYCO 5.1
Est. Mean BLO 84
TSH 0.86 .34-4.82 uIU/mL
Ferritin 179 5-244 ng/mL
Free T4 0.75 .59-1.31 ng/dL

Doctor said high iron so I donated blood, % of saturation was at like 80 something, but is now down to 66%.

Medicines I've taken:
I have been on Wellbutrin, Clonezapan, Xanax, Lorazepam, Buspirone, Clomipramine, Seroquel, Lexapro, Zyprexa, Zoloft, Cymbalta, Ativan, Risperdal, Paxil and Paxil CR (I believe that's all....as if that's not a lot). I have also taken Avelox, Ru-Tuss, Prednisone, Hydrocodone, Oxycodone, Lortab, Amoxicillin, Ambien and Lunesta.  Currently I take Prilosec everyday (since 14 for acid reflux disease), 20 mg of Ambien to sleep or Chloral Hydrate to sleep.

I was started on Hydrocortisone and worked up over 17 days to 20 mcg, while taking 5 mcg of Cytomel.  Doctor placed me on Paxil and I had a bad reaction so they stopped everything.

I have been told it sounds thyroid/endocrine related, but have had no help.  I was also told that if it was thyroid/adrenal that anti anxiety/anti depressants wouldn't work and that a positive antibodies test in saliva means Hashimoto's even if the blood was negative (as there are a lot of false negatives).  In correlation with the high homocysteine, I thought thyroid was the culprit.  I read elevated homocysteine levels can mean hypothyroid.  Not sure if it could be pituitary related or what, but I feel like I'm going through menopause (from what I've heard).  Any ideas or comments would be greatly appreciated.  Thanks and sorry for the long post, but I'm trying to lay everything out there hoping someone can help me out.  
Avatar universal
Blood Antibodies Test Results:

Thyroid Peroxidase AB <10.0 IU/ML (Reference Ranges <35)
Thyroglobulin AB <20.0 IU/ML (Reference Ranges <20

Saliva antibodies test results: Positive
Avatar universal
Hi.

Based on the tests that were done, it appears that your doctors are seriously thinking of a thyroid disorder as one possible cause of your symptoms.

Has a thyroid scan been done? Normally, in hypothyroidism, TSH should be markedly elevated. The only reason why it would be normal is if the abnormality rests in the pituitary or the hypothalamus. If this is being entertained, a TRH test can be done to help in the diagnosis.

Hope this helps.
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