OpenHealth Q&A

Seeking Insights on Possible Autoimmune Disease

I am a 37-year-old male who generally maintains a healthy lifestyle. My BMI stands at 21.9, and I do not use tobacco or drugs and only consume alcohol sparingly. My sleeping patterns are, thankfully, quite sound. In July 2024, during a trip to Central Asia where I encountered unsanitary food and water conditions, I suddenly experienced foamy urine alongside severe fatigue and dizziness. These troubling symptoms have persisted since then. Upon returning home, I learned I had several gastrointestinal infections including campylobacter, plesiomonas shigelloides, enteroaggregative E. coli, enteropathogenic E. coli, and cyclospora cayetanensis, which caused continuous diarrhea for approximately two to three months until antibiotics (sulfa and azithromycin) finally cleared them. A urine dipstick test indicated the presence of protein, measuring at 30, but no ketones were found. This led my healthcare provider to suggest a consultation with a urologist or nephrologist to explore possible kidney issues. Blood tests conducted during this period showcased normal levels of A1c (5.4), cortisol, and testosterone (around 700 total), as well as functioning thyroid, kidney, and liver organs. The only abnormal finding was elevated cholesterol, which I’ve had for some time now. I used to be quite active, particularly in running; however, in October and November, I was diagnosed with bilateral hip labral tears via MRI, closely following an X-ray assessment that identified bilateral hip impingement. Pain forced me to pause my running activity as recommended by my orthopedic consultant. While the discomfort fluctuates, at least I have clarity regarding its origins. I mention this as it might relate to other emerging symptoms. After the urine protein discovery, an evaluation by a urologist revealed no significant concerns, as subsequent tests only indicated trace amounts of protein. Furthermore, two distinct nephrologists ruled out kidney disease through extensive blood tests, random urine samples, and a 24-hour urine collection, yet the foamy urine and dizziness remained persistent. Numerous comprehensive metabolic panels during this duration returned normal results. Towards the end of November, I began feeling what I believed to be lower back pain, which has not subsided. Recent X-rays and MRIs of my lumbar spine showed no abnormalities, leading my orthopedist to suggest the discomfort may stem from my sacroiliac joints. He also mentioned it is uncertain whether my labral tears factor into this issue. Additionally, I began experiencing morning stiffness in my hands and a trigger finger in my left pinky around December; these symptoms typically ease within an hour post-awakening. A baker's cyst in my right knee has developed despite no signs of arthritis or injuries noted in imaging. I endure painless cracking in nearly all my joints, including shoulders, neck, wrists, and spine, with occasional random pains in my ankles lasting for weeks before dissipating. A consultation with a rheumatologist in January yielded negative results for any rheumatological diseases, save for a slightly positive ANA (titer 1:40), which the doctor viewed as inconsequential. Post-recovery from my intestinal infections, I’ve been having two to three bowel movements daily, with nearly half of them floating and occasionally appearing greasy. There's no clear pattern in relation to my dietary choices impacting these occurrences. Moreover, I often experience blurry vision, primarily in one eye but occasionally alternating. This confusion usually dissipates briefly with rapid blinking, though it returns shortly thereafter. During my annual eye exam last week, my optometrist confirmed the early stages of cataracts, a condition first noted a year ago, despite everything else appearing normal. I’ve dealt with red eyes for most of my life, so I cannot determine if this issue has worsened recently, but the blurriness is a new development coinciding with all the other peculiar symptoms. My wife suggested I might want to address health anxiety with a therapist, speculating that some symptoms could be mental health-related. However, the therapist I met with did not share that viewpoint. If you've made it this far, I would greatly appreciate any thoughts on my situation. Could I possibly be dealing with an undiagnosed autoimmune condition? Perhaps seronegative rheumatoid arthritis or ankylosing spondylitis? If so, what steps should I take for a proper diagnosis? Genetic testing? Given my blood results came back negative, consulting another rheumatologist may seem futile. The physical symptoms—particularly the debilitating fatigue and dizziness—are distressing, but the mental burden of not understanding my condition, its cause, or my path to recovery is undeniably the hardest aspect. Thank you to anyone who has taken the time to read my story.

Answers (1)

3/25/2025, 2:30:50 PM

OpenHealth AI

It sounds like you've been on a challenging journey with your health, and the combination of physical symptoms and uncertainty is understandably distressing. The symptoms you're experiencing — including fatigue, dizziness, joint issues, and changes in bowel habits — raise important questions about possible underlying conditions, including autoimmune diseases. Let's take a closer look at your situation and outline some steps forward.

Main Points:

1. Persistent Symptoms: Your ongoing fatigue, dizziness, foamy urine, and new joint-related issues suggest a need for further investigation, despite previous evaluations.
2. Potential Undiagnosed Condition: The symptoms could relate to an undiagnosed autoimmune condition, including seronegative rheumatoid arthritis or even another condition.
3. Mental Health Consideration: Health anxiety may be a factor, but it's essential to focus on the physical symptoms you're experiencing to rule out underlying conditions.

Explanation:

From your description, it seems that your health challenges began following your trip, possibly linked to the gastrointestinal infections you contracted. The presence of protein in your urine and persistently abnormal symptoms can sometimes indicate underlying issues, even when kidney disease has been ruled out. Your combination of fatigue, dizziness, joint pain, and the recent blurriness in vision align with various autoimmune and rheumatological diseases, some of which can indeed present without abnormal lab tests in early stages.

Next Steps:

1. Regular Monitoring: Keep a detailed symptom diary noting the onset, duration, and intensity of all symptoms — fatigue, joint pain, bowel changes, and visual disturbances. This will help any healthcare professional you consult understand your condition better.

2. Follow-Up with Rheumatologist: Seek another opinion from a rheumatologist, particularly one who specializes in undiagnosed conditions or autoimmune diseases. Bring your symptom diary and recent test results.

3. Consider Additional Testing: Discuss genetic testing and more specific autoimmune panels that might not have been previously tested. Conditions like seronegative arthritis can sometimes require specialized tests that go beyond standard assessments.

4. Dietary Review: Consider working with a dietitian to evaluate your diet’s impact on your gastrointestinal symptoms. Floating stools can be indicative of malabsorption issues, which may need addressing.

5. Mental Health Support: While physical symptoms are paramount, considering mental health support remains vital. Even if your therapist did not connect your symptoms to anxiety, managing stress and anxiety effectively can improve overall well-being.

6. Stay Informed and Advocate: Empower yourself with knowledge about potential conditions and be an advocate for your health in all appointments. This includes asking questions about referrals to specialists or requesting further testing.

Your journey is complex, and it’s essential to focus on each symptom thoughtfully while remaining in close communication with healthcare professionals. Remember, you're not alone in navigating these challenges, and seeking different perspectives can often lead to more clarity. Please keep track of your symptoms and do not hesitate to express your concerns in your upcoming consultations.