OpenHealth Q&A

Which Specialist Should I Consult?

As a 25-year-old woman, measuring 5'4" and weighing 150 pounds, I’m dealing with several health conditions, including polycystic ovary syndrome (PCOS), endometriosis, ADHD, mild scoliosis, asthma, temporomandibular joint (TMJ) discomfort, rosacea, and sleep apnea. To manage my asthma, I utilize a Wixela steroid inhaler every morning and night. Currently, I am under the care of a cardiologist as we investigate potential postural orthostatic tachycardia syndrome (POTS) due to the intermittent heart palpitations that I have experienced for a couple of years. Recently, these palpitations have become more frequent, along with episodes of lightheadedness, especially when transitioning from a bent or squatting position to standing. Despite being quite active and running between 25 and 30 miles weekly, I have noted concerning changes in my heart rate during exercise. My heart rate can spike to 195 beats per minute and tends to remain above 160. Over the past year, this trend has worsened, and any effort to run faster than a 13-minute mile catapults my heart rate into the 170s. Moreover, I have been coping with persistent neck pain for the past two years, characterized by a constant aching discomfort that makes it difficult to find relief. I also experience hypermobility in my shoulders, elbows, and knees. Recently, I have noticed intermittent facial numbness on the left side, along with occasional flushing sensations across my entire face. A throbbing headache has persisted since yesterday, aggravated by standing, even though I have been hydrating and eating adequately after a 10-mile run—a symptom that has continued for approximately 24 hours. Results from my lab tests, including thyroid and cardiac evaluations, have returned normal results with the exception of mildly low potassium levels and mean platelet volume (MPV), both of which were off by just 0.1. A CT scan of my head and neck conducted three days ago also yielded normal results. On occasion, I experience numbness in my ring and pinky fingers as well as some numbness in a few toes. I am uncertain whether these varied symptoms are interconnected and if I should pursue evaluation for an autoimmune disorder. A VA examiner had previously suggested that I might have Ehlers-Danlos syndrome, as these issues could be related. Given the complexity of my situation and the multitude of symptoms, I am considering whether it would be prudent to consult a specialist, such as a rheumatologist or endocrinologist, in addition to my primary care physician.

Answers (1)

3/27/2025, 3:01:27 PM

OpenHealth AI

It's clear that you're dealing with a complex mix of symptoms that may be interconnected. Here’s how to approach your situation with actionable steps.

Main Points:

1. You have multiple health concerns that might benefit from specialized care.
2. Consider consulting a rheumatologist, given the suspicion of Ehlers-Danlos syndrome and your symptoms.
3. Keeping track of your symptoms may help in managing them effectively.

Explanation:

Your history suggests a range of health conditions, including PCOS, endometriosis, ADHD, asthma, and potential signs of POTS or an autoimmune disorder. The concerns about your heart rate during exercise, along with your neck pain and episodic numbness, need thorough evaluation.

A rheumatologist would be a good choice because they specialize in autoimmune disorders and connective tissue diseases, including Ehlers-Danlos syndrome. They can conduct further evaluations to see if your symptoms are related to a connective tissue disorder or other autoimmune issues.

Next Steps:

1. Schedule an Appointment with a Rheumatologist: This will allow you to get a focused evaluation related to your symptoms and the suspicion of Ehlers-Danlos syndrome.

2. Document Symptoms: Keep a detailed journal of your symptoms, including their frequency, duration, and any triggers (like exercise intensity or position changes). This will provide valuable information for any healthcare provider.

3. Monitor Heart Rate During Activities: Pay close attention to how your heart rate changes with different activities. This data can help your healthcare providers understand your heart reactions better.

4. Hydration & Nutrition: Continue to hydrate well and ensure you're getting adequate nutrition, especially potassium-rich foods, since you mentioned mild low potassium levels. This can help overall health, particularly during exercise.

5. Consider a Referral for Neurological Evaluation: Given the intermittent numbness and headaches, it might also be worth discussing with your primary care physician the possibility of a referral to a neurologist for further evaluation.

By focusing on these prioritized steps, you can address your health concerns effectively and comprehensively. Let me know if you have more questions or need additional support navigating your health journey.