Unexplained Symptoms Despite Normal Lab Results – Seeking Input
Hello everyone! I’m a 26-year-old woman experiencing an increase in troubling symptoms over the past few years, particularly intensifying in the last 12 to 18 months. It’s incredibly frustrating because every lab test continues to return within normal limits, yet I feel terrible. I’ve been unable to work for the past three months and feel as though my concerns are dismissed. Many say it's psychological or even suggest I’m dramatizing my diet (currently limited to about 1600 kcal daily). For context, my family has a history of thyroid issues: both my aunt and grandmother have thyroid nodules; my aunt is asymptomatic, while my grandmother had symptoms related to hypothyroidism and had her thyroid removed. Additionally, my brother was diagnosed with type 1 diabetes following a COVID infection. I’ve contracted COVID three times myself. In the past, I experienced a significant weight fluctuation—losing 30 kg in five months after a mysterious illness that lasted three weeks, which resulted in a fever, loss of voice, throat pain, and sinusitis, compounded by the stress of a toxic relationship and finishing college. **Key Symptoms I’m Facing:** - Extreme fatigue, notable weakness, and brain fog (I sometimes forget even my phone number or address). - Bloating, swelling, sensitivity to cold, and experiencing cold hands and feet even in temperatures around 25 degrees Celsius. - Rapid weight gain from 80 kg to 112 kg within a year, despite maintaining a calorie deficit and regular exercise, which I previously didn’t need to do to stay at a healthy weight. - Hair loss, particularly around my temples, alongside thinning eyebrows, as well as reduced body hair and brittle nails. - Persistent low mood, clinical depression, and frequent crying. - Menstrual cycles ranging up to 103 days. - Orthostatic issues characterized by dizziness and vision disturbances upon standing up. - Joint and body pain, especially in knees and fingers. I’ve undergone assessments for conditions such as iron deficiency, B12 levels, and potential kidney or liver issues, but nothing definitive has surfaced. There’s a lingering suspicion that I might have hypermobile Ehlers-Danlos syndrome (hEDS) or postural orthostatic tachycardia syndrome (POTS), yet the hypermobility and discomfort have been longstanding, while these additional symptoms are relatively new. Earlier this year, I took 25 µg of levothyroxine from late January until the end of April after persuading my physician to trial it (when my TSH was 3.7). I noticed an improvement; my hair started to regrow in areas mentioned, I lost 2 kg down to 108 kg, and I experienced some increased alertness. I also began taking 30 mg of Elvanse in early April, which allowed me to tackle tasks, but I was still too weak to return to exercise, so I aimed for at least 8000 steps daily. Currently, I remain on Elvanse, yet its effectiveness has diminished since stopping levothyroxine. After four weeks without it, my weight started to climb again, and I felt my symptoms worsen significantly. **Most Recent Blood Test Results:** **Thyroid Panel:** - TSH: 3.40 mU/l (Reference: 0.35-4.94) - Free T3: 3.09 ng/l (Reference: 1.43-3.90) - Free T4: 9.1 ng/l (Reference: 7.0-14.8) - TPO Antibodies: 14 U/ml (Reference: <34) - TRAK / TSH Receptor Antibodies: 0.85 U/l (Reference: <1.22) **Complete Blood Count / Hematology:** - Hemoglobin: 13.2-13.8 g/dl - Hematocrit: 39.4-40% - MCV: 85-86 fl - MCH: 28-29 pg - RDW: 12.5% - WBC: ~6.0–6.5 - Platelets: 269–293 - Neutrophils: 3.7 G/l - Lymphocytes: 1.7 G/l **Iron Status:** - Iron: 23.9 µmol/l (Reference: 5.8-34.5) - Transferrin Saturation: 32% - Ferritin: Yet to be tested. **B12 & Folate Levels:** - Vitamin B12: 364 ng/l (Reference: 197-771) - MMA: 20 µg/l (Reference: 9-32) - Holotranscobalamin: 108 pmol/l (Reference: >50) - Folic Acid: 5.3 µg/l (Reference: >4.0) - Vitamin D: 25-OH D: 57 nmol/l (Reference: 75-125) – deemed insufficient, I plan to start taking a high dose of Vitamin D3/K3. **Other Parameters:** - CRP: 2 mg/l - Glucose (fasting): 94 mg/dl - Creatinine: 0.82 mg/dl - GFR: 99 ml/min - Liver/kidney enzymes: All within normal limits - EBV IgG levels high (425 and 168) indicating a past infection - Fasting Insulin: 3.6 mU/l - HOMA-IR: 0.85 **Other Hormones (Day 3 of Cycle):** - LH: 8.0 IU/l - FSH: 8.2 IU/l - Prolactin: 352 mIU/l (Reference: 109-557) - Estradiol: 31 pg/ml; low for luteal phase - Progesterone: 0.33 ng/ml - Testosterone: 0.7 ng/ml (Reference: <0.9) - SHBG: 59.5 nmol/l - Androstenedione: 1.75 µg/l (Reference: 0.4-3.4) - DHEAS: 2.28 mg/l (Reference: <4.3) Last May, I underwent a thyroid ultrasound showing a TIRADS 3 nodule on my left lobe, measuring 9x9x7 mm, and the total volume of my thyroid was assessed at 8.7 ml. Although a follow-up ultrasound was performed, no measurements were recorded, but the evaluation was that everything appeared normal, with estimations of each lobe's volume ranging from 2-4 ml. For reference, I stand at 183 cm (6 feet) tall and reside in Germany. I am utterly drained from being disregarded. Something does not feel right, and I desire my life back. I would greatly value any shared experiences, suggestions, or thoughts from the community as I await an appointment with an endocrinologist and seek a therapist—all while being monitored for depression and ADHD (diagnosed at 8, medication discontinued post-school, and recently resumed by my psychiatrist). I’m happy to provide additional information if needed; I’ll respond to comments as quickly as I can.
Answers (1)
7/1/2025, 12:02:38 PM
OpenHealth AI
I'm really sorry to hear about the difficulties you're experiencing with your health. Your symptoms are multifaceted and understandably frustrating, especially given the lack of clear answers from lab results. It’s important to acknowledge your concerns and your desire for a resolution. Let's break down your situation and focus on actionable steps that may help you.
Main Points:
- Symptom Complexity: You are facing a range of symptoms that could involve multiple systems (endocrine, neurological, and gastrointestinal).
- Thyroid Concerns: Given your family history and previous response to levothyroxine, thyroid issues remain a key focus.
- Next Steps: There are specific self-management strategies and considerations to discuss while you await further medical appointments.
Explanation:
Your symptoms, including fatigue, weight gain, hair loss, and mood changes, point towards a potential endocrine issue, possibly related to your thyroid but also potentially involving other areas such as hormone regulation or chronic fatigue syndromes. The presence of cold sensitivity, bloating, and other systemic issues could suggest conditions like hypothyroidism or even forms of dysautonomia like POTS, especially given your mention of dizziness upon standing.
You mentioned a prior positive response to levothyroxine; this suggests that there may be an underlying thyroid issue that requires ongoing attention, even if labs appear normal.
Actionable Steps:
-
Continue Tracking Symptoms: Keep a detailed symptom diary to note any patterns or triggers, including diet, energy levels, mood changes, and physical symptoms. This data can be invaluable when discussing your case with healthcare providers.
-
Reassess Thyroid Function: Ask your endocrinologist about the possibility of re-evaluating your thyroid function over a few weeks, especially considering your previous improvement with levothyroxine. Discuss the idea of monitoring TSH, Free T3, Free T4 regularly since these can fluctuate and may not always reflect the full picture. Your mention of T3 and T4 levels being within normal ranges could still warrant further investigation, particularly as this aligns with your symptoms.
-
Consider Nutritional Support: Since you mentioned being on a calorie deficit, ensure you're consuming a balanced diet rich in nutrients. Take note of any foods that might exacerbate your bloating or discomfort. It may also be worth discussing supplementation of vitamin D with a healthcare provider based on your levels and your plans to improve them.
-
Therapeutic Approaches for Mood: Since you are working through feelings of low mood and depression, seeking a therapist in conjunction with your psychiatrist may provide you with practical strategies to manage stress and improve emotional well-being, especially as you navigate medical uncertainties.
-
Footwear and Physical Support: If you're experiencing joint pain, consider ergonomic footwear or support for your knees and back to alleviate discomfort, as well as gentle exercises designed for flexibility and strength (like yoga or swimming) that are less stressful on your joints.
-
Monitoring Other Systems: Given your diverse symptoms, consider discussing testing for conditions like POTS or Ehlers-Danlos syndrome during your next appointment. Explain your symptoms and how they impact your daily life to ensure a comprehensive approach.
Conclusion:
Your experience is valid, and it is reasonable to seek thorough evaluation and management of your health concerns. Continue to advocate for yourself, and don't hesitate to ask for tests or evaluations that feel necessary. It might take time to find the right answers, but you're not alone in this. Stay hopeful, and stay connected with your support networks. Please feel free to share any further questions or updates as you progress.
Related Questions
Assessing My Health Concerns: How Anxious Should I Be?
I’m a 32-year-old woman, weighing 124 pounds and standing at 5 feet 6 inches tall. For over a year, I have been experiencing bright red rectal bleeding. Initially, I attributed this issue to hemorrhoids that developed during my pregnancy two years ago. The bleeding occurs with most of my bowel movements, sometimes happens without one, and on a few occasions, has been enough to stain the toilet bowl significantly. The color of the blood is typically darker than what I observe during a hemorrhoid flare-up. There is a notable family history of bowel cancer on both sides; one family member was diagnosed at age 45, and another at 60. In the past six months, I have encountered several episodes of severe abdominal pain—3 to 4 instances—intense enough to consider a trip to the emergency room. However, the pain usually subsides within about an hour. It’s unusual for me to experience such acute pain, given my high tolerance for discomfort; for example, I once played rugby shortly after dislocating and fracturing my finger. Recently, I mustered the courage to consult with my doctor, who recommended a FIT test, which returned a positive result (30.1). Additionally, I underwent a complete blood test, and aside from having low ferritin levels (7 µg/L), all other results were normal. I have since been referred for a colonoscopy on a two-week waiting list to rule out any possible bowel cancer. Given these circumstances, how concerned should I be? Thank you for your input.
Understanding Possible Seizure Triggers and Recurrence Risks
Health Background: I am a 21-year-old female, standing at 169 cm and weighing 65 kg. Over the past three years, I have been using oral contraceptives. As of this morning, I started taking 25 mcg of levothyroxine along with a weekly vitamin D supplement of 0.266 mg. Recently, I was diagnosed with hypothyroidism and found to have a vitamin D deficiency that I suspect has existed for the last three years. I do not consume alcohol or smoke, and I can confirm I am not pregnant. Two years ago, I experienced a mild concussion. I currently reside in Spain. A couple of months back, in mid-December, I blacked out twice. The second occurrence took place while I was at the doctor’s office after seeking urgent medical care for the initial incident. Following the second episode, I underwent a CT scan and an EKG, both of which returned normal results. Further tests, as directed by my physician, revealed a critical vitamin D deficiency and hypothyroidism; however, he expressed doubt that either of these conditions led to my loss of consciousness. I was then referred to a neurologist, and I am presently awaiting an appointment. Although the waiting period is lengthy, my doctor indicated that I should receive priority for scheduling, although the exact timeframe remains uncertain. The referral document summarized my events, labeling the second episode (which the physician witnessed) as a potential seizure devoid of tonic-clonic movements—a revelation that took me by surprise. After regaining consciousness, I felt extremely disoriented and terrified, struggling to process what was happening. I have no prior history of seizures, epilepsy, or any related conditions, and there is no known family history of these issues. If this indeed was a seizure, what might have triggered it? Additionally, what is the likelihood of experiencing another one? Since that time, I have not had any further incidents, but I have experienced moments where I felt a sense of impending doom, which I managed to overcome. I intend to wait for the neurologist's evaluation, but the uncertainty surrounding a possible neurological condition is quite distressing. Thank you for any insight you can provide!
Understanding EEG Results for My 22-Month-Old Son: Insights Needed
Could someone help clarify this for me? My son, who is just 22 months old, hasn’t started walking yet, becomes tired easily, and has been experiencing behavioral outbursts. He had a febrile seizure in February 2025, followed by another unexplained seizure in April 2025, which led us to consult a neurologist. Since he was 3 months old, he has been receiving therapy from a physical therapist for torticollis. At birth, he spent five days in the NICU due to issues with meconium aspiration. A recent MRI showed normal results, and he also had a follow-up EEG after one conducted in July 2025. The results from this recent EEG were abnormal for a pediatric patient in awake, drowsy, and sleeping states. Notably, there were brief episodes of left frontotemporal delta slowing, which occurred mainly when he was awake and drowsy. There were no signs of epileptiform activity detected. In contrast, the EEG performed back on July 3, 2025, was deemed normal for both awake and drowsy states, again with no evidence of epileptiform irregularities, although it did not capture any sleep data. This examination was prompted by the child's existing history of febrile seizures. Importantly, he is not currently on any anti-seizure medications. The EEG procedure used standard electrode placements per the 10-20 system, conducted a single-lead EKG, and included continuous video monitoring. During the analysis, the background activity was symmetric, indicating some anterior-posterior (AP) organization, with a dominant rhythm of 50-80 microvolts at 7 Hz. His drowsy state was marked by a reduced amount of eye blink activity, less breathing motion interference, and a generalized slowing in theta/delta frequencies. Stage II sleep exhibited spindles and vertex waves patterns. Additionally, there were intermittent bursts of 250-300 microvolts in the left frontotemporal region with semi-rhythmic activity of 2-4 Hz, mostly observed during wakefulness and drowsiness. No definitive epileptiform discharge was noted. Photic stimulation during the test did not elicit a strong response, and hyperventilation was not conducted during this session.
INTENSE Spine Discomfort, Breathing Difficulties, Muscle Twitches, and Sweating
To elaborate on the situation mentioned in the title, I’ve been experiencing unusual muscle twitches and spasms for the past few days, along with some discomfort in my back. However, today, I felt an unexpected sharp pain shoot through my spine, which has left my legs feeling numb and made it impossible for me to sit up straight. Additionally, I’ve been dealing with cold sweats for the last hour and struggling to breathe properly. Perhaps I’m just overanalyzing things and it’s a common occurrence, but the intensity of the pain is overwhelming—it's truly unbearable. I’m shaking quite a bit, and unfortunately, my parents aren’t responding to my attempts to reach them for help. I have a history of a chronic heart condition and arthritis, yet I’ve never experienced pain this severe, especially in my spine. For context, I am nearly 15 years old and female. My current medications include pain relievers, anxiety medication, beta blockers, and some vitamins, though those specifics may not be particularly relevant. I don’t smoke; however, I have tried vaping a few times, which might not matter much, but I thought it was worth mentioning as it was requested.
Understanding Atrial Fibrillation and Thyroid Issues: Variability in Cardioversion Decisions
Hello everyone, I’m reaching out for guidance regarding my mother’s current health situation, and I’d greatly appreciate any shared experiences or thoughts. **My mother's background:** - **Age**: 55 years - **Weight**: Recently dropped to 116 kg from 118 kg in just two days, likely due to diuretics. - **Health history**: Previously an underactive thyroid, undiagnosed and untreated, now presenting as overactive. - **Medications**: Currently taking thyroid medication and a beta-blocker (Rapiblock). **Current health status:** My mother has been hospitalized since Tuesday, experiencing **atrial fibrillation with heart rates exceeding 200** beats per minute due to her thyroid's hyperactivity. - The plan for cardioversion was initially settled on Tuesday. However, the following day, the medical team advised postponing it until her thyroid levels could be stabilized, believing that her heart rate would return to normal once her thyroid condition was managed. - Her **obesity** precludes her from undergoing a transthoracic echocardiogram, and due to her thyroid concerns, she cannot handle contrast dye (this has been a consistent issue for over four years). Therefore, the only feasible option was a **transesophageal echocardiogram (TEE)**, which has yet to be performed. - She has been prescribed various medications including beta-blockers and thyroid treatments in the past. - On Friday, a doctor proposed proceeding with cardioversion; however, the attending senior physician objected. - Today (Saturday), another clinician has expressed a desire to move forward with cardioversion, having initiated a new medication, as the senior physician is unavailable. - **Communication has been unclear**, as we were notified of developments by a nurse rather than the physician in charge, causing confusion and anxiety. - Currently, only a **chest X-ray** is scheduled, and the TEE remains unaddressed. **My inquiries are as follows:** 1. Is it common for medical professionals to have varying opinions and frequently revise medication or treatment plans like cardioversion? 2. Is it safe to conduct cardioversion in the absence of a TEE? I presumed that this was a standard procedure to exclude the presence of blood clots. 3. Is it usual practice to have only a chest X-ray prior to moving ahead with cardioversion? 4. How typical is it for patients or their families to not be directly informed about treatment changes and learn about them through nursing staff instead? I recognize that this cannot substitute for professional medical advice. I’m simply trying to discern whether these circumstances are typical or if we should express our concerns more assertively with the healthcare facility. Thank you for your insights!