Concerns About High ESR and Ongoing Symptoms: Seeking Guidance
For nearly two months, I’ve felt like a different person, although I notice small improvements day by day. The issues I've been grappling with include: - Sudden episodes of tachycardia with heart rates soaring between 150-170 beats per minute without any exertion. - Frequent panic attacks. - Heart palpitations that are concerning. - Episodes of dizziness as if the room is spinning. - A persistent feeling of lightheadedness, akin to fainting. - Shortness of breath during any physical activity. - A resting heart rate that has recently decreased from around 110 to approximately 80 bpm. - I suspect I passed two instances of what appeared to be worms in my stool. - Diarrhea occurring at least weekly. - A noticeable loss of appetite, contributing to a weight reduction of 30 pounds without effort. - Experiences of nocturia. - Leukocyte tests returned negative for rheumatoid arthritis. - Ongoing fatigue and insomnia. - Diagnosed as anemic due to a rare hemoglobin variant (Hb Hope) alongside low iron levels. I’ve undergone an iron infusion and currently take 325 mg ferrous iron tablets. - My A1C is measured at 6.3. - I’m on nifedipine 60 mg for blood pressure management and my levels are currently normal. - Notably high ESR at 120 and a C-Reactive Protein value of 20.5. - Stool tests for parasitic infection showed negative results. - Vestibular therapy has denied any signs of vertigo but identified a weak vestibular system, and I have been referred for further PT. - The cardiologist has dismissed the possibility of POTS without conducting specific tests; my primary care physician suggested inquiring further, but the cardiologist did not pursue it. - A herniated L5-S1 disc is contributing to chronic pain and sciatica affecting my left leg. My primary struggles involve a constant feeling of lightheadedness, anxiety, unrelenting sciatica discomfort limiting my activity, and insomnia preventing rest. What specific tests should I discuss with my primary care physician to exclude the possibility of active illness or cancer? The high ESR level is troubling me significantly. I’m exhausted by this ongoing struggle and wish for better health. My husband and I had hoped to expand our family this year. Any advice would be appreciated.
Answers (1)
7/3/2025, 6:11:03 PM
OpenHealth AI
It sounds like you're going through a very challenging time with multiple symptoms and concerns about your health. It's understandable to feel overwhelmed, especially with persistent issues like lightheadedness, tachycardia, and anxiety. It's important to address your worries systematically, particularly regarding your elevated ESR, which indicates inflammation in your body, although it does not specify the cause.
Key Points:
- Elevated ESR: This suggests inflammation, but further testing is needed to pinpoint the cause.
- Current Symptoms: Your symptoms, including anxiety, lightheadedness, and fatigue, may have interrelated causes.
- Focus on Health Concerns: It’s crucial to discuss appropriate tests with your healthcare provider to rule out serious conditions and understand the inflammation sources.
Explanation:
The erythrocyte sedimentation rate (ESR) can rise in various conditions, including infections, autoimmune diseases, and cancers, but it can also be influenced by non-specific factors. The presence of tachycardia, lightheadedness, and fatigue can result from a multitude of issues, including anemia, anxiety, and possibly underlying endocrine or autoimmune issues.
Next Steps:
-
Discuss Specific Tests with Your Doctor:
- Complete Blood Count (CBC): To check for any additional anomalies in your blood cell counts.
- Comprehensive Metabolic Panel (CMP): To evaluate organ function and electrolyte balance.
- Inflammatory Marker Tests: Besides ESR, consider tests like anti-nuclear antibodies (ANA) to check for autoimmune conditions.
- Thyroid Function Tests: Since thyroid issues can cause various symptoms including tachycardia and anxiety, it’s worth testing.
- Imaging Studies: Given your sciatica and lightheadedness, an MRI of the brain or cervical spine might be valuable if other neurological causes are suspected.
- Additional Cardiac Monitoring: Holter monitor (24-48 hour ECG) can help assess heart rates and rhythms, especially during episodes of tachycardia.
- Referral to a Hematologist: Especially important given your anemia and hemoglobin variant for further evaluation.
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Symptom Management:
- Hydration: Ensure you are well-hydrated, as dehydration can worsen lightheadedness.
- Diet: Aim to eat small, balanced meals to support iron levels and stabilize blood sugar, especially given your anemia and recent weight loss.
- Physical Therapy: Follow-up on your vestibular therapy and engage in exercises as directed to strengthen your vestibular system.
- Mental Health Support: Consider cognitive behavioral therapy (CBT) or speaking to a mental health professional to help manage anxiety and improve sleep patterns.
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Monitor and Document Symptoms:
- Keep a daily log of your symptoms, triggers, and any changes to help your healthcare provider and guide discussions on managing your health moving forward.
You are clear about your desire for better health and to potentially expand your family, which adds additional layers of support you might need. Take time to ensure you’re reaching out for emotional support too, as this journey can be tough. You deserve compassion and support through this process, and a comprehensive plan with your healthcare team can help identify the underlying issues so you can begin to feel better.
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