OpenHealth Q&A

Seeking Answers for Unexplained Symptoms

I worry that one day I might wake up unable to move my limbs because the cause of my symptoms remains unidentified. I am in need of advice on the possible underlying issues I could be dealing with. What inquiries should I make? Whom should I approach for a referral, and which diagnostics should I ask for, just to ensure that it isn't simply attributed to anxiety? Currently, I am experiencing persistent sensations of tingling, pins and needles, and even burning across various areas of my body, and these feelings seem to intensify over time. ### Background Information: Approximately a decade ago, I began to notice intermittent tingling on the right side of my face that lasted from thirty seconds to a minute for several months. After undergoing comprehensive blood tests, a CT scan, and an MRI, nothing conclusive was found. I was reassured it was likely anxiety, with advice to disregard it unless it worsened. Ever since then, I have dealt with occasional facial tingling. Roughly five years back, the sensations extended to the right side of my head and not just my face, prompting me to revisit my doctor. I underwent more blood tests and an MRI focused on multiple sclerosis, which yielded normal results without any lesions. During a consultation with a neurologist, I was met with a nonchalant attitude and was told it was likely just my anxiety, with a suggestion to return if the symptoms escalated. Notably, these tingling episodes do not occur during times of anxiety; they seem to manifest in moments of calm. Recently, the tingling sensations have resurfaced, but now they affect both sides of my face, alongside my arms, legs, hands, feet, and even my hips and chest. These sensations have become longer-lasting and increasingly painful, accompanied by my right arm feeling as if it’s about to “fall asleep.” Additionally, I’ve been experiencing forgetfulness and difficulty concentrating. Upon another visit to my doctor, the tests returned normal results yet again: - **Normal Findings:** Blood tests including CBC, HIV, Lyme disease, a comprehensive metabolic panel (checking glucose, potassium, sodium, etc.), along with levels of B12, B1, and folate were all within range. I have the celiac gene (HLA-DQ2) but without symptoms, and my IgA and tissue transglutaminase IgA values remain normal. - **Abnormal Findings:** My vitamin B6 is elevated at 27.2 (normal range is 2.1-21.7), though my doctor dismissed this as a possible cause. My ANA was positive at 1:80 initially, later dropping to 1:40, showing a pattern of both "Mitotic, Intercellular Bridge" and "Nuclear, Speckled," which my doctor also claimed does not imply an autoimmune issue. ### Personal Context: I am a 35-year-old female, weighing 135 pounds, with a history of cyclical vomiting syndrome and vasovagal syncope (fainting during vomiting), alongside an anxiety disorder. My current medications include nortriptyline at 50 mg, buspirone at 20 mg, and I am on a birth control pill. Interestingly, these tingling sensations started while I was previously on Prozac. I have another appointment scheduled tomorrow, and I anticipate hearing the phrase "it's purely anxiety" once more, but I am not convinced that this is the case. 1. What specific questions should I pose to help clarify my situation? Would it be reasonable to request a full body CT scan? How assertive should I be in pursuing this? Normally, I accept the doctor's recommendations, but after ten years, I would like to find a definitive answer. 2. Would it be prudent to request referrals to a neurologist, rheumatologist, spine specialist, or a dermatologist? 3. If we exclude the typical explanations, what might be the potential causes of my symptoms? Is there a chance I could have a slow-developing cancer concealed along my spine? Am I at risk of awakening one day completely paralyzed due to numbness? My doctors have dismissed the more common explanations, so what unusual possibilities should I be considering?

Answers (1)

7/28/2025, 11:20:54 PM

OpenHealth AI

It sounds like you are experiencing distressing and persistent symptoms, which have understandably led to concerns about your health. It's important to address your symptoms comprehensively and advocate for yourself during medical appointments. Here's how you can approach your situation:

Main Points:

1. Prepare specific questions for your doctor to help clarify your symptoms.
2. Consider referrals to specialists who can evaluate your symptoms more thoroughly.
3. Be aware of potential underlying conditions that might explain your symptoms.

Explanation:

You're describing sensations of tingling, burning, and forgetfulness that have spread and intensified over time. Given your history and the testing you've undergone, it’s reasonable to seek clarity. While anxiety can cause physical symptoms, the persistence and nature of your tingling sensations warrant further investigation.

Next Steps:

1. Prepare Questions for Your Doctor:

   • Specific Inquiries: Ask about the possibility of neurological conditions that could explain your symptoms. Questions like:
     • "Could my symptoms indicate a condition such as neuropathy or other neurological disorders?"
     • "What are the implications of having a positive ANA test, and how should we interpret my elevated vitamin B6?"
     • "Can you explain why my symptoms might not align with typical anxiety explanations?"
   • Diagnostic Tests: You may inquire whether a full-body CT scan or MRI of areas not previously examined could provide more insight. However, it's crucial to discuss why these tests might be warranted based on your symptoms and previous findings.

2. Consider Referrals to Specialists:

   • Given the variety and persistence of your symptoms, it might be useful to ask for referrals to:
     • Neurologist: To investigate neurological conditions.
     • Rheumatologist: To check for autoimmune disorders that might not have been previously considered.
     • Pain Specialist or Physical Medicine Specialist: To address the physical aspects of your symptoms.
   • It may also be appropriate to ask about referral to a spine specialist, especially if you have any symptoms that could imply nerve involvement.

3. Stay Informed About Potential Conditions:

   • While your doctors have ruled out common causes, consider the following conditions that can result in similar symptoms, though the overall risk for serious neurological conditions remains low:
     • Peripheral Neuropathy: Damage to the peripheral nerves can often cause tingling and numbness.
     • Autoimmune Disorders: The context of your symptoms and positive ANA could suggest a rheumatological condition might still be worth examining more thoroughly.
     • Vitamin Deficiencies or Toxicities: Beyond B6, evaluate other possible deficiencies affecting nerve health.
     • Chronic Conditions: Conditions like fibromyalgia can sometimes manifest as widespread pain and tingling.

Closing Support:

It’s understandable to feel frustrated and anxious about ongoing symptoms. Be empowered to advocate for your health during discussions with your doctors. Approach your upcoming appointment with clear questions and concerns listed, which may help you communicate effectively and ensure your health is taken seriously. Remember, it's important to express your need for answers and your willingness to explore all potential causes.