Request for Insight on Persistent Symptoms
I am seeking advice while I await appointments with cardiology and gastroenterology. Over the past year, I have experienced various symptoms that remain unexplained. Age: 26 | Height: 5’4” | Weight: Approximately 10 stone Current Medications: Sertraline, omeprazole, and piritizine (an antihistamine) Medical History: Corrected B12 deficiency, anxiety, and obsessive-compulsive disorder **Key Symptoms:** - My resting heart rate usually fluctuates between 80 and 100 bpm but can exceed 150 bpm when I walk or am exposed to heat. - Upon standing, my heart rate sometimes increases by more than 30 bpm, though this isn't consistent. - I frequently feel fatigued, experience brain fog, suffer from headaches, and hear ringing in my ears (tinnitus). - I occasionally have tingling or numbness in my hands and legs, along with tremors. - I experience pain in my ribs and upper back, sometimes presenting sharply. - Despite taking omeprazole, I still struggle with acid reflux, congestion, difficulties swallowing, and a sensation of food being stuck. - My skin can become itchy and flushed at times. - There was a brief period where the entire upper right side of my back felt numb; while this has improved, I still contend with considerable itching in that area. **Tests Conducted Thus Far:** - Blood tests (including TSH, inflammatory markers, B12, and iron) returned mostly normal results, though my ferritin levels were low-normal but are improving. - An ultrasound of my liver and kidneys showed normal findings. - An MRI of my ear nerve also yielded normal results. - My elevated ALT levels have normalized, although gamma-GT remains mildly elevated but stable. - An ANA test returned negative. - An endoscopy is scheduled, but I feel quite anxious about that procedure. - A 72-hour heart monitor test is forthcoming. **Questions I Have:** 1. Do these symptoms suggest conditions like POTS or MCAS, or could they indicate something different? 2. Is it advisable to proceed with the endoscopy and mild sedation considering my heart rate issues? 3. Are there any other conditions I should discuss with my healthcare providers? I appreciate any insights you might offer.
Answers (1)
8/28/2025, 12:24:03 PM
OpenHealth AI
Thank you for sharing your detailed symptoms and medical history. It's understandable to feel anxious given the complexity and persistence of your symptoms. While I can’t diagnose your condition, I can provide some insights based on the information you've provided, along with actions you can take.
Overview of Key Points:
- Your symptoms could align with conditions like Postural Orthostatic Tachycardia Syndrome (POTS) or Mast Cell Activation Syndrome (MCAS), but further evaluation is necessary.
- Proceeding with the endoscopy is important and can typically be done safely even with your heart rate concerns, but please share your anxieties with your healthcare team beforehand.
- Considering additional conditions with your providers might be advisable based on your ongoing symptoms.
Explanation:
- POTS is characterized by an excessive heart rate increase upon standing and can include fatigue and other symptoms like brain fog and palpitations, which aligns with your experience. MCAS may explain symptoms like flushing, itching, and gastrointestinal issues, but diagnosis requires specific tests.
- Your heart rate fluctuations are significant and should be monitored closely, especially during procedures. It's good that you're scheduled for further evaluation with the heart monitor.
- It's normal to be anxious about an upcoming endoscopy. Mild sedation is usually safe, but it’s crucial to discuss your heart rate fluctuations and any concerns with your medical team. They may adjust your sedation or monitor you closely for safety.
Next Steps:
- Communicate with your healthcare team about your symptoms, especially the heart rate issues, before the endoscopy. This will help them tailor the procedure to your needs.
- Track your symptoms consistently leading up to your appointments. Note when symptoms worsen or improve, as it may help your doctors understand patterns that could point to a diagnosis more quickly.
- Discuss potential conditions like POTS, MCAS, or any other you feel might be relevant during your next appointments with your cardiologist and gastroenterologist. Bringing a list of your symptoms and their timing can support this discussion.
- Practice relaxation techniques or mindfulness to help manage anxiety, especially regarding your endoscopy. Techniques may include deep breathing, meditation, or guided imagery to help calm your mind.
Remember, while it’s normal to feel uncertain with undiagnosed symptoms, you're taking proactive steps by seeking further evaluations, which is essential. Let me know if you have questions about any specific symptoms or strategies.
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