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Forum Name: Endocrinology Topics

Question: Possible pheochromocytoma

matman - Tue May 01, 2007 12:44 pm

Hello, I will do my best to explain and please forgive my lack of medical terminology. Age: 36 Sex: Male Past diagnoses: Hypertension, adrenergic Spells, adrenal hyperplasia, and Anxiety. Past surgeries: Right hernia and right and left eyes to correct “alternating lazy eyes”. Family history: Hypertension, Diabetes, goiter (my mother). Current Medications Vasotec 2. 5 mg twice daily, Tenormin 25mg once daily, and Klonopin 1 mg 4 times daily. I was very healthy until at the age of 18 years old (1989). I got Mononucleosis. Shortly after this, I got Pneumonia, as a secondary infection to strep throat, which was undiagnosed until the Pneumonia was diagnosed. I had a very severe reaction to Entex. My symptoms were; extreme nervousness, Anxiety, insomnia, and a fear I was going to die. I discontinued the medication and most symptoms went away. This seems to be the start of subtle symptoms that continued to manifest over the years. I started having small episodes of nervousness and Anxiety over the next year. My family physician dismissed these initially as just being the results of me going to college and wrestling. He just thought it was normal stress. My symptoms grew worse over the next few years. I had increased Anxiety, nervousness, tremors, sweating, a flushed feeling, Chest pains, Nausea Headaches, and some insomnia. My family physician had me take a couple of 24 hour urine VMA tests. I had elevated levels. He sent me to an endocrinologist (1992). I learned I was not to dump the acid out of the jugs. The endocrinologist repeated the 24 hour urine VMA and included the testing of metanephrines. The results were elevated with the urine metanephrines being 1. 29, normal (0-.29). I am not exactly sure were this range is from, as I can’t find it now on the web as being a reference. My T4 was 9. 7. The endocrinologist ordered a CT scan with results being normal (1992). The endocrinologist advised to try Doxepin or Prozac. I tried both, as well as several other Antidepressants. I had no success; they actually increased my nervousness and insomnia. The endocrinologist expected a patient with a pheo to be more adrenergic, losing weight, with Hypertension, and Headaches. With the lack of results, my family physician sent me to another endocrinologist (1992). I was tested for a carcinoid, the 5HIAA returned normal. The thyroid function was check and a prolactin which was 4. Thyroid functions were normal. TSH was 1. 4; T4 was 7, T3 resin uptake was 28%, and thyroid antibodies were negative. Without any endocrinologists being very close to where I live, my family physician just treated the symptoms, hoping to find the cause or another endocrinologist. Tragically in 1993, my family physician was killed in an automobile accident. I bounced around to some different doctors. In 1994, I saw another endocrinologist. He just performed a blood draw in his office for some type of test to see if the adrenal gland was overactive. It turned out to be negative. At this time, I had flushing, Anxiety, nervousness, insomnia, night sweats, Hypertension (controlled after several trial and errors with different medication), Headaches, developed some Acne, and fatigue. It was recommended that I go to The Mayo Clinic for my complicated problems. I have somewhat, learned to live with these problems, as I became frustrated with the medical system. I was tired of going to endocrinologists with no results. I have done this until now. I take the same medicines I did in 1994. I now have nervousness, Hypertension, Anxiety, tremors, Chest pain, sweats, inappropriate sweating (under arms), insomnia, flushing, heat intolerance, I feel terrible after exercise, my weight has gone down (even with attempts to increase it), frequent urination, and fatigue. My current family physician was referred me to an endocrinologist, unfortunately it it the same one I saw the first time. I do not really want to go down this course again, but I want to feel better. My symptoms have increased, I have more, and I want to have a healthy life. I have been police officer for over 14 years, so normal stress is nothing new to me. I am just looking for advise about what I could possibly have going on. Thank you in advance for any and all help. It is greatly appreciated!

Dr. Chan Lowe - Sat Jun 02, 2007 6:16 pm

When I read your symptoms I do have the thought that this may be Anxiety attacks. However, I am not aware of Anxiety attacks causing an elevated VMA in the urine. I am not as familiar with this test so I can't tell you how elevated this level is. I can't give you much guidance but I would suggest that you pursue the urine VMA issue some to see if this would give you more information. Best wishes.

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