43 yo female - registered nurse - no medical history other than lymphatic TB (MAC from patient exposure) w/ right cervical lymph node bx x3 (95,98.03). Cardiac family hx, mother lupus. Currently on topamax 50mg bid for headaches, ambien 12.5 for insomnia, enablex 15mg for nocturia.
Currrent symptoms: Insomnia, nocturia, recent weight gain (no change in diet), SOB, RUQ pain, decrease in monthly cycle w/ increase in flow, headaches (almost daily w/ no change after 8 weeks on topamax), stress fx to feet, lower ext edema, palpatations, facial flushing, hiatal hernia symptoms, heartburn, abdominal distention w/ no gas symptoms, constipation, memory loss, difficulty concentrating, vision changes, changes in peripheral vision, carpal tunnel symptoms, muscle weakness, extreme daytime fatigue, easy bruising, small cuts take longer to heal, back pain, tinglilng hands/feet (started before topamax), increased facial hair, hands intolerant to cold, mood swings, irritability, supraclavicular swelling and fatty area to back of neck (PCP says lympadema from previous lymph node bx),increased thirst, right flank pain, recurrent respiratory infections (3 in 7 months).
MRI was negative. Hormone levels DHEA (16.9); Estrone S (33); Estradiol (39); FSH (7); LH (2); Progesterone (1.1); Testosterone (24); 0800 Cortisol level after 48 hours of 0.5mg dexamethasone q6hr with last dose 0600 (8.5 ug/dl) Midnight cortisol level (5.9 ug/dl)
Thyroid levels: T-uptake 0.75 TU/Units (0.66-1.27) Thyroxine 4.6ug/dl (5.0-12.0); FTI 6.1 (6.33-12.4) Total T3 74ng/dl (90-190) Free T4 0.80 (0.8-1.5)
Glucose tolerance test
fasting 90; 1/2 hr 145; 1 hr 74; 2 hr 98; 3 hr 72; 4 hr 83; 5 hr 93
I had been working with an ARNP, and just saw a general practitioner last week. Both have said levels are normal. The only new test from MD was glucose tolerance test.
Any suggestions? I am having an increase in symptoms and having a harder time working now. I once was able to do 60 hours a week at the hospital with no problems, now I have a hard time climbing my stairs at home. There are no endocrinologists in this rural Alaska area and you cannot get a referral to one in Anchorange without "abnormal tesing" and my PCP here says I am perfectly normal, but my symptoms tell me otherwise. Do you have any suggestions of additional testing I can request or do you feel my test results are indeed normal? I know as a nurse I should be more educated in this, but my knowledge in this area is limited. Thank you for your help.