
What Causes Brain Fog,muscle Stiffness And Pain With Elevated Vitamin D Level?

Hello
Detailed Answer:
Hello,
Good day.
We will surely keep the blood work reports confidential and I would certainly appreciate if you could attach a copy.
Noted your history.
Now, many things can cause this. From hormonal changes at one end, to menopausal sumptoms to anxiety at the other end. Was the metanephrines done in blood or urine? How did they collect it?
I would surely want to know the results of these tests.
Fibromyalgia will cause aches and pains over muscles, but no tremors. Similarly most persons would have had an Epstein barr virus attack in their youth and that has nothing to do with your current symptoms.
I noted your history of epilepsy and do not personally think that is the cause.
Did the symptoms start whilst in a hot shower? Were you worried or anxious for any reasons before these symptoms happened?
Since the symptoms happened soon after an episode of sore throat, infection is top in the list which can cause shivers and tremors. Since these episodes have settled now, please relax. We shall wait for the blood results. In the interim, I would appreciate if you could attach the blood works done so far. ( if you had a urine test, please attach that too)
HAve a great week end
Regards
Binu


Hi
Detailed Answer:
Hello,
Good day.
EB virus infection can come back later in life again. What i meant was that, your childhood EB virus infection has nothing to do with current episodes. Virus infection usually cause fever, but many viral infections can present with just muscle pain, tiredness, shivers etc. These incidents follwing a sorethroat attack could be due to a viral infection itself. Your doctor did all the blood tests to rule out an adrenaline excess by doing a plasma metanephrine test. This is rare and unlikely, but not impossible.
Anxiety can cause these symmptoms too. Please relax while you wait for the blood results.
Regards
B


Best wishes
Detailed Answer:
Wish you a speedy recovery


Hello
Detailed Answer:
OOps. I didnt get any test reports. Please try attaching it again. You may also mail a copy to YYYY@YYYY
The sample might have lysed and thats why it was not suitable for metanephrine test. I hope the sample for ACTH was collected in the morning fasting and it was covered in ice bags before it was transported to lab.
Yes, you are right. Anxiety is a diagnosis off exclusion. We should always rule out other serious disorders before we label it as anxiety
Regards
Binu


Progesterone .3 ng/ml or multiply by 1000 to get 300 pg/ml
Estrogen: 168 pg/ml or divide by 1000 and .168 ng/ml
Regardless of which units used in ratio, I get 1.786 : 1 Progesterone Estrogen ratio
300 pg/ml = X (progesterone)
168 pg/ml 1 (Estrogen)
I'm thinking that must be wrong but I used an example posted and understood how they calculated but this seems way off. Anyhow, The FSH is hard to read but looks like 0.6 mIU/ml but if that doesn’t sound right, I will call the office and ask because I do not see where .6 falls in range. I was fasting. Did test 6:30 am in the morning. I was interested in the progesterone/estrogen ratio (estrogen dominance) but of course this .6 fsh seems very low.
Hello. Welcome back
Detailed Answer:
Hi,
Happy that your question session is open again.
Hope you read my email regarding the estrogen and progesterone.
The ratio of progesterone to estrogen will change based on the timing of menstrual cycle.
Your estrogen level is 168 pg/ml
Progesterone is 300 pg/ml
P:E ratio is 1.78 : 1
Your FSH level is low ( nearing menopause we expect it to be high).
Were/Are you on any hormonal pills?? This can cause FSH to go down.
May I know why was estrogen and progesterone checked for ?
( ENDOCRINOLOGISTS AND GYNECOLOGISTS REQUEST FOR PROGESTRONE AND ESTROGEN BLOOD TESTS ONLY FOR SPECFIC INDICATIONS )
Please understand that the blood level of progesterone and estrogen is very much dependent on the timing of your menstrual periods.
Few days before ovulation , the estrogen levels peak. But progesterone levels will be minimum then. Once you ovulate, you enter in to the second half of menstrual period called as Luteal phase. In this phase, the progesterone levels peak. ( the peak value around 7 days before next period).
THIS MEANS THAT, PROGESTERONE LEVELS WILL BE VERY LOW IMMEDIETLY BEFORE OVULATION AND LEVELS PEAK AROUND 7 DAYS BEFORE PERIODS.
Good to know that you are responding to clonazepam. VMA is normal and that is reassuring.
Regards
Binu
*** PLEASE CHECK YOUR EMAIL ( I am attaching a photo of the estrogen/progesterone peaks). Again, this holds good only during normal menstrual age. Post menopause, levels of estrogen and progesterone reach a plateau.


Hello
Detailed Answer:
Hello,
Good to know that the FSH level is normal. It is not anywhere near the menopausal range. Your estrogen levels are good too. This points that you may not develop menopause very soon. ( atleast one year?).
I mentioned earlier that progesterone levels will be lower during first half of menstural cycle. If you happen to test progesterone during that time, it will be low. There is no much scientific data on P:E ratio and things like that in menopause.
You may find many such things in the internet and i am afraid that internet gives many such misleading informations. You can not find such a thing in standard endocrinology text books or peer reviewed medical journals. Useful menoapuse websites for puublic by FDA etc do not mention anything about it.
Hormones like estrogen and progesterone are present in minute quantities ( pico gram, nano gram etc) and until now, no hormonal assay is perfect to detect them. For the same reason, endocrinologists never ask for these tests unless in specefic situations. ( eg: we may request progesterone test during infertility investgation.. Estrogen is done in delayed puberty, early puberty, male gynecomastia and few situations like that). If you had visited an endocrinologist instead of a phsyician, probably he wouldn't have agreed to your request to do these tests ( for the above mentioned reasons).
Benzos are okay for short term use. ( few weeks). If your problems persists beyond few weeks, then you may need further assessment, relaxation exercises, meditation and possibly non benzo group medications for some time. These newer group medicines will improve the chemical composition of neurotransmitters ( including GABA etc) and wil help to deal with anxiety.
Regards XXXXXXX

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