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What Causes Facial Flushing, Abdominal Pain, Intermittent Diarrhea And Calf Pain?
Question: Hi, I'm a 27 year old female that has been having problems since the middle of November last year. I have started to have facial flushing (dry) abdominal pain, intermittent diarrhea, pain in my calf's and feet (only when I stand or walk or put pressure on them), heartburn, nausea, weight gain. As I said this started in November last year. Since then it has gotten worse I have a loss of apatite because of the abdominal pain, weight loss and since three weeks ago I started to get spider veins on my thigh, arms, stomachs. I have been in contact with a doctor since march of this year and we have run some tests. The tests we have taken are catecholamines, 5-HIAA, estrogen, progesterone, CBC, Electrolytes, HbA1c, TSH, Free T4 and Prolactinthey where in normal range. With the new development of spider veins I'm starting to worry. What could it be? And what should I do? My next appointment with my doc is on the 30th of may. I haven't meet my doc since march this year and she doesn't know about the spider veins.
Brief Answer:
Cushing's syndrome
Detailed Answer:
I have reviewed the attached photographs.
There is an uncommon condition called Cushing's syndrome. It causes some of the symptoms you are reporting.
A simple way to screen for this possibility is to do a Midnight Saliva Cortisol test.
This is assuming you have a conventional sleep wake cycle ie you go to bed at night and wake up in the mornings.
There are couple other methods to test for this problem too such as a 24 hour urine free cortisol collection.
Ask your doctor or endocrinologist whether you both wish to proceed with this and then , which particular test
Cushing's syndrome
Detailed Answer:
I have reviewed the attached photographs.
There is an uncommon condition called Cushing's syndrome. It causes some of the symptoms you are reporting.
A simple way to screen for this possibility is to do a Midnight Saliva Cortisol test.
This is assuming you have a conventional sleep wake cycle ie you go to bed at night and wake up in the mornings.
There are couple other methods to test for this problem too such as a 24 hour urine free cortisol collection.
Ask your doctor or endocrinologist whether you both wish to proceed with this and then , which particular test
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi thanks for the quick answer, i told my doc to take a cortisol test for cushings syndrome and i left a blood sample on Wednesday this week. I'm not sure that a simple blood sample is the best way to screen for cushings syndrome. I though that i would do either a 24h urine test or a night time saliva test. I haven't gotten the test results yet. Can you determine its cushings syndrome by a simple blood test? And do i need to worry about the new development of spider veins?
Brief Answer:
Follow up
Detailed Answer:
The typical blood test for screening for Cushings syndrome is the 1 mg Overnight Dexamethasone Suppression test which entails taking a tablet of 1 mg of dexamethasone at 11 pm or midnight followed by a blood test at 8 am the next morning.
So I am not sure which test you underwent
Follow up
Detailed Answer:
The typical blood test for screening for Cushings syndrome is the 1 mg Overnight Dexamethasone Suppression test which entails taking a tablet of 1 mg of dexamethasone at 11 pm or midnight followed by a blood test at 8 am the next morning.
So I am not sure which test you underwent
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I just left a normal blood sample around 3pm. So im pretty sure it will just show the level of cortisol i had in my blood at the time. But becouse i just keep getting more and more spider veins. Im most worried about them. Right now i have some on my thighs, my stomach, around my eyes, on my breats and on the inside of my elbow on both arms. My bigger veins have also turned bright blue so i can see them.
Brief Answer:
Second follow up
Detailed Answer:
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
Some liver conditions can cause spider veins.
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day
Second follow up
Detailed Answer:
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
Some liver conditions can cause spider veins.
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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