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What Causes Pain In Arms,legs,neck With Dizziness And Fatigue?

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Posted on Fri, 5 Sep 2014
Question: I had a PSVT three years ago. They said it was from to much caffinee. Ever since then, I thought something was wrong with my heart. had an Echo, EKG, Holter, Stress done, all came back fine. I stopped taking my lexapro two months ago now, and I've been feeling like something is still wrong. I feel I get skipped beats. I also have a slow pulse resting 50 to 60 bpm. I saw the cardio doctor two Thur ago. EKG, Echo, Holter, Stress, he said everything was normal.
I told my Primary doctor everything that was going on, he sent me for blood work. My cholesterol Non HDL is 194mg/dL. Cholesterol, Total is 238mg/dL; LDL-Cholesterol is 172mg/dL.
My ANA Screen, IFA also came back Positive, ANA Titer is 1:40 titer; ANA Pattern is Speckled.
I had more tests done by a ruthemogolist and all came back normal except my vitamin D was at 16. She gave me D3-50, 50,000 to take once a week.
I've had arm pains, leg pains, feeling weak, lightheaded, ancy. Always thinking its still something with my heart not right. I get pains in my left side of my neck and sometimes right. Even my head I get pains. What could be wrong?? Is 16 also low for vitamin d


I always feel like something is going to happen everyday. And the history is gerd not XXXXXXX

I can't even concentrate at work anymore, I loose my focus and have to go walk around or something when my job isn't even stress full.

I also feel like my heart stops or gets this weird feeling. My cardiologist said he saw the pwave missing on a beat here and there but I never hit the button on my holter so I didn't even notice it. All of the times I hit the button, nothing was there other then sinus tac normal rhythm. I'm so freaked out with all of it.

And I'm just tired. My resting heart rate is between 50 to 65bpm. It varies. I'm 5'8" and 190lbs And Im not athletic which is why I dont understand why my resting HR is that low.

Today I woke up at 630am to let my dog out then went to lay back down. When I laid down, it kept feeling like my heart was beating normal then skipping a beat then going back to normal, and kept doing that. I dont know if its all my anxiety doing this or if I should get seen again. Its really freaking me out. The holter I had down two weeks ago didn't show that. What should I do?
doctor
Answered by Dr. Naval Mendiratta (2 days later)
Brief Answer:
? cause

Detailed Answer:
Good evening mam.

Well I have gone through your history. One thing I can interpret is that you are very stressed and constantly worried about something. If your holter and 2d echo is repeatedly normal then you need not worry about your heart condition. Some people do have a low heart rate at the baseline and as long as it is not causing any symptoms it is useful for the heart.

What I would like to know is:

1. How are your thyroid levels. I am not too sure if you checked those?

2. Do you have lot of stress in life?

3. Do you experience frequent bowel motions or frequent urination?

4. How about irritability and forgetfulness?

Ana is positive in very low titre and since the further tests are negative it shouldn't be a cause for concern.

Your vitamin d levels are quite low. You need treatment for it. It will help your body ache and fatigue.

Do let me know these answers. Will try and help you reach a conclusion. Hope the information was useful
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Naval Mendiratta (7 minutes later)
1. How are your thyroid levels. I am not too sure if you checked those?
I attached my lab results in the original question, not sure if they are in there.

2. Do you have lot of stress in life?
Yes I have alot of stress

3. Do you experience frequent bowel motions or frequent urination?
I don't have bowel movements like crazy, maybe three times a day. Urination is frequent only because I drink alot of water.

4. How about irritability and forgetfulness?
I do forget stuff alot. I am very irritable.

I was also giving D3-50 50,000 uli (i think uli) weekly for the vitamin D. I haven't' taken it yet. Is it safe?
doctor
Answered by Dr. Naval Mendiratta (1 hour later)
Brief Answer:
? cause

Detailed Answer:
Dear XXXXXXX I went through your blood reports as well. Most of them are fairly normal except your Cholesterol levels. ANA i wont be too bothered about as your further profile is negative and the titres are very low. Your thyroid levels are normal as well.
XXXXXXX I feel like cause of all the stress and a previous episode of PSVT has made you a bit over conscious. Once the mind becomes over conscious, they tend to constantly wander about things. As u mentioned, The Holter and Echo reports are all normal, you shouldn't worry about it. You need to have faith in a doctor and let him manage your conditions.

The symptoms of forgetfulness, irritability, stress do point towards a condition called Fibromyalgia. i will suggest you read on the site i am mentioning: www.rheumatology.org---> Patient Education..> fibromyalgia

Do let me know if your symptoms fit into it. I can guide you further how to manage it.

Yes vitamin D levels are safe to take. You can take this dose every week for 8 weeks and then make it once a month, so you dont overdose it as well

Looking forward to your answer. Would be happy to help you here.


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Naval Mendiratta (12 minutes later)
What about this part, is this normal? Even the pwave thing

"I also feel like my heart stops or gets this weird feeling. My cardiologist said he saw the pwave missing on a beat here and there but I never hit the button on my holter so I didn't even notice it. All of the times I hit the button, nothing was there other then sinus tac normal rhythm. I'm so freaked out with all of it."
doctor
Answered by Dr. Naval Mendiratta (5 minutes later)
Brief Answer:
cardiac

Detailed Answer:
See XXXXXXX The absent P waves is usually not a normal finding. But yes if it is absent you are gonna experience far worse symptoms than just palpitations. Maybe that was just one observer findings that he may not have seen a P wave. But if you have seen a sinus rhythm for yourself , that also a few times you need not be worried about it. If you want you can repeat an ECG in a couple of days time from a new place and new machine, Just to compare the findings. If it s normal, then that should erase your doubts and you can overlook this problem.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Naval Mendiratta (18 minutes later)
He saw the missing pwaves on a holter monitor. it was only like 3 or 4 beats. then the pwave was back, should I really be worried? Should I see another cardiologist and have another holter done for 24 hours?
doctor
Answered by Dr. Naval Mendiratta (17 minutes later)
Brief Answer:
? Cause

Detailed Answer:
I wouldn't be too worried if it is 3-4. Any persons holter can have 7-8 missing beats but they are not considered abnormal. Yes, if the frequency is more and they are causing symptoms then we need to evaluate further. You dont have any form of heart block or anything. But if you dont feel satisfied, then you can get one more done.
XXXXXXX do read about the condition i asked you too. You know, as a patient you will visit many doctors looking for many answers. Sometimes when everything is normal, it wont explain your symptoms and it will lead to disappointment and the urge for new investigations. . From my experience, i have learnt is that every patient needs a diagnosis. Once a diagnosis is confirmed, a patient tends to be more relaxed and takes medicines with more faith.

Do let me know once you go through it. I am ready to help you out here :)



Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Naval Mendiratta (32 minutes later)

Tenderness to touch or pressure affecting joints and muscles ( i get this in my lower back)
Fatigue (always feel light headed or tired)
Sleep problems (always tired when I get up)
Problems with memory or thinking clearly (can never remember anything)

Depression or anxiety (anxiety)
Migraine or tension headaches (tension headaches I think, always feels tight in my head)
Digestive problems: irritable bowel syndrome (commonly called IBS) or gastroesophageal reflux disease ( I have gerd)
Irritable or overactive bladder (irritable bladder)
Pelvic pain (pain in lower lower back)
Temporomandibular disorder—often called TMJ (a set of symptoms including face or jaw pain, jaw clicking and ringing in the ears) (ringing in ears, once in a blue moon I get jaw pain)

doctor
Answered by Dr. Naval Mendiratta (6 hours later)
Brief Answer:
? FM

Detailed Answer:
Do you think half of your symptoms fit into this problem...? if yes i can guide you further on how to manage it. But you need to be convinced in the first place regarding the diagnosis.

You are a young male, and sometimes one set of events triggers a lot of problems ahead. If your lab results and everything is coming normal, that shouldn't be a cause for concern. When they are abnormal, then you need to get worried. Cause there is no end to investigating a patient. Echo, holter , Angiography can all keep going on without finding an exact reason.

So if you are convinced about the diagnosis of fibryomyalgia, do let me know. But if you still feel one more holter would satisfy you,then go ahead with it. No harm. but yes, you need to de-stress yourself first.

Hope the information was useful
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Naval Mendiratta (15 minutes later)
I didnt have an angograph done. shoukd i? i do want to believe the fm but i just dont understand what causes me heart to feel like it has weird beats and if they are even real or if im imagining it
doctor
Answered by Dr. Naval Mendiratta (6 minutes later)
Brief Answer:
? FM

Detailed Answer:
No no no,... Dont subject yourself to invasive test. hmm, i will suggest you can get done another holter from another cardiologist. And see the report. If it is normal, let that be the last one. You should be happy to find it normal.

But i do want to know why are you so stressed??What really is bothering you inside.
Try to talk it out. ( other than the health issue, which are dealing with). You will feel better.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Naval Mendiratta (13 minutes later)
I always was fine in life and lived it to the highest. i always felt a skipped beat here and there when i was running around or making my heart race. Once i had a pstv and they had to give me adenazine to restart my heart, i relalized im not invincable anymore. now every weird feeling i have or skip i freak out. i dont have anyone to talk to about this because no one understands. its so hard for me to manage this in life. :/. if you have an iphone and want to imessage me, feel free. YYYY@YYYY is my imessage address.
i just have to some how make my mind realize im fine. i had an echo, holter and stress three years ago and it was fine. i also had another echo three years ago because i didnt believe this doctor. everyone says im normal but my beats dont feel it
doctor
Answered by Dr. Naval Mendiratta (27 minutes later)
Brief Answer:
?fM

Detailed Answer:
Hmm. I understand. Sometimes one event can shake you so much that you lose all that self confidence in yourself and are constantly worrying that anything can happen any moment.
XXXXXXX i will be XXXXXXX and open with u. You are very young and you got your whole life ahead of you. You need to excel in your carrier and family life. Constantly subjecting yourself to end number of tests which are coming out normal, wont solve much. All you need is mental conditioning, that yes this test is ok. Now i shouldn't worry about anything. On the contrary, you are more worried that everything is normal.

We got one life to live. And there are things which are beyond our control. If anything has to happen, it will and one wont have a control over it. What we have control over, is the present we are living in. We need to enjoy these moments and live it to the fullest as u used to.

you need to have trust and believe in your doctor, that what he has seen and recommended you is good. It s like flying in an airplane and leaving the control over the pilot that he is gonna get you there safe. But yes to satisfy you, i ll suggest you get a cardiac evaluation done. If that is normal, dont subject yourself to another one.

On personal front, nah i dont use iphone. Not a big fan of it. I hope you have a girlfriend. A companion makes things quite easy..
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Naval Mendiratta (14 minutes later)
so you think i should get another cardiac work up? I do have a GF. just sucks shes not a doctor. Is the Vitamin D3-50 pills 50,000 uli safe to take? im going to try one if you tell me its safe
doctor
Answered by Dr. Naval Mendiratta (3 hours later)
Brief Answer:
Vitamin D is safe to take

Detailed Answer:
I think you will be more satisfied after the cardiac work up. There is no harm in 2nd opinion and you will feel at ease as well.

Yes, Vitamin D is safe to take. The recommended dose if 2000 Units a day. We normally prescribe in XXXXXXX as 60000 IU per month as a maintenance dose. But if the patient has the defeciency, We give 60000( 50000 units) once a week for 8 weeks to build the levels and then maintain it at once a month dosage. So you can go ahead with it as i have advised. you will see the improvement in the fatigure and general wellness..

Hope the information was helpful. Do let me know of whatever help i can be.

But yes, try and consult a psycologist to de stress urself. Include Regular exercises in your routine and socialize more. It will help.

Regards
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Naval Mendiratta (7 hours later)
Okay Ill take the vitamin D. its just when I check my pulse, it always feels like I get one beat quicker then the rest sometimes, like there normal beat beat beat, but then i get one thats like beatbeat beat beat beat beat. Idk if its just me thinking that or what. Idk what to do anymore
doctor
Answered by Dr. Naval Mendiratta (19 minutes later)
Brief Answer:
No need to do anymore

Detailed Answer:
I think there is no need to do anything more than a 2nd opinion from a cardiologist and a psychologist consultation. Everything will be fine.
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Answered by
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

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What Causes Pain In Arms,legs,neck With Dizziness And Fatigue?

Brief Answer: ? cause Detailed Answer: Good evening mam. Well I have gone through your history. One thing I can interpret is that you are very stressed and constantly worried about something. If your holter and 2d echo is repeatedly normal then you need not worry about your heart condition. Some people do have a low heart rate at the baseline and as long as it is not causing any symptoms it is useful for the heart. What I would like to know is: 1. How are your thyroid levels. I am not too sure if you checked those? 2. Do you have lot of stress in life? 3. Do you experience frequent bowel motions or frequent urination? 4. How about irritability and forgetfulness? Ana is positive in very low titre and since the further tests are negative it shouldn't be a cause for concern. Your vitamin d levels are quite low. You need treatment for it. It will help your body ache and fatigue. Do let me know these answers. Will try and help you reach a conclusion. Hope the information was useful