Question: XXXXHi, my name is XXXX and I've decided to write a brief history. I have an acute problem with tachycardia, weakness, and elevated DHEA and cortisol that started 4 weeks ago after a DMPS heavy metals challenge test was administered. I also have vertigo and an ENT evaluated me and concluded it was not inner related, but may be vascular in nature.

4 weeks ago, I went to St. XXXXXXX and had a "DMPS challenge test" done by an integrative MD in which I was given a DMPS IV and gave a urine sample before and after to see if any levels of heavy metals were excreted. I did perfectly fine with the infusion, but the next day (20 hours later) when I returned to get a routine Vitamin IV from the same doctor, I felt lightheaded and faint, my blood pressure XXXXXXX and heart rate elevated to 135. The next two days after returning to XXXXXXX I felt very weak, although my blood pressure was low (92 systolic).

Two days later, the weakness continued, although my heart rate elevated. My heart rate remained elevated from a range of 100-120 for the next two weeks, and my blood pressure was 140/80 in a bedridden state. My normal blood pressure is 115-120 (systolic)My endocrinologist did a thorough blood workup and the only abnormality was elevated cortisol, which she said could cause tachycardia but would not cause the profound weakness. During this entire time, I was so weak that I was unable to walk to the bathroom at my home. The tachycardia was preventing me from sleeping, so my primary care doctor put me on Popranolol 10mg – 3X/Day to decrease my heart rate and Clonazepan to help me sleep.



Since that time, I’ve regained a small amount of strength, although I am still very weak to where it is difficult to walk, and the vertigo has turned into extreme lightheadedness. My heart rate remains in the range of 85-100, although it is sporadic, and sometimes will be 111 when it is time for a dose, or as low as 74 when it is time for a dose. My blood pressure has come down to normal levels.

I had a cardiology work-up in 2012 at St. Francis Heart Hospital. Everything was normal.

I should also tell you that 2 episodes of weakness similar to this, without tachycardia, have happened in the past 10 years. Also, I have a small (2mm) pituitary lesion that my neurologist has been keeping an eye on for 3 years that may be a factor.

I have also had small bouts where it feels like I can't take a deep breath, and this lasts for about a week, I've had this for 3 years. It's happened more frequently the past 3 months, but usually goes away within a week. It came back about a week ago, and I have difficulty taking deep breaths, although I would not say that I'm "short of breath" and my blood/ox levels are 98/99.

I had a pulmonology test and evaluation by a pulmonologist who said everything was normal 6 weeks ago. An ER chest X-ray did not say anything. Although my doctor has noticed my lungs sound "diminished" but she wonders if it's due to the weakness.


The six main symptoms are:

1) Profound Weakness

2) Hard to take regular, deep breaths

3) Lightheadedness

4) Elevated Cortisol/DHEA

5) Kidney pain on and off

6) an intense burning in the back of my occipital region of my neck



My questions:

Since I don't do well with contest agents:
With an MRI, MRA, CTA, etc. -- Can enough of a picture be given if we were to scan my head, neck, and torso WITHOUT CONTRAST to look at:

1) Vascular function in those areas
2) Lung Problems
3) Kidney/Adrenal problems
4) Basic brain function

Are any other blood tests/tests being overlooked?

Thank you,
XXXX

Also, here are the labs I've had done so far - only 2 were abnormal - are there any more I should ask of my primary care doctor? thank you!





Labs Completed





Component

WBC

RBC

Hgb

Hct

Abnormal 44.9 Ref Range 34.5-42.8 %



MCV

MCHC

RDW

Plt

MPV

nRBCs

Neutrophil (%)

Lymph (%)

Mono (%)

Eos (%)

Baso (%)

Absolute Segmented Neutrophils

Absolute Lymphocytes

Absolute Monocytes

Absolute Eosinophils

Absolute Basophils

ESR

Metanephrone

Normetanephrine

FOLLICLE STIMULATING HORMONE

LUTEINIZING HORMONE

INSULIN LIKE GROWTH FACTOR

PROLACTIN

ALDOSTERONE/RENIN ACTIVITY RATIO

CORTISOL



ACTH

XXXXXXX R Prabhala, MD Final result

T4 FREE

XXXXXXX R Prabhala, MD Final result

TSH

XXXXXXX R Prabhala, MD Final result

METANEPHERINE,URINE 24 HOUR

XXXXXXX R Prabhala, MD Final result

ALDOSTERONE, URINE 24 HOUR

XXXXXXX R Prabhala, MD Final result

CORTISOL,URINE Abnormal 72 Ref. Range 45

XXXXXXX R Prabhala, MD Final result

METANEPHRINES,URINE

XXXXXXX R Prabhala, MD Final result

ALDOSTERONE,URINE

XXXXXXX R Prabhala, MD Final result

CoRTISOL,URINE

XXXXXXX R Prabhala, MD Final result

Yes. I am noticing that I have a pain in the region beneath the lower ridge of my left rib cage and when I lay on my right side it is easier to take deep breaths. Could this be my spleen being enlarged? If so, at what point should I be concerned since I am feeling very sick anyway.