What Do My Lab Test Results Indicate?

Question: Hi, my name is XXXXX and I've decided to write a brief history. I have an acute problem with tachycardia, weakness, and elevated cortisol that started 3 weeks ago. I also have vertigo and an ENT evaluated me and concluded it was not inner related, but may be vascular in nature.

3 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 (a week ago) I’ve regained a small amount of strength, although I am still very weak to where it is difficult to walk, and I still struggle with vertigo. 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. However, because of the sporadic nature of my heart rate and now that beta blockers are involved, I wanted to consult you.

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.

The six main symptoms are:

1) Profound Weakness
2) Tachycardia
3) Vertigo when I turn my head
4) Elevated Cortisol
5) frequent urination
6) Lightheadness

Two questions:

1) Could the vertigo/lightheadedness be a vascular problem that I should see a cardiologist for? or a neurologist?
2) I also have an intense burning in the back of my occipital region of my neck and in conjunction with the severe lightheadedness, I'm wondering what imaging I should have done? Would an MRI without contrast serve any purpose? My body doesn't do well with injections.
3) This is an acute relapse, although I've had this problem for 12 years and had multiple MRI's of my brain in the past. My neurologist is following a pituitary lesion that is 2mm. The only thing I've not had done is imaging to check about my vascular system. If my MRI's have been okay in the past, is there any reason to believe anything has changed in the last year?


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

Is it possible that I have some sort of a fungal infection in my any sinuses that may be located at the base of my head (occipital region). The reason I ask is that Tinidazole seems to help with this burning sensation.