Rule Out Autoimmune Disease If Multiple Systems Are Involved

Q: I’m 53, male, no significant medical history. I was very active physically; I was doing ultra marathons, multi-day treks and sports. Ten years ago I became chronically exhausted and unable to recover from exercise or any physical exertion. I was having non-restorative sleep, joint pain and paresthesia in hands and feet. I had 50 lb weight gain, brain fog, sore lymph nodes in neck and armpit, GI discomfort, elevated CK, high BP and cholesterol, poor vision, generalized chest pain, and generally uncomfortable in my own skin. It has impaired my personal and professional lifestyle considerably.

I’ve seen several specialists with various tests; rheumatologist, neurologist, GI, infectious disease, cardiologist, x-rays, ultrasounds, blood tests, others I can’t recall. I was on Lyme treatment for 2 years which helped slightly, but majority of people are telling me that I don’t have lyme. Testing shows pretty flaking results in my opinion. I tried prozac for a year, which a psychiatrist disagreed with. He was right; it did nothing for my symptoms. One specialist I have not seen is an endocrinologist. I’m waiting for a referral but that could take several months to a year. I recently did a 24 hour saliva test; the results were low- AM 6.6, noon 3.8, PM 3.8, night 2.9, burden 17. I’ve done several TSH tests over the years, all within normal range: .8 to 1.26 mU/L.
Testosterone: 15.5, 19.9 pmol/L
Calcium: 2.38, 2.35, 2.4, 2.31, 2.46 nmol/L
PTH: 5.8 pmol/L
I’ve been tested several times for diabetes and all tests were normal. Any ideas? Thanks, 
By: Greg

Reply:

As far as lyme disease is concerned, this disease is caused by a bacteria which gets transmitted via a tick. When affected by this bacteria, your body produces specific antibodies against it. 

So, the diagnosis may be confirmed by a blood test which detects the presence of specific antibodies against this bacteria. Commonly, ELISA test is done for Lyme disease. A western blot test is then done to confirm it. 

You may first go for this specific test to rule out any possibility of this diagnosis.

The presentation of your symptoms do sound like some autoimmune disorder. Lyme disease also has this component. If it is not lyme, other autoimmune disorders like- multiple sclerosis, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, lupus and other disorders such as Crohn’s disease, HIV and neurodegenerative diseases need to be considered. This would not be easy and would require further specific investigations and evaluations. 

It’s unlikely to be diabetes, thyroid or any other endocrine disorder in isolation. However, such problems may accompany.

You would require many referrals and doctors of different specialties like a rheumatologist, immunologist and an endocrinologist.

Few Tips to Begin Managing This Condition

  1. Sort out your own family history. Has anyone in your family (maternal or paternal side) had similar symptoms?
  2. Keep a complete symptom list when visiting a doctor.
  3. Inquire about the physician and hospital experience with autoimmune disease. 
  4. The doctors may take some time to make a diagnosis, meanwhile putting you on some medications. It is suggested to stay calm and not worry during the treatment. Stress only worsens the condition. Try relaxing and eat light healthy food. 

Take Care,

Buddy M.D.

 

Medical Advice (Q&As) on “Rule Out Autoimmune Disorder if Multiple Systems Are Affected

  1. Kimberly

    Hi, I’m 24yrs old and currently am being diagnosed for having ms. All the symptoms I have been having are signs of ms. My question is, I’ve been having pain in my right shoulder for about a month. Now just curious if it is possible that it’s a flare up?

    Reply
    1. Buddy M.D. Post author

      Multiple sclerosis can affect any part of the body.

      Let us first know your earlier symptoms. Which part of your body was affected when you were first hit by this condition.

      Reply
      1. kimberly

        Before anything I had the burning and numbness on the left side of my body. I had MRI done in which lesions were found and just about a month or so my right shoulder has been in a lot of pain. It first felt like I’d slept wrong so I began stretching it out and still hasn’t gotten any better but the pain comes and goes. There are times where I get like a shock around my arm so I’m curious if it’s possible that it is a flare up.

        Reply
        1. Buddy M.D. Post author

          It is difficult to say whether this was a MS flare up or not. However, you definitely need a check up to rule out the possibility of a flare up.

          A flare up may present with sudden onset of a new symptom or recurrence of the older symptoms.

          Sometimes, there may be false alarm for a flare up. Triggers like drinking alcohol or getting a throat infection may give symptoms that appear to be a flare up.

          Such episodes go away as the trigger subsides.

          Reply