Ask a doctor on the topic of Internal medicine

Thyroid gland? Or something else???

January 8, 2010 | 10,00 EUR | answered by Dr. med. Olaf Stephan

I am starting to doubt myself and think that I am imagining all of this. So far, no clear findings from my second doctor.

I have been a vegetarian for 4 years. At the same time, I have taken on a new physically demanding job. I used to work in an office. I have been taking the pill for about 20 years and I do not take any other medication.

Since this time, I have been experiencing more frequent pain in my legs. If I sit for a long time, I can hardly get up. I always compare it to an old lady, even though I am only in my mid-30s. In the evenings after work, I have increased pain with slight pressure on my legs, swollen finger joints, and morning stiffness in the joints of my fingers and legs. Increased hair loss, still tired despite 12 hours of sleep. Unjustified nervousness and irritability. I often experience extreme fatigue, where I have to lie down because I can't do anything, constantly feeling cold, weight gain even though I eat less. Feeling of a lump in the throat. Increased mucus production. Constant bloating for the past six months.

Recently had problems with extremely high blood pressure of 180/110 and a pulse of 99, with days of pressure in the chest and the feeling that my throat is closing. EEG and EKG showed no abnormalities.

My latest blood test results:

ft3: 3.88 pg/ml (1.71 - 3.71), this value was even 4.2 two months ago. However, I stopped taking the pill for one week before the last blood test. I usually take it continuously.

ft4: 1.15 ng/dl (0.70 - 1.48)

TSH-basal: 1.29 (0.35 - 4.5)

This whole situation is really getting on my nerves because no one can tell me what is causing all of my pain and discomfort. I would really appreciate a competent answer.

Thank you in advance.

Dr. med. Olaf Stephan

Dear Inquirer,

The complex complaints you have described initially suggest a possible thyroid dysfunction, however, the normal values of fT3, fT4, and TSH definitely rule out any thyroid disorder in terms of over- or underfunctioning, so it cannot be the cause. Unfortunately, there are several groups of diseases in which these symptoms can also occur, so a complex internist diagnosis, possibly including imaging methods, appears to be necessary in your case. So far, only a few examinations have been carried out on you. Therefore, you should definitely consult a specialist in internal medicine, who will coordinate further examinations, and it may be necessary to undergo stationary diagnostics in a hospital for a few days. Based on the facts you have provided, I am unable to make a further differential diagnosis. Other hormonal disorders, diseases from the rheumatic spectrum, or certain metabolic disorders can potentially cause similar symptoms, as well as kidney and liver diseases, and chronic infections (e.g. Lyme disease). It is clear that further investigations are needed to clarify your complaints, as your well-being and performance are evidently significantly impaired. Therefore, you should not delay seeing the internist any longer.

Wishing you a speedy recovery,

Best regards, Olaf Stephan.