Diagnostic Medicine and Potentially a Hormone Disorder


Q: Do I have a hormone disorder? Is it a viral or bacterial infection? Could it be something more obscure or rare?

Symptoms:  Hello to whom this may concern:

I've been experience random episodes of illness for about 2 weeks now, with no clear answer as to what I have. I started going to my PCP and been seeing the doctors but so far they've found nothing either.

Initially, I got sick on Wednesday evening, February 19. It happened when I was driving home from work, I had barely driven for about 25 minutes when I started feeling kind of lightheaded and dizzy. I also felt a small pain near my lower left back but nothing sharp. I tried eating some food but it didn't fully alleviate the symptoms so I drove to my brother's place who lives closer than my house. I stayed home from work the next 2 days so I had 4 days to recover until Monday. I also went to a general doctor on Thursday but he didn't do much in-depth analysis, just said my throat was kind of irritated and assumed it might be like a mild flu; said my lungs and breathing sounded fine, and attributed my increased heart rate when I had that first episode on Wednesday to the fact that I was agitated and such.

I went back to work the following Monday (Feb. 23) not feeling fully recovered, but unwilling to miss work anymore. I was doing fine for most part the first 3 days until Wednesday, at the very least able to perform my job but feeling sluggish on most days and leaving early for 2 days, since I figured if it was some kind of flu it would go away soon. Then on Thursday of that week it hit me again at work, it was right after we had had lunch: I had resumed my work but started feeling really fatigued, kind of hot and sweaty, maybe even a bit faint. I drank some water which of helped, but ended up asking one of my coworkers to take me to the hospital. They just looked at vitals, and attributed any inconsistencies and my description of what had happened to a "flu-like illness," which I thought was nonsense at this point. They also did a flu-test, and I guess that was negative as I was told I did not have it.

After this second incident, I took a visit to my PCP and again I was asked some questions: I think I may have focused too much on gastrointestinal symptoms because she just told me I could have some mild gastritis and so I was just given something for potential acid reflux or stomach complains. Went back to work this week, felt okay on Monday but again on Tuesday started feeling similar symptoms so I just stopped before I ended up at the hospital again, where they didn't do almost anything. I felt kind shaky, again really hot and somewhat sweaty and constantly dizzy which gets worse with everyday activities that I used to perform without any issues whatsoever (including my job).

I went to the same clinic (PCP supported) again on that same Tuesday when I had the third episode. I was seeing by different doctors this time, they asked me many questions again. The initial tests that they did for blood and a stool test all were negative or said they looked fine. This last time they took more blood and will also be doing a UA. Other tests include such things as CBC, HIV, TSH and T4, etc. I'm still awaiting results, but thought I'd get any other opinions from someone who knows more than me?

A:   Hello,
Thank you for your query at AskTheDoctor.com

I understand your concern.
From your entire detailed history, it does seem like a viral infection. Viral infections are very unpredictable with a waxing and waning course, and in some cases, the recovery can even take up to a month or more. The recovery phase will typically have a lot of fatigue and sometimes body aches, associated with nausea and headache.
When I was going through your history, one more thing that seemed probable was a thyroid hormone disorder. In the end, you mentioned, they asked you to get thyroid profile done, so your PCP is on the right track. We have to wait for the results and further management can be based on that. If the CBC is altered, a bacterial infection will be suspected and a blood culture will further help in getting a conclusive diagnosis.
But, according to me, from your history, the most probable causes are a viral flu or thyroid hormone disorder.

Hope this was helpful,

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