[43F] Experiencing joint pain, migraines, and hormonal symptoms

Question

Doctors say my tests are normal range and left undiagnosed. Anyone else have these issues?

Patient Description

A 43-year-old female reports experiencing sharp, stabbing joint pain that began in the elbow last June and has since spread to all joints, worsening as the day progresses, rated as 8/10 in severity. Accompanying symptoms include night sweats, severe fatigue, sudden and intense hot flashes worsening around the time of her period, migraines with nausea and dizziness rated 9/10 in severity, and light-headedness rated 5/10. Additionally, the patient has noticed weight gain around the midsection, changes in menstrual cycle with recent spotting and absence of period for the current month, and a significant decrease in sex drive for almost a year. The patient has a history of anxiety and depression, seasonal allergies, and an allergy to penicillin. Current medications include Trazodone 50mg, Venlafaxine ER 150mg, Meloxicam 7.5mg, and Omeprazole 20mg, all taken once daily. No relief from current treatments for joint pain has been reported. The patient's mother has celiac disease, but no other family history of autoimmune diseases was noted. The patient has been missing one marker for celiac disease in past evaluations.

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Arora's Assessment

What might be happening

Based on the information you've provided, several conditions could be contributing to your symptoms:

  • Perimenopause: This is the transition phase before menopause. It usually starts in women in their 40s but can start earlier. Symptoms can include hot flashes, night sweats, mood changes, irregular periods, and fatigue. The changes in your menstrual cycle and the presence of hot flashes suggest this could be a possibility.

  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. The widespread joint pain and severe fatigue you're experiencing could be indicative of this condition.

  • Depression: Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. It can lead to a variety of emotional and physical problems. Given your history of depression and the presence of fatigue, lack of sex drive, and migraines, this could be contributing to your symptoms.

  • Rheumatoid Arthritis: This is a chronic inflammatory disorder affecting many joints, including those in the hands and feet. Given your joint pain and the fact that it's worse as the day goes on, this could be a possibility.

Please note that these are possibilities based on the information you provided and not a diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Consult with a healthcare provider: Given the severity and persistence of your symptoms, it's important to consult with a healthcare provider. They can conduct a thorough evaluation and order tests as needed to determine the cause of your symptoms.

  2. Keep a symptom diary: This can help identify any patterns or triggers related to your symptoms. Note down when each symptom occurs, its severity, and any potential triggers (such as stress, certain activities, or food).

  3. Maintain a healthy lifestyle: Regular exercise, a balanced diet, and adequate sleep can help manage symptoms and improve overall health.

What you should look out for

  • If your symptoms worsen or you develop new symptoms, seek medical attention immediately.
  • If your joint pain becomes severe or is accompanied by redness, swelling, or warmth, seek medical attention immediately.
  • If your migraines become more frequent or severe, or are accompanied by other symptoms such as vision changes, difficulty speaking, or weakness on one side of your body, seek medical attention immediately.

Remember, it's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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9 mo ago

People Also Ask

What are the common symptoms of perimenopause?

Common symptoms of perimenopause include irregular periods, hot flashes, night sweats, mood swings, sleep disturbances, and changes in libido. These symptoms occur as the body transitions towards menopause.

How is fibromyalgia diagnosed and treated?

Fibromyalgia is diagnosed based on a history of widespread pain lasting more than three months, along with other symptoms such as fatigue, sleep disturbances, and cognitive difficulties. There is no specific test for fibromyalgia, so diagnosis often involves ruling out other conditions. Treatment typically includes medications, lifestyle changes, and therapies such as physical therapy and counseling.

Can depression cause physical symptoms like joint pain and fatigue?

Yes, depression can manifest with physical symptoms, including joint pain, fatigue, headaches, and digestive issues. These symptoms are often linked to the body's stress response and can be exacerbated by the mental and emotional strain of depression.

What are the early signs of rheumatoid arthritis?

Early signs of rheumatoid arthritis include joint pain, stiffness (especially in the morning or after periods of inactivity), swelling, and warmth in the joints. It often starts in smaller joints like those in the hands and feet and can progress to other areas over time.

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3 Comments

Archie#3960

9 mo ago

Did you get tested for C Reactive Protein (inflamation marker)?

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Anonymous#4476

9 mo ago

Inflammatory markers are normal

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Janice#4034

9 mo ago

My mother had something similar that turned out to be fibromyalgia. Pretty unsatisfactory "diagnosis of exclusion" that means all the tests come back negative but the symptoms are still there. Apparently more common in people with depression. Interestingly enough what helped her was yoga, stretching, and a regular exercise regimen...

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