YANMD

September 1, 2016 6:59 AM

Over the last couple of years I’ve had a growing list of minor but unpleasant symptoms. While I’ve been chalking many of them up to getting older, I’m starting to wonder if there is some overarching problem that these are all symptoms of. Descriptions of hair loss and possible hormonal imbalance within.

The issues I’ve been having:

Melasma, or darkening of the skin on the upper lip. I read that this can be related to either being on hormonal birth control or being pregnant, neither of which applies to me.

My gums, as extensively detailed in my Ask history, are receding and frequently puffy/red.

Hair loss. It has noticeably receded at my temples, and seems to have thinned diffusely over the rest of my scalp as well. Also, weirdly, I seemed to have developed frequent acne at my temples where the hair loss was happening.

A noticeable drop in energy. I usually have plenty of nervous energy to burn off through exercise, but it’s been a struggle to stick with my usual routine. Perhaps correspondingly, my digestive tract seems to have slowed to a crawl and I’ve noticed an abrupt drop in my calorie needs. I’m also not particularly interested in eating, which is SO not like me.

Finally, this past week I’ve been absolutely exhausted, achy and frequently dizzy. I thought I had a mild late-summer cold that seemed to lift over the last couple of days, but it’s back today.

Despite being unbelievably tired, I have a hard time staying asleep at night.

The tests I’ve had done so far:
Vitamin B12 (which was high, but possibly explainable by taking supplements and eating nutritional yeast)
Ferritin (which was in the teens, I’ve been taking supplements since)
Testosterone (which was 36 ng/dL in a standard range of 14 - 76 ng/dL)
TSH (which was 1.959 uIU/mL in a standard range of 0.550 - 4.780 uIU/mL)

The doctor said my tests were normal and this was a head-scratcher. Is there something else I should be testing for? Requesting a specialist of some kind? I realize that not all of these symptoms are necessarily related, and some may just be related to getting older/changing hormones, but it seems suspicious that I would suddenly have a pile-on of issues like this.

Thanks, internet strangers!

posted by whistle pig to Health & Fitness (7 answers total)

Did your doctor run an additional round of bloodwork to see if the supplements for iron actually raised your ferritin levels? I'd want to know they were actually working. Sometimes supplementation doesn't work, or doesn't work fast enough.

Have you had Vit D tested? Low D is very common and could cause some of your symptoms.

Do you live in an area where Lyme disease is endemic? If so, have you seen a rash? Has your doctor run bloodwork?

Beyond that, I'd suggest asking for a referral to an endocrinologist (to look for PCOS (if you're female) or other endocrine issues) and/or a rheumatologist (to look for rheumatological issues, e.g. Sjogren's; there are a lot that cause exhaustion, etc. and a lot of other issues).

You say you have issues staying asleep. How do you feel when you wake up? Do you feel well-rested? If not, and if the more obvious stuff doesn't pan out, I'd look into sleep issues (e.g. sleep apnea). If you're female, note that sleep disorders are under-diagnosed in women and women present different symptoms from men (including difficulty sleeping and frequent waking), so make sure you get a good referral if you do this route.

For the record, your doctor's tests have only scratched the surface of possible issues. I would definitely keep going back and asking for more options, referrals, etc.
posted by pie ninja at 7:29 AM on September 1, 2016 [3 favorites]

Check for insulin resistance. It can cause patches of darkened skin, as well as fatigue and a general feeling of "blah." I have IR and find the best way to control it is to go low-carb. There are ways of low-carbing on vegetarian or vegan diets too, although it's harder.

Seconding a sleep test. I have apnea to go with the IR and getting a CPAP changed my life. I sleep better (no nightmares or wakening every few hours), find it easier to eat healthy (no stuffing carbs for quick energy), my mood, energy, and executive functions are 1000% improved.

I also had low Vitamin D - my endocrinologist gave me these ultra-high-dose Vitamin D capsules which I took for a month. That helped my energy and mood, too.

Keep pushing for a complete blood panel as well as a test for insulin resistance and a sleep test.
posted by Rosie M. Banks at 7:48 AM on September 1, 2016 [2 favorites]

Also putting my money on the ferritin. The normal range is 11-306 ng/mL for women, 23-336 ng/mL for men. But there's evidence that optimal levels for women are above 70-80. (Mine has been tested at 38, which one doc said was A-OK fine and another said merited supplementation until I got to 70. Which is also the level at which, for people with hair loss, hair seems to return.) Low iron can absolutely cause fatigue, hair loss, most of your symptoms. Iron is also implicated in the proper functioning of your thyroid. (Another weird reference range thing. You can have "normal" TSH levels but still see symptoms.)

It takes 3-4 months for ferritin levels to improve with supplementation.
posted by cotton dress sock at 7:49 AM on September 1, 2016 [1 favorite]

Related to the insulin resistance suggestion, if you have ovaries you should get looked at for PCOS.
posted by brilliantine at 8:03 AM on September 1, 2016 [3 favorites]

Sounds like PCOS to me, if you are female.
posted by heathrowga at 8:44 AM on September 1, 2016 [2 favorites]

Another vote for PCOS, assuming you have ovaries.
posted by intergalacticvelvet at 9:01 AM on September 1, 2016 [1 favorite]

Have you had blood tests for lupus?
posted by KateViolet at 1:39 PM on September 1, 2016 [1 favorite]