Is this SIADH?

December 20, 2023 7:19 PM

The short version: last year was admitted to the ER with hyponatremia. SIADH was mentioned as being the cause after urine and serum were evaluated. Was discharged after observation (no treatment was given). Repeated Sodium and Osmolality at home. Serum Sodium was normal. I am including the results of tests performed for your perusal,

The longer version is I have been trying for the longest time to figure out the root cause of why I am so sick. The list of symptoms is pretty long but the main and most troublesome are
Constipation (multiple exams)
Diarrhea (multiple exams, labs)
Raynaud's (seemingly - does not appear typical though dx'd numerous times)
Granuloma Annulare (seemingly dx'd but still doubtful - photos available upon request)
Insomnia
Left ventricular dysfunction
Random tachycardia (seen numerous times by cardiologists, EKG's etc)
Normlocalcemic Hyperparathyroidism (dx'd via labs)

Was considering that this might be MENS1 syndrome, but imaging did not produce evidence of either pituitary or pancreatic findings.
Endocrinologists were not concerned with elevated PTH - though am candidate for surgery. It's now just a matter of finding the surgeon.

All of the above conditions and symptoms (other than the Raynaud's which I've suffered from for over 30 years) have appeared roughly at the same time - 7 years ago. At that time I was exposed to high levels of pesticides, fungicides and herbicides living in a farming community. Just surmising this could be a catalyst.

That's it. Thanks for reading if you've gotten this far.

posted by watercarrier to Health & Fitness (9 answers total)

Response by poster: Forgot to mention that ANA is consistently negative and Scleroderma has been ruled out based on negative antibodies (repeated numerous times).
posted by watercarrier at 7:23 PM on December 20, 2023

There used to be a wonderful site called CrowdMed where you could post questions like this, and then "medical detectives" would try to figure out your illness. However, the company seems to be defunct now. But you can try this Subreddit: https://www.reddit.com/r/CrowdDiagnosis/
posted by alex1965 at 7:47 PM on December 20, 2023 [1 favorite]

Response by poster: @alex1965 - tried all the routes. Including the ones you've mentioned. Thank you.
posted by watercarrier at 7:51 PM on December 20, 2023

Re:random tachycardia. If you can capture the tachycardia with electrodes by going to urgent care/ ER, they can identify the type of tachycardia, and where in the heart it originates. I get SVTs and can usually convert to normal heart rhythm with cold water on the face or the Valsalva maneuver. My reports of weird heart rhythm were blown off until I had to go to the ER and it was documented.

based on the medscape article, ask to be treated for a trial period.
posted by theora55 at 6:40 AM on December 21, 2023

Having watched a family member go through hyperparathyroid, it really can cause all kinds of weird symptoms. I hope that getting that surgery resolves some of these, so then you can hopefully seek diagnosis for the narrower range that is left.
posted by hydropsyche at 6:59 AM on December 21, 2023 [2 favorites]

I'm just going to address the question that was posed, "Is this SIADH?" - I'm a doctor, not yours, and this is not medical advice. SIADH cannot be diagnosed or excluded based on the test results you provided. Although some conditions and medications can cause persistent or chronic SIADH, there are other causes of SIADH that are quite transient, like pain and nausea. If hyponatremia resolves without treatment, then it is likely either not SIADH to begin with or it was SIADH due to a transient problem that resolved on its own.
posted by telegraph at 7:22 AM on December 21, 2023 [4 favorites]

A Holter monitor (Ziopatch, worn for a week) helped diagnosed the type of tachycardia I have. Prescription ivabradine helps a lot.
posted by Iris Gambol at 2:33 PM on December 21, 2023

I am not a doctor. Just a patient that has been sick a lot. And I had hyperparathyroidism with normal calcium levels.

If you have been diagnosed with hyperparathyroidism (vs just having high pth), proceed with hyperparathyroid surgery prior to seeking further diagnosis. Otherwise the picture simply won’t be clear. Choose a surgeon who specializes in this surgery even if you have to travel for it. You’ll avoid a second surgery and have a much smaller scar.
posted by Kalatraz at 4:05 PM on December 23, 2023

One more thought not knowing where you were farming… For the GI issues if you have had a full workup from a gastroenterologist and they have found no issues (so frustrating), have you been tested for food intolerances, alpha gal, lyme disease, celiac, etc? If the system is working okay sometimes it’s a reaction to the foods.
posted by Kalatraz at 4:12 PM on December 23, 2023 [1 favorite]