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Old 08-09-2007, 02:59 PM   #31
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

I had been curious about thyroiditis.
That is one reason I have been so pressed to have someone check my thyroid.

I have yet to receive my CT scan results of my neck. I am hoping that if it is thyroiditis, it is subacute and just goes away.

Prior to my issues, i had gone to the doc that said i had allergies, swollen glands, etc. My saliva glands, right under my ears to my jaw would swell. Also, my gums would tend to swell as well. This doesn't seem to occur quite as often as my left side thyroid area swelling.

Could be possible that it wasn't allergies and could have been viral/bacterial getting to the thyroid?

Could thyroiditis raise epinephrine, norepinephrine and metanephrine levels?

from my undestanding, acute or subacute (not sure of diff) thyroiditis can most likely be temporary. Thyroiditis can begin by releasing too many hormones (hyperthyroid) then once exhausted, can turn to hypothyroid. Once inflammation decreases and it has a chance to heal, it can return to normal with the potential of permenantly staying hypo.

I realize if experiencing the hyperthyroid aspect. i would/could get hypertension.

I have read that i should have my t3, t4 and free t3, free t4 checked as the TSH could be normal. I am waiting patiently for my results hoping that they will show something.

I have tried getting in to see a endocrinologist within University of Utah health services, however they work on referral basis only. I am interesting in getting into a endo so bad. I imagine they'd be more apt to help me out.


I have looked at so many conditions. Thank you all for your help and guidance.

It is so hard! To be healthy one minute, then the next you're debilitated at home feeling ill and remaining in bed since that is the only place you feel best for over a month.

Thanks again!!

 
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Old 08-09-2007, 06:29 PM   #32
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

How very frustrating! It's stressful enough without things like this happening. At least they were upfront about the problem!


As frustating as it is, at least they are taking your condition seriously and trying not to overlook anything...but yes, it must be very frustrating. Perhaps they'll give you a two for the price of one discount, .



Don't let them dismiss this...some docs try to ignore what they don't understand and given the timing of this swelling, I would think it was important.

Good! You may be demanding more things as time goes on...am reassured to know they are listening to you!

Thanks for keeping us up to date, Jim...am relieved to know things are moving along as that is part of the battle. Someone I know who battled cancer and the health care system often said, "Now we'll have to hurry up and wait!'' I think he summed it up well...

But while we're hurrying up to wait, please know that although some of us may not have similar symptoms, or health care experiences, we want to support you in whatever way we can...even if it's just by listening. So if you ever want or need to vent, this may be a very good place to do so.

Take care, bigjim.

Bethsheba

Last edited by Administrator; 07-17-2010 at 09:27 AM.

 
Old 08-11-2007, 08:09 PM   #33
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Sorry to be so long in getting back to you, I've been contending with a another bout of thyroiditis. I've only had two major bouts in 30 yrs, but I get small episodes now & then.

My endo's have told me that eventually my thyroid will burn out but I can expects inflammation from time to time especially if I get a virus. Another thing my first Endo told me was at times a part of my thyroid may slough off much like a scab. Because of the hormone in that tissue, I might get a adrenalin rush with elevated pulse/b/p etc. I believe I have had this. My 2nd Dr. wanted me to take high doses of thyroid hormone to essentially kill the gland. The risk was too much for me.

You might want to see a ENT- that's what I had to do this last time cause there was a 4 month waiting period for a Endo. The ENT was able to at least confirm the diagnosis as thyroiditis & offered to take care of me until I could see the Endo.

I think you should get some help. I was remembering how I negected to take action soon enough when my 2nd major bout with thyroiditis started & it got worse than my first episode. The inflammation gets out of hand.

Steriods can be used instead of aspirin for the inflammation. But with your GI problems you need to be careful.

I don't know if there is a connection between thyroiditis & Pheo. I wouldn't be surprised. If I have time I'll ask my Endo next week at my office visit. The Thyroid Association would probably know or someone on the thyroid board. Fam

 
Old 08-13-2007, 04:08 PM   #34
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Hi Everyone....

Well, I had had received a call from my doc in regards to my neck CT scan and plasma catecholamine tests.

The CT scan was negative for any masses, swelling, abnormalities. Everything was good there.

However, my blood plasma catecholamine (norepinephrine, metanephrine, etc) levels were abnormally elevated. (just as my 24h urinalysis taken over a month ago. )

Basically the doc referred me to an endocrinologist. Apparently he had already consulted this particular endo in regards to my condition and was awaiting for the results of this blood test prior to making the next move.

They set my appointment up for Aug 27th, however, the doc feels that I should see this Endo much sooner, so they are going to be persistent in getting me in at an earlier time.

I had asked about referrals to other endo's if i can find a sooner appt and they said that they would refer me. I am considering the Salt Lake University Medical Center, however i am worried that if i push them in that direction to refer me there, then I may compromise the possibility of a sooner appointment with this current endo for an appointment much later down the road.
Then again, I may be gaining someone with a little more experience, determination and knowledge.

It never dawned on me to inquire on what my plasma catecholamine levels were when i was on the phone with my doc's assistant. I have called back and requested that they fax my records to me.

I will post once i receive them.

Finally, some progress... and more hurry up and wait.

Thanks everyone

 
Old 08-13-2007, 08:44 PM   #35
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Im happy that i requested a copy of their findings. The clear neck scan doesn't seem so clear to me and the blood catecholamine test makes no sense to me.

First, the results of the ct scan of my neck:

CLINICAL HISTORY:Neck Swelling

TECHNIQUE: Serial axial CT images through the neck were obtained following IV contrast administration.

FINDINGS:The spaces of the suprahyoid neck appear unremarkable without adenopathy, mass lesion, or obvious inflammatory changes or abcess.

There are scattered nonspecific subcentimeter lymph nodes identified throughout the neck.

There was a marker placed at the site of clinical concern along the left lateral aspect of the neck. There is no mass lesion or abnormal inflammitory change identified in this location.

The infrahyoid neck appears grossly unremarkable, (heres the kicker) with the exception of a small 4-mm hypodense lesion on the right thyroid gland. I question thyroid cyst.

IMPRESSION: 1. Scattered nonspecific lymph nodes scattered throughout the neck in an otherwise unremarkable CT evaluation of the neck. No evidence of mass lesion or abnormal inflammatory change.

HOW ABOUT THAT for everyone dismissing my complaint of the pain in my neck.

Is it possible for a thyroid cyst to cause increased hypertension? Increased urine catecholamine's?

Here are the results of my blood catecholamine test.

basically, it appears that they only tested norepinephrine levels.

norepinephrine 431 pg/ML
Catecholamines, Total 431 pg/ML

Reference-Norepinephrine:
Supine: 112-658 pg/ML
Upright: 217-1109 pg/ML.

Well, hopefully someone can advise on what these ranges mean. I am concerned about the possible thyroid cyst and if it may be causing all of my ailments.

THANK YOU EVERYONE!

Last edited by kerry4; 08-13-2007 at 08:46 PM.

 
Old 08-13-2007, 09:07 PM   #36
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Hi there, BigJim,

In answer to your question... the only thing that will raise your catecholamines is an adrenaline producing tumor... a pheochromocytoma... (a note, when found outside the adrenal glands they are often called an 'extra-adrenal tumor' or an 'extra-adrenal paraganglioma'.

You are going in the right direction (seeing an Endo)... the wait to see one that is knowledgable in pheochromocytoma can be long (the best in my area has a 9 month waiting list and I have an appt with another on Oct 1st). You can call the Endo's office and ask to be put on the list of patients willing to come in if there is a cancelation.

As for your plasma free metanephrine test, did it give a 'range' for the normal limits... was it done with you laying down and with an IV needle? (This test is reccomended to be done with you resting for 20 minutes with an IV needle in place for the blood draw to reduce any release due to the needle stick.... it is that sensistve.)

The next test they will probably do is an MiBG... a specialized MRI with a low yeild iodine contrast that will cause any pheo's to 'light up'... they know you have one, now they have to find it. After they find it, they will start you on a three week course of medication to supress the hormone release of the tumor then remove it. For 90% of people with a pheo that is the end of it and the end of high blood pressure and all the other nasties like racing heart, stomach upset, sweating... etc.
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Old 08-14-2007, 03:45 AM   #37
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Peny,

I am so very, very glad you're posting on these boards!! The information you share is invaluable, and you are able to explain the most complex info in a way that can be understood. Bsheba

 
Old 08-14-2007, 07:18 AM   #38
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Could a paraganglioma place itself on the thyroid?

The blood catecholamine test was performed nothing like I have read they should be performed. Standing vs laying w/ an IV.

Upon my initial visit, my doc had consulted an endo while i was there via telephone. I imagine that the endo told him what to do, however not every detail of performing the procedure.

I just had a nurse take 3 vials of blood from me as i was sitting.

it turned out that those vials disappeared and i had to return some 2-3 days later to provide one more vial of blood. Basically in the usual blood test fashion. Sitting and getting stuck and drawn blood.

I have the copy of my blood test report. it says nothing about plasma free metanephrines. Only the norepinephrines. There is listed under the measurements for dopamine and epenephrine levels it says not enough was available to measure..

I'd imagine that I would need this to be performed again. I am sure that once the endo sees this report, he would know enough to have it done correctly.

I am concerned about this thing on my thyroid. I would enjoy it if it were a hyperparathyroid nodule, as I would take a trip to florida for the 20 minute minimal invasive surgery. Oh well

Being that i have a thyroid type cyst and adrenal or extra-adrenal catecholamine mass (as shown from urinalysis but no actual physical evidence), could it be possible that I may have MEN or MEN II? I sure would hope that isnt the case.

I learned yesterday that my wife has a friend at my kids daycare whose husband (not much older than myself) had a sudden onset of hypertension, severe anxiety, severe panic episodes, etc. Apparently they took him to University of UT hospital and they examinied him, they couldnt figure it out. He was transferred to another hospital where he had 5 top utah docs and surgeons assigned to his case.

AS it turns out, he had some issue with his heart. Valve issue or something. Well, they were able to operate, correct and he is healthier than ever.

I just like hearing those stories as I hope that I have the same successful outcome. I get so upset at even watching my neighbors mow their lawn or normal yard work. I used to be able to do that with no problem, mountain bike, hike, etc. It is so heartbreaking and depressing to me that I cant do that. I get so upset that the medical care system operates as it does today.

[removed]

I cannot wait until i can take my family hiking, fishing, camping and live a normal life again. I am so sad right now, and these anxiety/BP meds sure done help with that aspect.

I thank everyone of you for your support. I know that there are others out there that suffer more than myself. I just think to myself my situation could be a lot worse.

Thank you again

Last edited by mod-anon; 08-15-2007 at 12:03 AM. Reason: do not post websites with forums

 
Old 08-14-2007, 10:10 AM   #39
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

I got a call from the endo's office! They moved my appt from Aug 27th to Aug 20th. I am excited. Progress!

I sure hope he is good and is capable of good, quick, efficient diagnosis.

 
Old 08-14-2007, 12:56 PM   #40
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

BigJim,

Congrats on getting the Endo appointment moved up... it looks like you are definately on the road to a concrete diagnosis and with hope that four letter word we all love... "cure".

MEN I, MEN II and any other Multiple Endocrine Neoplasia (when more than one endocrine system are involved, ie- thryroid, parathyroid, adrenal gland, pancreas, etc) might be a possibility, but that is something that only the Endo can determine after the proper testing.

Take heart that you have a Dr that is taking you seriously and is making sure that you are getting the help that you need... many flounder for years with Dr's that refuse to listen or are unwilling to look into 'rare' conditions, often telling the patient that it is anxiety or a mental condition!

Hopefully things will be done quickly for you and within the next 6 months you will be able to return to the active lifestyle that you once had and all this will just be a bad dream.
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Old 08-20-2007, 04:30 PM   #41
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Sorry MOD.

I was able to see an actual enocrinologist today.
Being the initial consultation, it wend pretty much exactly as I expected.

I explained the entire 2 month history of my issues.

He basically said that he wanted to rule out any chest carcinoid, intestinal masses, paraganglioma, extra adrenal pheo, etc. He said based on the results of the tests, he may perform a CT/MRI of my chest and/or head.

With the new found potential thyroid cyst, someone is finally performing an extensive thyroid check and not just TSH.

He requested I do the following tests:

--Another 24hour urinalysis
-Creatinine Clearance
-Fractionated Catacholamines
-Hydroxyindolacetic Acid 5 (HIAA)
-Metanephrines
-VMA

-Plasma Catecholamines
-Free T3
-Free T4
-TSH
-Free Cortisol
-Comprehensive Metabolic Panel
-Serum Metanephrines

I am doing the urinalysis today and will be giving blood tomorrow for all the tests.

My followup is next Thursday the 30th. I really cannot wait. I really wish the medicine system was like House M.D.. Oh well.....

I am trying hard to limit my use of the Xanax as much as possible. I have called my primary doc twice and left messages requesting an alternative anxiety med as I would rather avoid any addiction/withdrawl symptoms altogether.

 
Old 08-20-2007, 04:53 PM   #42
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Thanks, Jim for letting us know which tests you are getting as it helps us decided whether some of us need to go back & get more tests. Glad you are making progress.

I know how depressing it can get being very sick with no apparent hope in site. Just don't give up. I found writing in my journal really helped when I looked out the window & saw the snowing flying. I love to walk in the snow with my dog. Please keep up-to-date. Fam

 
Old 08-21-2007, 08:23 AM   #43
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Quote:
Originally Posted by penybobeny View Post
...Take heart that you have a Dr that is taking you seriously and is making sure that you are getting the help that you need... many flounder for years with Dr's that refuse to listen or are unwilling to look into 'rare' conditions, often telling the patient that it is anxiety or a mental condition!

Hopefully things will be done quickly for you and within the next 6 months you will be able to return to the active lifestyle that you once had and all this will just be a bad dream.
Yes...it's important that we listen to our bodies...if something in our body isn't normal for us, then it needs more investigation, or credible explanation, and not just a pat on the hand.

Bethsheba

Last edited by bethsheba; 08-21-2007 at 12:07 PM. Reason: typo

 
Old 08-22-2007, 06:50 PM   #44
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

From my experience with understanding pheo, your test results are very much in the normal range, as is penybobeny's. When someone has a pheo, their results usually jump into the 1,000th range on several repeats.
Pheos do not always show up where you are hurting either.
There are many illnesses and other things that can raise catecholomines including diabetes, laying a certain way, foods, etc. Please do not get too worried about having a pheo since the only symptom of pheo you seem to have is high blood pressure. It does sound like something endocrine is going on and I am glad you are on the right path.
While the PFM test is a very good test for diagnosing a pheo, urine fractioned catecholomines is another one. It sounds like you had the urine and the blood draw and not the PFM.
Once a pheo is suspected through a positive test, plan on a long haul before there is an operation. There has to be many many other tests performed, and a time blocking the body (at least three weeks) before a surgeon can operate. I pray you do not have a pheo.

Last edited by belleforward33; 08-22-2007 at 06:51 PM.

 
Old 08-23-2007, 08:32 PM   #45
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

After days of calling and leaving messages with my primary doc to request something other than Xanax, I finally got a call back yesterday. The MA said that if I wanted a replacement, then I would need to come in and talk to the doc. That was fine, since i needed to follow up with him on the progress of my diagnosis.

The Xanax works, however, I DO NOT want an addiction so i only use when needed.

Well, my wife and i were with the doc for quite some time. After getting my doc up to speed on all of the appointments and tests i had undergone since our last meeting, I elaborated on all of my symptoms.

The doc just happened to have a little questionairre book that he asked me to fill out while he stepped out.

I looked at the front and it had been something in regards to depression.

I completed his little test and he came back and added up some scores on another sheet. He basically said that this confirms his impression that i had some depression with the anixety.

He opted to give me something called and SSRI called Paxil. He wanted me to take Paxil for a couple weeks to build it up. He then gave me a prescription renewel of Xanax to have as a backup incase the paxil cant supress panic attack, etc.

He did much to ensure me that he is positive that the depression and anxiety is a result of everything that is going on, and not the cause.

Before all was said and done, he scheduled me in for an MRI of my head next thursday to rule out anything evident in the pituitary, etc..

SO, more drugs and a mri later.

I have read so much about this Paxil and had a friend that had been on it for a month. I opted to pretend that I never even got the prescription.

Personally, i hate meds and would rather avoid them, rather than take these that can screw up the chemistry in my head. (Not that it isnt already)

Anyone have to take paxil?

Thanks.

 
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