Looking for a diagnosis

[notscared2dream]

Hi. GP has tentatively diagnosed me with PCOS (awaiting ultrasound). He also thinks that Cushings or an Autoimmune Connective Tissue Disease may be present, either as well as, or instead of PCOS.Symptoms and blood tests taken are listed below:
Fatigue;irregular menstrual cycles 27days-40days; moodswings; dizziness;headaches; weightgain (round middle and neck area);excess body hair;forgetfulness; unable to concentrate; prone to skin conditions (rashes,fungal infections,dermatitis,rosacea,skin tags); tender heels; muscular and joint aches/pains (no swelling); numbness,and pain in facial region;pressure sensation in ears;shortness of breath and very defined breathing (worse when tired or on exertion);heart palpitations;hair loss;dry,grainy,irritated eyes;clumsiness;sensation of lump in throat (fluids to help swallow food);loss of appetite;suspected thoracic outlet syndrome; have also had trouble with not producing oxytocin during labours and breastmilk never 'came in'.
All symptoms come and go. The fatigue is there all the time, but varies in intensity. Blood tests were all taken over a month ago. Symptoms such as joint/muscular pain, the eye problems, clumsiness and forgetfulness have worsened since then.
Blood tests - HbA1c:40mmol/mol A, TSH:1.13mIU/L, Sodium:141mmol/L, Potassium:4.0mmol/L, Iron:19umol/L, Transferrin:2.74g/L, Iron Binding:62umol/L, Iron Saturation:30%,  Ferritin:54ug/L;Taken cycle day 3 - FSH:4.2, LH:5.5, Estradiol:125pmol/L. Taken cycle day 13 - Prolactin:403mlU/L, Progesterone:0.80nmol/L Testosterone:2.1nmol/L; Creatinine:65umol/L, Glomerular Filtration Rate:>90mL/min/1.73m2; Glucose:4.9mmol/L; C Reactive Protein:<5.0mg/L, Rheumatoid Factor:<15.0IU/mL, Uric Acid:0.36mmol/L; ANA:Positive, Pattern:Speckled, Titre: 80; Cholesterol:5.6mmol/L, Triglyceride:1.3mmol/L, HDL Cholesterol:1.3mmol/L, Chol/HDL ratio:4.2, LDL Cholesterol:3.7mmol/L; Microsomal antibodies: <100; Thyroglobulin antibodies: <100; Anti-Thyroid Peroxidase 22IU/mL

[Krishna Kumar, MD]

Dear notscared2dream,

Thanks for writing in.

The symptoms and laboratory test results that you have described point towards Cushing's syndrome and /or Polycystic ovarian disease.

Cushing's disease is a condition which is produced due to an excess of adrenal steroids in the body. The problem can lie either within the hypothalamus, the pituitary gland or the adrenal glands themselves. It is also seen in people who receive exogenous steroids for some reason.

This is diagnosed using a 24 hour urine free cortisol level and a low dose dexamethasone suppression test.

The treatment depends on the identified cause.

I would also like to know if a complete blood count has been done for you. I would also like to know if Vitamin D levels, parathyroid hormone levels and alkaline phosphatase levels have been done for you.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Krishna Kumar

[notscared2dream]

Don't know if I can add a note to my post above, didn't see any way to edit it. Anyway - Additional symptom which I forgot to add above - areas of extra sensitive skin ( some of these areas feel grazed or sunburnt, others feel bruised). Pain when clothes brush against these areas, or if they are lightly touched. No marks, or rashes visable.
By notscared2dream