34 y o womanly next to fatigue, communal dull pain, elevated cpr of 7.5, am on SSRI low dose for depression, any design?
I have been feeling a bit rotten lately. For a couple of months I have had a lot of nouns, some joint pain (mainly wrists, base of thumbs, vertebrae, neck, shoulders and 'clicky' hips, bit on my feet. Feeling stiff after sleeping and not great rest of day any! Thought it was just getting old! :)
I've be to the GP a couple of times but because I am on a low level SSRI anti-depressant they seem to just write it stale as stress related or depression related pain/fatigue and not take it very seriously. I am worried though because I've never really have joint ache/ muscle pain before. It hurts to straighten my hand out properly, when I do straighten my fingers it really feels stretched at my wrist tendons. My fingers seem to want to curve in more than formerly.
Anyway they did a blood test to check thyroid levels, rheumatoid factor etc. The GP said it was adjectives fine, no probs. is there anything that stands out or anything other test I should be asking for? I noticed the CRP stratum was outside of the range, but it looks low still at 7.5 - what does this mean? I hold a family history of autoimmune disorders including Ankylosing Spondylitis, RA , Chrohn's disease etc
I would appreciate any ideas you may have! I freshly want to work out why I am getting all this joint pain, tiredness etc. I also own been feeling the cold a lot more, extraordinarily forgetful and generally feeling 'foggy' and trouble concentrating.
Answers:
Thank you for the question. I'm sorry to hear in the order of this.
Based on the cursory history that you've provided (thank you), I would have to disagree with your physician. I believe that your symptoms have an "organic" create.
A young woman with a strong family history of autoimmune disorders who have persistent fatigue, depression, cognitive symptoms, and symmetrical polyarthralgias may have an underlying autoimmune disease.
Further, I'm not so sure that your CRP is low. Based on the number that you've provided, it is markedly elevated, which is another clue that something is going on. The CRP is a general, non-specific sight for inflammation in the body -- from any cause.
If I may ask for additional history,
1. Do you own a family history of lupus?
2. Have you been experiencing fever, spike loss ,and weight loss?
3. Does your facial skin "burn" when exposed to sunlight?
4. Rashes on your lower legs?
5. Cough, shortness of breath, chest wall pain?
6. Problems with your kidneys?
7. "Nodules" on your fingers, arms, elbows?
8. Do your paw joints feel stiff in the morning? If so, how long does the stiffness final?
9. Do your joints become red, swollen, and hot?
Your answers to these questions may help.
ADDENDUM:
Thank you for the more information.
What worries me about your history is the hand stiffness that lasts for an hour (especially if longer), which is a cardinal sign of rheumatoid arthritis (one of my mentors within my medical training, Dr. Frank Arnett, wrote the book on RA). Symmetrical joint pains are also a sign of systemic lupus erythematosus, but I'm more concerned about RA.
Here's what I recommend. Since your physician appears to be out of his league, please refer yourself to a rheumatologist for a specific evaluation for RA. The soft tissue swelling in RA can be so subtle that it evades detection by patients (and most GPs). I recommend that you hold plain-film X-rays of your hands and feet to look for evidence of RA. The fact that your rheumatoid factor is cynical means nothing, because a substantial percentage of patients with RA are "sero-negative" for RF. There is a more sensitive and specific blood assessment for early RA called the anti-citrullinated cyclic peptide antibody (anti-CCP) that can be ordered by a rheumatologist. If you have true "synovitis" (soft-tissue swelling) of your hand/foot joint, "erosions" (bony destruction) or osteopenia (thinning of the bone) in your hand/foot X-rays, and your CCP is positive, then you likely enjoy RA.
I hope this helps. I wish you well.
ADDENDUM #2:
If RA is definitively excluded, as all right as lupus, then fibromyalgia may be considered as a diagnosis of exclusion. Source(s): My remote medical training.
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I've be to the GP a couple of times but because I am on a low level SSRI anti-depressant they seem to just write it stale as stress related or depression related pain/fatigue and not take it very seriously. I am worried though because I've never really have joint ache/ muscle pain before. It hurts to straighten my hand out properly, when I do straighten my fingers it really feels stretched at my wrist tendons. My fingers seem to want to curve in more than formerly.
Anyway they did a blood test to check thyroid levels, rheumatoid factor etc. The GP said it was adjectives fine, no probs. is there anything that stands out or anything other test I should be asking for? I noticed the CRP stratum was outside of the range, but it looks low still at 7.5 - what does this mean? I hold a family history of autoimmune disorders including Ankylosing Spondylitis, RA , Chrohn's disease etc
I would appreciate any ideas you may have! I freshly want to work out why I am getting all this joint pain, tiredness etc. I also own been feeling the cold a lot more, extraordinarily forgetful and generally feeling 'foggy' and trouble concentrating.
Answers:
Thank you for the question. I'm sorry to hear in the order of this.
Based on the cursory history that you've provided (thank you), I would have to disagree with your physician. I believe that your symptoms have an "organic" create.
A young woman with a strong family history of autoimmune disorders who have persistent fatigue, depression, cognitive symptoms, and symmetrical polyarthralgias may have an underlying autoimmune disease.
Further, I'm not so sure that your CRP is low. Based on the number that you've provided, it is markedly elevated, which is another clue that something is going on. The CRP is a general, non-specific sight for inflammation in the body -- from any cause.
If I may ask for additional history,
1. Do you own a family history of lupus?
2. Have you been experiencing fever, spike loss ,and weight loss?
3. Does your facial skin "burn" when exposed to sunlight?
4. Rashes on your lower legs?
5. Cough, shortness of breath, chest wall pain?
6. Problems with your kidneys?
7. "Nodules" on your fingers, arms, elbows?
8. Do your paw joints feel stiff in the morning? If so, how long does the stiffness final?
9. Do your joints become red, swollen, and hot?
Your answers to these questions may help.
ADDENDUM:
Thank you for the more information.
What worries me about your history is the hand stiffness that lasts for an hour (especially if longer), which is a cardinal sign of rheumatoid arthritis (one of my mentors within my medical training, Dr. Frank Arnett, wrote the book on RA). Symmetrical joint pains are also a sign of systemic lupus erythematosus, but I'm more concerned about RA.
Here's what I recommend. Since your physician appears to be out of his league, please refer yourself to a rheumatologist for a specific evaluation for RA. The soft tissue swelling in RA can be so subtle that it evades detection by patients (and most GPs). I recommend that you hold plain-film X-rays of your hands and feet to look for evidence of RA. The fact that your rheumatoid factor is cynical means nothing, because a substantial percentage of patients with RA are "sero-negative" for RF. There is a more sensitive and specific blood assessment for early RA called the anti-citrullinated cyclic peptide antibody (anti-CCP) that can be ordered by a rheumatologist. If you have true "synovitis" (soft-tissue swelling) of your hand/foot joint, "erosions" (bony destruction) or osteopenia (thinning of the bone) in your hand/foot X-rays, and your CCP is positive, then you likely enjoy RA.
I hope this helps. I wish you well.
ADDENDUM #2:
If RA is definitively excluded, as all right as lupus, then fibromyalgia may be considered as a diagnosis of exclusion. Source(s): My remote medical training.
Related Questions: