Brief Answer:
Has she seen a neurologist, endocrinologist?

Detailed Answer:
Good evening. I'm very sorry your wife has been feeling so very out of sorts without any apparent diagnosis of semblance. I've read the response of one of colleagues on this network and agree that the constellation of symptoms you've presented fail to congeal into 1 obvious syndrome or Diagnostic rubric. Nevertheless, some of what you mention can be analyzed independently and worked upon for further answers.

For example, if she has shakes and tremors then, her diagnosis can be simplified to one of several possibilities if there were more characterization of the problem.

If her tremors and shakes and all her other symptoms have only been present for 1-2 years then, to me something metabolic, chemical, toxic, or degenerative is causing the picture. Let's take the shakes and tremors. I would say these need to be seen by a neurologist and perhaps a movement disorders specialist would be best equipped to recognize these tremors as either part of a PARKINSONIAN SYNDROME or otherwise other entity such as ESSENTIAL TREMOR, TREMORS INDUCED BY MEDICATION, SUBSTANCE WITHDRAWAL, OR CHEMICAL/HORMONAL IMBALANCES such as could happen with prescription drugs not taken properly, excessive caffeine intake, hyperthyroidism, serotonin syndrome (often brought on by drug reactions), or adrenal storm. If her tremors are mostly prominent when the hands are sitting quietly and she is just watching TV or not doing much then, this is suggestive of a PARKINSONIAN syndrome. If the tremors are mostly seen or worsen when the hands engage in activity then, she has more of an ESSENTIAL TREMOR (less common in women than men). If she has suffered any strokes in the past or is metabolically imbalanced for some reason then, she could have tremors that are due to chemical toxicity and should be tested for things such as heavy metals as well as hormonal problems such as FT4, TSH, FT3, TT3, and even MICROSOMAL ENZYME assays which can all point to a thyroid gland problem.

Tinnitus is best evaluated by first obtaining an audiogram and then, having someone knowledgeable in tinnitus itself actually measure the frequency of the tinnitus. There are causes for this symptom that can involve either turbulent flow of blood or even obstructions to the flow of cerebrospinal fluid that could be under increased pressure inside the head. Both an MRI of the brain and a spinal tap which can measure fluid pressure can be very useful to see if there any problems there that can explain the symptoms.

Chronic fatigue or perhaps what you mean is excessive daytime sleepiness...along with your statement of poor quality of sleep despite 10-12 hrs. of sleep can be very easily and effectively measured using a SLEEP STUDY so as to rule out things such as sleep apnea, narcolepsy, hypersomnia, and again, Parkinson's Disease or Parkinsonian like syndromes which are well known for causing these kind of sleep alterations. Double check to make sure that any sleep study clearly INDICATES that they are looking for possible narcolepsy vs. idiopathic hypersomnia otherwise, they may not do the MSLT tests which will clearly distinguish one from the other.

Cold and shivering usually goes to core temperature which is mainly regulated by intensity of metabolism and this comes from EATING WELL, METABOLIZING EFFICIENTLY, and having normal thyroid as well as pituitary gland function. Again, an imaging study of the brain specifically looking for things called ADENOMAS in the pituitary gland or even more significant mass lesions could explain a lot of what's going on in your wife if it's never been looked at or looked for....your neurologist can help direct the right type of tests in this case.

Imbalance could be related to the tinnitus and again, I refer you to the brain where specific locations such as the PONTOCEREBELLAR ANGLE could be looked at more small tumors called SCHWANNOMAS...these are cancerous lesions but they do cause a lot of problems such as what you describe.

You state that labs say she will live to be 100. I assume you trying to say that the labs that have been obtained fail to show any obvious abnormalities. But of course, that also depends upon which laboratory studies have been obtained to begin with and I would refer you in the previous paragraph to a number of standard labs that evaluate the thyroid gland. You could also look at things such B12, Folate, Vitamin D, ESR, CRP, ANA, and very importantly all liver and kidney enzymes.

I would recommend getting a good physical and in this case...sounds like she needs a good NEUROLOGICAL EXAMINATION with perhaps an ENDOCRINOLOGICAL examination to follow as well in order to better direct the traffic of the laboratory tests otherwise, you could order hundreds of tests and never find what really works.

If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my answers/suggestions have helped? Again, many thanks for posting your questions and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 40 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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