What Causes Facial Flushing With Irregular Menstruation And Heartburn?

Posted on Tue, 14 Jun 2016

Question: Hi, im 27 years old and I have been having dry facial flushing everyday for the last 6 months. Every episode lasts for 1-3 hours and have a Sudden onset. I have not found any type of triggers for it.I have also been having stomach cramps and diarrhea. And I have been feeling nauseous. I have also been having iregular periods and heart burn. I have been to the doctor and they have run tests and they where all in normal range. The tests they took where Catecholamines and 5-hiaa 24h urine test, estrogen and progesterone. I'm eating amitriptyline, duloxetine and lyrica for a previous problem with nerve pain. I was also eating these medications during the tests.
What can be the causes of my problems? And what should I ask my doctor to do next?

Answered by Dr. Shehzad Topiwala (1 hour later)

Brief Answer:
Hormone tests

Detailed Answer:
Sorry to learn about the troublesome symptoms.

The medications you have listed are not known to cause these type of problems.

There are several other possibilities such as a thyroid condition and rare medical conditions like Gastrinoma and VIPoma.

When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH
Free T4
Prolactin
Gastrin
serum vasoactive intestinal polypeptide (VIP) concentration
25 hydroxy Vitamin D

None of these tests require any fasting and can be done at any time of the day

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (57 minutes later)

Thanks for the detaild answer. Before doing the 24h urine test i asked my doctor if my medication would effect the results and she told me that it would not. But after reading on the internet that tricyclic antidepressants and sndi medication lowers the value of the 5-HIAA test i started to worry. Dose the mefication im on effect the tests that i have taken? Kind regards

Answered by Dr. Shehzad Topiwala (4 hours later)

Brief Answer:
Follow up

Detailed Answer:
It is true that some medications do interfere but the ones you are on specifically are not known to have a significant effect.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (2 hours later)

Hi again, i have also started to burp alot in a effort to relieve the pressure that I'm feeling from my stomach. This happens if i have eaten anything. Also because of the discomfort im feeling in my stomach i have been experiencing a loss of appetite. Could this be related?

Answered by Dr. Shehzad Topiwala (9 hours later)

Brief Answer:
Second follow up

Detailed Answer:
Possibly.

I strongly suggest you see a Gastro-enterologist in-person to evaluate these stomach related problems.

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar