I have a relative who is 83 and has the following conditions listed below...
His complaint is severe cold intolerance. Although he feels cold his temperature is normal and he feels warm to the touch in all extremities. This has been progressive over the past 4 months or so.
1. Hereditary hemachromatosis, treated with phlebotomy for over 30 years, relatively well controlled.
2. Type II DM, corrently off of all agents with reasonable sugars in the 140s.
3. Hypertension, has been on Prinivil, recently discontinued.
4. Atrial fibrillation, treated for several years with Amiodarone, with relatively severe side effects that took over a year to clear. He's been off of this for several years, well before current symptoms started. He has always remained rate controlled. Subsequently placed on Coumadin.
5. Hepatocellular carcimona, diagnosed in December and just recently (Feb 12th) treated with laparoscopic RF ablation. Solitary lesion 3.5 cm.
Portal vein thrombosis, just diagnosed at the time of this surgery.
6. Esophageal varicies, never bled. Cirrhosis on visual examination of the liver is relatively unimpressive. He likely has these due to #5 above.
The obvious... yes his thyroid function has been tested and his T4 and TSH are fine, but I don't know if anti-thyroid antibodies have been checked.
O.K., so now to all of you really smart neurologists and endocrinologists, where would you go from here on the workup.
This may seem to be a trivial problem given the above list, but believe me to him it is his most debilitating symptom. He spends much of the day in bed covered with blankets, and when he does get up he takes a heating pad with him, tucked inside his clothes!