Unexplained Symptoms: Which Specialist Should You See? - Internal Medicine

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When dealing with unexplained symptoms such as the ones you've described—persistent unpleasant odors, sensations of heat or irritation on the skin, visual disturbances, and respiratory discomfort—it's essential to approach the situation methodically. Given your medical history, including the removal of your thyroid due to a thyroid tumor, it’s crucial to consider both physical and psychological factors that may be contributing to your symptoms.


Understanding Your Symptoms
1. Olfactory Hallucinations: The experience of smelling odors that are not present (like fecal or spicy smells) can be classified as olfactory hallucinations. These can arise from various causes, including neurological conditions, sinus issues, or even psychological factors. Since you mentioned that your father does not experience these smells, it suggests that this may be a sensory processing issue rather than an environmental one.

2. Skin Sensations: The feelings of heat, tingling, or itchiness on the skin can be associated with several conditions, including neuropathy, which can occur after thyroid surgery due to nerve damage or changes in blood flow. It could also be a manifestation of anxiety or stress, which can heighten bodily sensations.

3. Visual Disturbances: Seeing "dust" or particles that others do not can also be indicative of a sensory processing issue or could be related to anxiety or other psychological conditions.

4. Respiratory Symptoms: The chest tightness and difficulty breathing, even when wearing masks, could be related to anxiety, especially if these symptoms worsen in stressful situations. However, they could also indicate a physical condition that needs to be evaluated.


Recommended Specialists
Given the complexity of your symptoms, it would be prudent to consult with several specialists:
1. Neurologist: Since some of your symptoms could be neurological (especially the olfactory hallucinations and skin sensations), a neurologist can conduct tests to rule out any underlying neurological conditions.

2. Psychiatrist or Clinical Psychologist: Given the potential for psychological factors, including anxiety or stress-related disorders, a mental health professional can help assess whether your symptoms are linked to psychological conditions. They can provide therapy or medication if necessary.

3. Allergist/Immunologist: If there’s a possibility that your symptoms are related to allergies or environmental factors, an allergist can perform tests to determine if you have any sensitivities that could be causing your respiratory symptoms.

4. Endocrinologist: Since you have a history of thyroid issues, consulting an endocrinologist may be beneficial to ensure that your hormonal levels are balanced and that there are no residual effects from your previous surgery.


Additional Considerations
- Sleep Hygiene: Your difficulty sleeping could exacerbate all your symptoms. It’s essential to establish a good sleep routine and address any underlying anxiety that might be affecting your sleep quality.

- Stress Management: Techniques such as mindfulness, meditation, or cognitive-behavioral therapy (CBT) can be beneficial in managing anxiety and stress, which may help alleviate some of your physical symptoms.

- Documentation: Keep a detailed diary of your symptoms, noting when they occur, their intensity, and any potential triggers. This information can be invaluable for your healthcare providers in diagnosing and treating your condition.


Conclusion
Navigating unexplained symptoms can be challenging, especially when they affect your quality of life. By consulting with the appropriate specialists and considering both physical and psychological factors, you can work towards understanding and managing your symptoms effectively. Remember, it’s essential to advocate for your health and seek comprehensive care that addresses all aspects of your well-being.