Dry Eyes, Throat, and Tongue: Possible Causes and Solutions - Internal Medicine

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Hello! It sounds like you're experiencing a complex set of symptoms that include dry eyes, a dry throat, and changes in your tongue. Let's break down your concerns and explore possible causes and solutions.

1. Dry Eyes: Your diagnosis of dry eye syndrome is quite common and can be caused by various factors, including environmental conditions, prolonged screen time, and underlying health issues. Dry eyes occur when the tear glands do not produce enough tears or when the tears evaporate too quickly. This can lead to discomfort, redness, and blurred vision. Treatment options typically include artificial tears, prescription eye drops, and lifestyle changes such as taking breaks from screens and using humidifiers.

2. Dry Throat: A dry throat can be related to several factors, including dehydration, allergies, or even mouth breathing during sleep. If you are experiencing dry mouth as well, it may be worth investigating further. Conditions like Sjögren's syndrome, which is an autoimmune disorder that affects moisture-producing glands, could be a consideration, especially since you mentioned that your saliva production is reduced on one side. However, since your rheumatologist has ruled out rheumatoid arthritis and primary Sjögren's syndrome, it may be beneficial to explore other causes, such as allergies or environmental factors.

3. Changes in the Tongue: The sensation of a "weird" tongue and changes in the tongue's appearance, such as a thin coating or rough texture, can be associated with several conditions. These might include dehydration, nutritional deficiencies (such as vitamin B12 or iron), or even oral thrush. It's essential to maintain good oral hygiene and stay hydrated. If the symptoms persist, consider consulting a dentist or an oral specialist for a thorough examination.

4. Autoimmune Concerns: Your concern about other autoimmune diseases is understandable, especially given your symptoms and the elevated rheumatoid factor. While it’s good that your rheumatologist has ruled out certain conditions, if you continue to feel unwell, it might be worth seeking a second opinion or consulting a specialist in autoimmune diseases. Conditions like lupus or other connective tissue diseases can sometimes present with overlapping symptoms.

5. Further Investigations: Since your symptoms have not improved, it may be beneficial to undergo further testing. This could include blood tests for other autoimmune markers, imaging studies, or even a biopsy of the salivary glands if deemed necessary by your healthcare provider.
6. Specialist Referrals: In Taipei, you can seek out specialists in rheumatology, ophthalmology, or even an ENT (ear, nose, and throat) specialist who can help address your throat and tongue symptoms. A multidisciplinary approach may provide a more comprehensive understanding of your condition.

7. Lifestyle Modifications: In the meantime, consider implementing some lifestyle changes that may help alleviate your symptoms. Staying well-hydrated, using a humidifier at home, avoiding irritants (like smoke or strong fragrances), and practicing good eye care (such as the 20-20-20 rule for screen time) can be beneficial.
In summary, while your symptoms may be interconnected, they can also arise from various independent factors. It’s crucial to continue working with your healthcare providers to monitor your condition and explore further diagnostic options. Don't hesitate to advocate for yourself and seek additional opinions if you feel your concerns are not being fully addressed. Wishing you the best in finding relief and answers!