[18F] Experiencing extreme fatigue and headaches with a history of thyroid disorders in the family

Patient Description

An 18-year-old female reports extreme fatigue persisting for approximately a week and a half, which is not alleviated by rest and affects daily activities such as school work. The patient also experiences headaches daily for the past four days, with occasional migraines, pain behind the eyes, and pressure. Weakness is noted, and the patient has been wearing glasses less frequently. There is light bleeding and spotting for the past four days, associated with the use of Depo-Provera birth control. The patient has a family history of thyroid disorders and iron deficiency, particularly in her mother and grandmother. No significant weight changes, chest pain, shortness of breath, swelling in extremities, palpitations, vision changes, or neurological deficits were reported. The patient does not have any known allergies or adverse reactions to medications and is not on any other medications besides Depo-Provera.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Hypothyroidism: This is a condition where the thyroid gland doesn't produce enough thyroid hormones. Symptoms can include fatigue, weakness, and depression. Given your family history of thyroid disorders, this could be a possibility.

    • Treatment typically involves daily use of the synthetic thyroid hormone levothyroxine, which restores adequate hormone levels.
  • Iron-deficiency anemia: This condition occurs when your body doesn't have enough iron to produce hemoglobin, which is needed for red blood cells to carry oxygen around the body. Symptoms can include fatigue and weakness. Given your family history of iron deficiency, this could also be a possibility.

    • Treatment typically involves iron supplements and changes to your diet.
  • Side effects from Depo-Provera: This birth control method can cause side effects such as fatigue, changes in menstrual bleeding, and headaches.

    • If side effects are severe or persist, you should discuss alternative birth control methods with your doctor.

Please note that these are just possibilities and not a definitive diagnosis. You should consult a healthcare professional for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your doctor to discuss your symptoms. They may want to perform some tests to check your thyroid function and iron levels.
  2. Keep a symptom diary. Note down when you feel particularly fatigued or have headaches, and any factors that might have contributed (such as stress or lack of sleep).
  3. Try to maintain a balanced diet rich in iron. Foods high in iron include red meat, leafy green vegetables, and fortified cereals.
  4. Ensure you're getting enough sleep. Aim for 7-9 hours per night.
  5. Stay hydrated and avoid alcohol and caffeine, which can contribute to headaches.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe headache or migraine that doesn't improve with over-the-counter medication
  • Difficulty breathing or chest pain
  • Severe weakness or fatigue that prevents you from doing your daily activities
  • Any new or worsening symptoms

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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9 mo ago


People Also Ask


What are the common symptoms of hypothyroidism?

Common symptoms of hypothyroidism include fatigue, weight gain, cold intolerance, dry skin, hair loss, muscle weakness, and depression. A blood test measuring thyroid hormone levels is typically used for diagnosis.


How can iron-deficiency anemia be diagnosed and treated?

Iron-deficiency anemia is diagnosed through blood tests that check hemoglobin and iron levels. Treatment usually involves taking iron supplements and eating iron-rich foods like red meat, beans, and spinach.


What are the potential side effects of Depo-Provera?

Potential side effects of Depo-Provera include changes in menstrual bleeding, weight gain, headaches, mood changes, and decreased bone density. If side effects are severe, discussing alternative birth control options with a doctor is recommended.


How can I manage headaches and migraines at home?

To manage headaches and migraines at home, try resting in a dark, quiet room, applying a cold compress to your forehead, staying hydrated, and using over-the-counter pain relief medications. Keeping a headache diary can also help identify triggers.

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