[18F] Experiencing headaches, nausea, dizziness, hot flashes, and unexplained weight gain

Patient Description

An 18-year-old female has been experiencing daily throbbing and achy headaches rated 5-6/10 in severity, primarily on the sides and front of the head, sometimes behind the eyes, for a couple of weeks. The headaches are relieved by a cold compress. Additionally, she reports hot flashes characterized by intense sweating, lightheadedness, dizziness, followed by feeling freezing cold, for over a month. These hot flashes seem to be triggered by physical activity or transitioning from outdoors to indoors. She also mentions unexplained weight gain despite expectations of weight loss. Her menstrual cycle has been stable for the past few months. She does not have a family history of thyroid disorders or PCOS, and she has not experienced any sudden vision changes or severe headaches with a rapid onset. The patient has been taking sertraline (125 mg) and lamotrigine (Lamictal, 100 mg) for an unspecified duration. No other medications, allergies, or pre-existing conditions were reported. She has used marijuana and nicotine recently.

Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

Polycystic Ovary Syndrome (PCOS): Given your history of ovarian cysts and recent weight gain, PCOS could be a possibility. PCOS is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.
- Treatment of PCOS often focuses on managing individual concerns, such as infertility, hirsutism, acne or obesity. Specific treatment might involve lifestyle changes or medication.
Thyroid disorders: Your symptoms of weight gain, hot flashes, and fatigue could be due to a thyroid disorder such as hypothyroidism. This condition is characterized by an underactive thyroid gland that doesn't produce enough thyroid hormone.
- Treatment typically involves taking thyroid hormone medication to normalize hormone levels.
Side effects of medications: Both sertraline and lamotrigine can cause some of the symptoms you're experiencing, including headaches, dizziness, and weight gain.
- If you suspect your symptoms are due to your medication, do not stop taking them without first consulting your doctor. They can discuss potential alternatives or adjustments to your dosage.

What you can do

Consult your doctor: It's important to discuss these symptoms with your doctor, especially since they're affecting your daily life. They can provide a formal assessment and order relevant tests if necessary.
Monitor your symptoms: Keep track of when your symptoms occur, their severity, and any potential triggers. This information can help your doctor determine the underlying cause.
Maintain a healthy lifestyle: Regular exercise, a balanced diet, and adequate sleep can help manage your symptoms and improve your overall health.

What you should look out for

Seek immediate medical attention if you experience:

Severe abdominal pain
Difficulty breathing
A sudden, severe headache
Any other symptoms that are severe or concerning

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 accurate information.

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11 mo ago

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