[19F] Experiencing a range of concerning symptoms

Patient Description

A 19-year-old female reports a constellation of symptoms including worsening vision with squiggly lines, headaches described as sometimes sharp but mostly throbbing, nausea particularly in the morning and after eating, fatigue, feeling faint upon standing, loss of appetite, and a high heart rate that reaches 188 during exercise accompanied by excessive sweating. These symptoms have been present for varying durations, with nausea being a two-year issue and others like vision changes and loss of appetite being more recent, over the past two weeks. The patient has been on Adderall for three years, Lexapro for four years, and Accutane for three months, and has allergies to tree nuts, peanuts, shellfish, and oranges. No chest pain, difficulty breathing, or recent fainting spells were reported. There is no known past medical history of chronic illnesses or conditions.

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Arora's Assessment

What might be happening

Based on the information provided, here are some possible explanations for your symptoms:

  • Orthostatic Hypotension: This condition is characterized by a sudden drop in blood pressure when standing up from a sitting or lying position, leading to dizziness and lightheadedness. The high heart rate you're experiencing when standing up could be your body's attempt to compensate for the drop in blood pressure.

    • Treatment typically involves lifestyle modifications such as standing up slowly, staying hydrated, and avoiding alcohol and caffeine.
  • Migraines: Migraines are a type of headache characterized by throbbing pain, often on one side of the head, and can be accompanied by nausea and visual disturbances like seeing squiggly lines (also known as an aura).

    • Treatment usually involves medications to relieve pain and prevent future migraines, as well as lifestyle modifications to avoid triggers.
  • Side effects of medication: Some of your symptoms could be side effects of the medications you're taking. Adderall can cause increased heart rate, headaches, and loss of appetite. Accutane can cause fatigue, visual disturbances, and increased sweating.

    • If this is the case, your doctor may adjust the dosage or switch you to a different medication.
  • Anxiety or Stress: Chronic stress or anxiety can cause a variety of physical symptoms, including headaches, high heart rate, nausea, and loss of appetite.

    • Treatment usually involves a combination of therapy, stress management techniques, and medication.

What you can do

  1. Consult with your doctor: It's important to discuss your symptoms with your doctor, who can provide a formal diagnosis and appropriate treatment. They may want to adjust your medications or refer you to a specialist for further evaluation.

  2. Monitor your symptoms: Keep track of when your symptoms occur, their severity, and any potential triggers. This information can be helpful for your doctor.

  3. Stay hydrated and eat a balanced diet: This can help manage symptoms of orthostatic hypotension and migraines.

  4. Practice good sleep hygiene: Getting enough sleep and maintaining a regular sleep schedule can help manage migraines and fatigue.

What you should look out for

Contact your doctor immediately if:

  • Your symptoms worsen or you develop new symptoms
  • You experience severe headaches, especially if they come on suddenly
  • You have difficulty breathing or chest pain
  • You have a severe reaction to a medication

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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10 mo ago

People Also Ask


What are the common symptoms of orthostatic hypotension?

Common symptoms of orthostatic hypotension include dizziness, lightheadedness, fainting, blurred vision, and nausea, especially when standing up quickly from a sitting or lying position.


How can migraines be managed or treated?

Migraines can be managed with medications to relieve pain and prevent future attacks, lifestyle changes to avoid known triggers, maintaining a regular sleep schedule, staying hydrated, and sometimes using stress management techniques.


What are the potential side effects of taking Adderall and Accutane together?

Adderall can cause increased heart rate, headaches, and loss of appetite, while Accutane can lead to fatigue, visual disturbances, and increased sweating. Taking them together may exacerbate these side effects, so it's important to consult with a doctor for proper management.


How can anxiety or stress manifest physically in the body?

Anxiety or stress can cause physical symptoms such as headaches, increased heart rate, nausea, loss of appetite, fatigue, and sweating. These symptoms can vary in intensity and may require a combination of therapy, stress management techniques, and medication for management.


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