[19F] Experiencing severe weakness and brain fog with infrequent meals

Patient Description

A 19-year-old female reports experiencing severe weakness, brain fog, nausea, and occasional fainting when not eating for 3-4 hours. These symptoms began 2-3 years ago and occur approximately five times a week. The weakness is severe, having once resulted in a fall and head injury. Brain fog can become so severe that it affects speech. Eating alleviates symptoms, but they persist for about an hour afterward. Additional symptoms include confusion and shakiness, with occasional dizziness and sweating. No heart palpitations reported. The patient has no family history of diabetes and does not consume alcohol or recreational drugs. Current medications include escitalopram (30mg), lamotrigine (100mg), iron supplements (60mg), and VyLibra birth control pills, all taken once daily. No known medication allergies. The patient has been on escitalopram for 5-6 years, birth control for 4 years, and iron and lamotrigine for about 4 months.

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Arora's Assessment

What might be happening

Based on your symptoms, a possible explanation could be:

  • Hypoglycemia (Low Blood Sugar): This occurs when your blood sugar levels drop too low, often due to not eating for several hours. Symptoms can include weakness, confusion, shakiness, and fainting. It's important to monitor your blood sugar levels, especially since eating seems to relieve your symptoms.

    • Testing: A doctor might recommend blood tests to check your glucose levels, especially during an episode.
    • Treatment: Typically involves eating small, frequent meals and snacks that include complex carbohydrates and proteins to maintain stable blood sugar levels.

  • Reactive Hypoglycemia: This is a condition where blood sugar drops after eating, usually within a few hours. It can cause similar symptoms to those you're experiencing.

    • Testing: A glucose tolerance test may be used to diagnose this condition.
    • Treatment: Similar dietary adjustments as for hypoglycemia, focusing on balanced meals.

What you can do

  1. Dietary Adjustments: Try eating smaller, more frequent meals throughout the day. Include a mix of proteins, fats, and complex carbohydrates to help stabilize your blood sugar.

  2. Monitor Symptoms: Keep a journal of your symptoms, noting what you eat and when symptoms occur. This can help identify any patterns or triggers.

  3. Use MDandMe: Track your symptoms and meals using MDandMe to gain insights and share detailed information with your healthcare provider.

  4. Stay Prepared: Carry snacks like nuts or granola bars to help manage symptoms if you can't eat a full meal.

What you should look out for

  • Seek Medical Attention: If your symptoms worsen or you experience more frequent fainting, it's important to consult a healthcare professional.

  • Emergency Symptoms: If you experience severe confusion, loss of consciousness, or any new symptoms, seek immediate medical care.

Remember, it's important to consult with a healthcare provider for a formal diagnosis and personalized treatment plan.

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2 mo ago

People Also Ask

What is hypoglycemia and what are its common symptoms?

Hypoglycemia is a condition where blood sugar levels drop too low. Common symptoms include weakness, confusion, shakiness, fainting, dizziness, and sweating. It often occurs when a person hasn't eaten for several hours.

How can dietary changes help manage symptoms of hypoglycemia?

Dietary changes can help manage hypoglycemia by maintaining stable blood sugar levels. Eating smaller, more frequent meals that include a balance of proteins, fats, and complex carbohydrates can prevent blood sugar from dropping too low.

What is reactive hypoglycemia and how is it different from regular hypoglycemia?

Reactive hypoglycemia occurs when blood sugar drops after eating, usually within a few hours. It differs from regular hypoglycemia, which is often due to not eating for an extended period. Both conditions can cause similar symptoms, but reactive hypoglycemia is specifically related to the body's response to food.

What should I do if I experience severe symptoms like fainting or confusion?

If you experience severe symptoms like fainting or confusion, it's important to seek medical attention immediately. These could be signs of a more serious issue, and a healthcare professional can provide the necessary care and guidance.

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