[19M] With headaches, nasal congestion, and fatigue

Patient Description

A 19-year-old male reports experiencing headaches with a pain level of 6-7 out of 10, occurring on and off for two days. The headaches develop gradually, lasting one to two hours, mostly in the late morning to afternoon and occasionally in the evenings. Caffeine provides some relief. Accompanying symptoms include trouble sleeping, frequent sneezing, a minor cough with sputum, sunken eyes, nasal congestion, possible low-grade fever, and fatigue. The patient also feels disoriented, though it does not affect daily activities. Symptoms began the same day as a semi-rigorous run in warm weather. The patient has seasonal allergies but no history of sinus issues. Current medications include glycopyrrolate (1mg daily) and omega-3 fish oil. Atomoxetine (40mg daily) was stopped a few days before symptoms appeared. There are no known drug allergies or chronic illnesses.

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Arora's Assessment

What might be happening

Your symptoms could be related to a few different issues:

  1. Sinusitis or Allergies: The combination of headaches, nasal congestion, sneezing, and fatigue suggests sinusitis or a flare-up of seasonal allergies. These conditions can cause pressure in the forehead and lead to headaches. Treatment often includes decongestants, antihistamines, or nasal sprays.

  2. Dehydration or Heat Exhaustion: Given that your symptoms started after a run in warm weather, dehydration or mild heat exhaustion could be contributing to your headaches, fatigue, and disorientation. Staying hydrated and resting in a cool environment can help.

  3. Withdrawal from Atomoxetine: Stopping atomoxetine suddenly might cause withdrawal symptoms, including headaches and fatigue. It's important to discuss any medication changes with your doctor.

What you can do

For Sinusitis or Allergies:

  • Continue taking your allergy medication as directed.
  • Use a saline nasal spray to help with congestion.
  • Consider using a humidifier in your room to keep the air moist.

For Dehydration or Heat Exhaustion:

  • Drink plenty of fluids, especially water or electrolyte drinks.
  • Rest in a cool, shaded area and avoid strenuous activities until you feel better.

For Headaches:

  • Over-the-counter pain relievers like ibuprofen or acetaminophen can help, but follow the recommended dosage.
  • Apply a cool compress to your forehead to relieve pain.

General Tips:

  • Keep a symptom journal using MDandMe to track your symptoms and any triggers.
  • Share this information with your healthcare provider for further evaluation.

What you should look out for

Seek medical attention if you experience:

  • Severe or worsening headaches.
  • High fever or persistent fever.
  • Confusion or difficulty staying awake.
  • Shortness of breath or chest pain.

Remember, it's important to consult with a healthcare professional for a proper diagnosis and treatment plan.

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5 mo ago

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People Also Ask


Can seasonal allergies cause headaches and fatigue?

Yes, seasonal allergies can cause headaches and fatigue due to sinus pressure and the body's immune response to allergens. Managing allergies with antihistamines and decongestants can help alleviate these symptoms.


What are the symptoms of dehydration or heat exhaustion?

Symptoms of dehydration or heat exhaustion include headaches, fatigue, dizziness, dry mouth, excessive sweating, and confusion. It's important to stay hydrated and rest in a cool environment to prevent these conditions.


Could stopping atomoxetine suddenly cause withdrawal symptoms?

Yes, stopping atomoxetine suddenly can lead to withdrawal symptoms such as headaches, fatigue, and mood changes. It's important to consult with a healthcare provider before making any changes to medication regimens.


What are some effective ways to relieve sinus congestion?

Effective ways to relieve sinus congestion include using saline nasal sprays, taking decongestants, using a humidifier, and staying hydrated. These methods can help reduce nasal congestion and associated symptoms.


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