[20F] Experiencing chronic fatigue and lightheadedness with exertion

Patient Description

A 20-year-old female reports chronic fatigue that is not alleviated by sleep or caffeine, and has been present since around the age of 11 or 12. The patient experiences pain in the sides when running, quick exhaustion during physical activity, and lightheadedness upon standing that occasionally results in transient vision loss. These symptoms have been consistent over time, with one episode around the age of 12 where the patient nearly passed out. The patient's weight has been stable since the age of 15, and they are currently 104 pounds at a height of 5'0". The patient finds relief when sitting with legs pulled against the chest and struggles with brain fog. There is no mention of any recent changes in weight or other new symptoms.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Chronic Fatigue Syndrome: This condition is characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest. The exact cause of chronic fatigue syndrome is still unknown.

    • There's no single test to confirm a diagnosis of chronic fatigue syndrome. You may need a variety of medical tests to rule out other health problems that have similar symptoms.
  • Iron Deficiency Anemia: This condition occurs when your blood lacks adequate healthy red blood cells, which provide oxygen to body tissues. Symptoms can include fatigue, weakness, pale skin, chest pain, dizziness or lightheadedness, and inflammation or soreness of your tongue. Iron deficiency anemia is usually treated with dietary changes and iron supplements.

    • A simple blood test can confirm whether you have iron deficiency anemia.
  • Postural Orthostatic Tachycardia Syndrome (POTS): This condition affects circulation and is characterized by the body's inability to make the necessary adjustments to counteract gravity when standing up. The primary symptom of POTS syndrome is orthostatic intolerance, or the development of symptoms when standing up that are relieved by reclining.

    • POTS can be diagnosed through a variety of tests, including a tilt table test, which monitors how your heart rate and blood pressure respond to changes in posture and position.

What you can do

It's important to consult with a healthcare professional who can provide a formal assessment and order relevant tests if necessary. In the meantime, here are some things you can do:

  1. Keep a symptom diary: This can help you and your healthcare provider identify patterns that might not be apparent otherwise.
  2. Stay hydrated: Dehydration can exacerbate feelings of fatigue and lightheadedness.
  3. Eat a balanced diet: This can help ensure you're getting all the nutrients your body needs to function properly.
  4. Try to maintain a regular sleep schedule: Going to bed and waking up at the same time every day can help regulate your body's natural sleep-wake cycle.

What you should look out for

You should seek immediate medical attention if you experience:

  • A sudden, severe headache
  • Chest pain or difficulty breathing
  • Fainting
  • A rapid or irregular heartbeat

Remember, while I strive to provide accurate and helpful information, I'm an AI and not a doctor. Always consult with a healthcare professional for accurate information.

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11 mo ago

Top picked over-the-counter products for POTS: Heart Rhythm Society Treatment Consensus

People Also Ask


What are the common symptoms of Chronic Fatigue Syndrome?

Common symptoms of Chronic Fatigue Syndrome include extreme fatigue that doesn't improve with rest, sleep disturbances, muscle or joint pain, headaches, sore throat, and cognitive difficulties such as brain fog.


How is Iron Deficiency Anemia diagnosed and treated?

Iron Deficiency Anemia is diagnosed through a blood test that measures hemoglobin and iron levels. Treatment typically involves dietary changes to include more iron-rich foods and taking iron supplements as prescribed by a healthcare provider.


What is Postural Orthostatic Tachycardia Syndrome (POTS) and how is it diagnosed?

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects circulation and is characterized by symptoms like dizziness, lightheadedness, and rapid heartbeat upon standing. It is diagnosed through tests such as a tilt table test, which evaluates how heart rate and blood pressure respond to changes in posture.


What lifestyle changes can help manage symptoms of chronic fatigue and lightheadedness?

To manage symptoms of chronic fatigue and lightheadedness, it is recommended to stay hydrated, maintain a balanced diet, keep a regular sleep schedule, and track symptoms in a diary to identify patterns. Consulting with a healthcare professional for personalized advice is also important.


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