[20F] Experiencing fatigue, cravings, and neurological symptoms

Patient Description

A 20-year-old female has been experiencing fatigue, particularly at night, which worsens with long walks and is alleviated by rest and consuming sugary foods. This has been ongoing for approximately one month. She has also reported unintentional weight loss. For the past six months, she has had cravings, specifically for chicken, mostly at night. Additionally, she experiences severe dizziness, rated an 8 out of 10 in severity, with symptoms like seeing stars and tunnel vision, especially upon standing up, which has been a long-term issue. She also experiences shortness of breath, heart palpitations, and chest pain. She has a personal history of epilepsy, diagnosed at age 10, and anemia, as well as a family history of cancer, diabetes, and heart conditions. She had a severe adverse reaction to Lamictal in the past. Currently, she is not on any medications except for a multivitamin (Nature's Bounty Hair, Skin & Nails) which she started today.

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Arora's Assessment

What might be happening

Based on the information you've provided, there are several possibilities:

  • Iron Deficiency Anemia: This condition can cause fatigue, dizziness, and cravings for non-food items (known as pica), which could potentially extend to unusual cravings for certain foods. Unintentional weight loss is not typically associated with anemia, but it could be a result of an underlying condition causing the anemia.

    • Treatment typically involves iron supplementation and addressing the underlying cause of the iron deficiency.
  • Hypoglycemia: This condition, characterized by low blood sugar, can cause fatigue, dizziness, and cravings for sugary foods. It's more common in people with diabetes, but can occur in people without diabetes.

    • Treatment involves eating small, frequent meals throughout the day, and including a good balance of proteins, carbohydrates, and healthy fats in your diet.
  • Orthostatic Hypotension: This is a form of low blood pressure that happens when you stand up from sitting or lying down, and can cause dizziness and fainting.

    • Treatment often involves lifestyle changes, such as drinking plenty of fluids and avoiding alcohol.
  • Chronic Fatigue Syndrome: This is a complex disorder characterized by extreme fatigue that can't be explained by any underlying medical condition.

    • Treatment focuses on symptom relief.
  • Eating Disorders: Certain eating disorders can cause fatigue, weight loss, and unusual food cravings.

    • Treatment involves a combination of psychological therapy and nutritional counseling.

Please note that these are only possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Make an appointment with your healthcare provider to discuss your symptoms. They may want to conduct some tests to help determine the cause of your symptoms.
  2. Keep a symptom diary. Note when your symptoms occur, what you're doing at the time, and what foods you've eaten.
  3. Try to maintain a balanced diet and stay hydrated. This can help manage symptoms of fatigue and dizziness.
  4. Try to get regular exercise, which can help improve energy levels and overall health.
  5. If you're feeling dizzy, sit or lie down immediately to prevent falls and injuries.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms significantly worsen
  • You experience severe chest pain or difficulty breathing
  • You faint or lose consciousness
  • You have severe abdominal pain or vomiting

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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9 mo ago


People Also Ask


What are the common symptoms of iron deficiency anemia?

Common symptoms of iron deficiency anemia include fatigue, weakness, pale skin, shortness of breath, dizziness, cravings for non-food items (pica), and cold hands and feet.


How can hypoglycemia be managed in individuals without diabetes?

Hypoglycemia in individuals without diabetes can be managed by eating small, frequent meals throughout the day, ensuring a balanced intake of proteins, carbohydrates, and healthy fats, and avoiding excessive consumption of sugary foods.


What lifestyle changes can help manage orthostatic hypotension?

Lifestyle changes to manage orthostatic hypotension include staying well-hydrated, avoiding alcohol, rising slowly from sitting or lying positions, wearing compression stockings, and increasing salt intake if advised by a healthcare provider.


What are the potential causes of unintentional weight loss?

Potential causes of unintentional weight loss include hyperthyroidism, diabetes, depression, eating disorders, gastrointestinal disorders, and chronic infections. It's important to consult a healthcare provider for an accurate diagnosis.

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