[20M] Experiencing lightheadedness and heat intolerance

Patient Description

A 20-year-old male reports experiencing significant lightheadedness and heat intolerance for approximately six months. The lightheadedness is described as intense but brief, occurring for a few seconds and is strong enough to feel like he might lose consciousness. It is often triggered by exertion or anxiety. He also experiences tingling in his hands and feet when taking deep breaths. The heat intolerance manifests as reddening and heating of the cheeks and forearms, taking about an hour to cool down. There are no palpitations during lightheadedness, but they occur when bending over or standing up quickly. No chest pain or swelling in the legs or feet is reported. The patient has a history of taking clomipramine, Prozac, and Lexapro, and is currently on Provix, a new SNRI. He has a family history of heart problems and anxiety disorders and has been diagnosed with Autism, Anxiety Disorder, and severe OCD. Allergies include Delcum cough medicine and sulfa drugs.

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Arora's Assessment

What might be happening

Based on your symptoms and history, here are some possibilities:

  1. Heat Intolerance and Flushing: Your symptoms of overheating, facial and arm redness, and prolonged cooling down could be related to autonomic dysregulation, which can sometimes occur with anxiety disorders or as a side effect of medications. It might also be related to your body's response to stress or exertion.

  2. Lightheadedness and Vertigo: The intense but brief episodes of lightheadedness, especially triggered by anxiety or stress, could be related to anxiety or panic attacks. These can cause a sudden rush of adrenaline, leading to symptoms like dizziness and tingling in the extremities. The history of medication changes might also play a role in these symptoms.

  3. Medication Effects: Since you mentioned starting clomipramine and experiencing these symptoms, it's possible that your body is still adjusting to changes in medication. Some antidepressants can affect blood pressure and heart rate, contributing to lightheadedness and heat intolerance.

What you can do

Lightheadedness and Vertigo:

  • Seek Medical Advice: It's important to discuss these symptoms with your healthcare provider, especially given your history of medication changes. They may want to evaluate your current medication regimen and consider adjustments.
  • Manage Anxiety: Continue with therapy and consider techniques like deep breathing, mindfulness, or relaxation exercises to help manage anxiety and prevent episodes.
  • Stay Hydrated: Ensure you are drinking enough fluids, as dehydration can worsen lightheadedness.

Heat Intolerance:

  • Cool Down Strategies: Use fans, cool showers, or air conditioning to help manage heat intolerance. Wearing lightweight, breathable clothing can also help.
  • Monitor Triggers: Keep track of activities or situations that trigger these symptoms using a journal or an app like MDandMe. This can help you and your healthcare provider identify patterns and potential solutions.

What you should look out for

  • Seek Immediate Care: If you experience severe symptoms such as chest pain, fainting, or significant changes in heart rhythm, seek medical attention promptly.
  • Monitor Symptoms: Keep an eye on any new or worsening symptoms, and report these to your healthcare provider. This includes any changes in the frequency or intensity of your lightheadedness or heat intolerance.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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1 mo ago


People Also Ask


What could be causing my lightheadedness and tingling in extremities?

Lightheadedness and tingling in extremities can be caused by anxiety or panic attacks, which lead to a sudden rush of adrenaline. It can also be related to autonomic dysregulation or side effects from medications.


How can medication changes affect symptoms like heat intolerance and dizziness?

Medication changes, especially with antidepressants, can affect blood pressure and heart rate, leading to symptoms like dizziness and heat intolerance. Your body may need time to adjust to new medications.


What strategies can help manage heat intolerance effectively?

To manage heat intolerance, use fans, cool showers, or air conditioning. Wear lightweight, breathable clothing and monitor activities or situations that trigger symptoms to identify patterns.


When should I seek immediate medical attention for my symptoms?

Seek immediate medical attention if you experience severe symptoms such as chest pain, fainting, or significant changes in heart rhythm. Also, report any new or worsening symptoms to your healthcare provider.


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