[21F] Experiencing extreme fatigue and multiple symptoms

Patient Description

A 21-year-old female reports suffering from extreme fatigue that has been worsening over the past few months, with a notable increase in severity recently. The fatigue is so profound that it significantly affects her ability to work and be productive, and it intensifies with activities such as walking or standing. Additionally, she has been experiencing upper abdominal pain described as stabbing and throbbing, rated at a severity of 5 out of 10, persisting for about a year. She also mentions difficulty with temperature regulation, presenting with chills and fluctuations between feeling excessively cold and hot, which started a week ago. The patient has been experiencing visual trails for the past 2 years, and she notes dry skin issues that have migrated from her face, where it was peeling and red, to her hands, causing pain. There is also a mention of unintentional weight changes. No alleviating factors for the fatigue were reported, and bowel movements were described as dry as of today.

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Arora's Assessment

What might be happening

Based on the information you've provided, several conditions could be causing your symptoms:

  • Hypothyroidism: This condition occurs when your thyroid gland doesn't produce enough thyroid hormones. Symptoms can include fatigue, weight gain, constipation, increased sensitivity to cold, dry skin, and depression.

    • Treatment typically involves daily use of the synthetic thyroid hormone levothyroxine, which restores adequate hormone levels and reverses the symptoms of hypothyroidism.
  • Chronic Fatigue Syndrome (CFS): This is a complicated disorder 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.

    • There is no cure for CFS, treatment focuses on symptom relief.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues.

    • Treatment often involves a team approach, including your doctor, a physical therapist, and possibly other health professionals.

Please note that these are potential explanations for your symptoms, but only a healthcare professional can provide a formal diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may want to conduct tests to rule out conditions like hypothyroidism.
  2. Keep a symptom diary. Note when your symptoms occur, their severity, and any potential triggers. This information can be helpful to your healthcare provider.
  3. Try to maintain a healthy lifestyle. Regular exercise, a balanced diet, and adequate sleep can help manage symptoms of fatigue.

What you should look out for

Seek immediate medical attention if:

  • Your fatigue becomes so severe that you can't perform your usual daily activities
  • You have thoughts of harming yourself or others
  • You experience sudden weight loss, heart palpitations, or a loss of consciousness

Remember, I'm an AI and this advice is based on the information you've given me. It's always important to consult with a healthcare provider for an accurate diagnosis.

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10 mo ago

People Also Ask


What are the common symptoms of hypothyroidism?

Common symptoms of hypothyroidism include fatigue, weight gain, constipation, increased sensitivity to cold, dry skin, and depression. It's important to consult a healthcare provider for a proper diagnosis.


How is Chronic Fatigue Syndrome diagnosed?

Chronic Fatigue Syndrome is diagnosed based on a thorough medical history and physical examination. There are no specific tests for CFS, so doctors often rule out other conditions first. Diagnosis may involve meeting specific criteria related to the duration and severity of fatigue.


What lifestyle changes can help manage fibromyalgia symptoms?

Lifestyle changes that can help manage fibromyalgia symptoms include regular low-impact exercise, stress management techniques, maintaining a healthy sleep routine, and eating a balanced diet. It's often beneficial to work with healthcare professionals to develop a personalized plan.


When should I seek immediate medical attention for fatigue?

You should seek immediate medical attention for fatigue if it becomes so severe that you can't perform your usual daily activities, if you have thoughts of harming yourself or others, or if you experience sudden weight loss, heart palpitations, or a loss of consciousness.


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