[21F] With chest and bone pain, nausea, and fatigue

Patient Description

A 21-year-old female presents with symptoms of chest pain, bone pain in the limbs, nausea, and fatigue. The chest pain is described as moderate, tapering off, and occurs sporadically, sometimes accompanied by shortness of breath. The bone pain, which is the most bothersome symptom, started suddenly and has been occurring on and off for the last couple of days, with no known relief. There is no associated swelling or redness, and no recent unusual physical activities or injuries. The patient reports a loss of appetite but no vomiting, diarrhea, constipation, or recent weight loss. Menstrual cycles are semi-regular with a missed last cycle. No history of anemia or hormonal imbalances. Dietary intake of calcium and vitamin D is believed to be adequate. No recent travel or family history of autoimmune diseases or metabolic disorders, although there is a family history of hyperthyroidism and cancer. The patient has Tourette's Syndrome, diagnosed in 2021, and has undergone a tonsillectomy and wisdom teeth removal in the past. Allergies include fire ants, cockroaches, and poppy seeds, with no medication allergies and no current medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations for what you might be experiencing. Please remember that these are not diagnoses, and it's important to consult with a healthcare professional for an accurate assessment.

  1. Viral Infection or Flu: Your symptoms of fatigue, nausea, headaches, and loss of appetite could be indicative of a viral infection or the flu. These illnesses can cause a range of symptoms, including bone pain and chest discomfort, as your body fights off the infection.

  2. Anemia: Given your fatigue, headaches, and loss of appetite, anemia could be a possibility. Anemia occurs when your body doesn't have enough healthy red blood cells, leading to reduced oxygen flow to your organs. This can cause fatigue, weakness, and sometimes bone pain.

  3. Thyroid Issues: With a family history of hyperthyroidism, it's worth considering thyroid imbalances as a potential cause. Thyroid issues can lead to fatigue, changes in appetite, and other systemic symptoms.

  4. Stress or Anxiety: Sometimes, stress or anxiety can manifest physically, causing symptoms like chest pain, headaches, and fatigue. It's important to consider your mental health and any recent stressors in your life.

What you can do

For Viral Infection or Flu:

  • Rest and stay hydrated. Ensure you're drinking plenty of fluids and getting enough sleep.
  • Over-the-counter medications like acetaminophen or ibuprofen can help alleviate pain and reduce fever.
  • Monitor your symptoms, and if they worsen or persist, seek medical attention.

For Anemia:

  • Consider incorporating iron-rich foods into your diet, such as spinach, red meat, and legumes.
  • Schedule an appointment with your healthcare provider to discuss your symptoms and possibly get a blood test to check your iron levels.

For Thyroid Issues:

  • Keep track of your symptoms and any changes in your energy levels or weight.
  • Discuss your family history and symptoms with your doctor, who may recommend a thyroid function test.

For Stress or Anxiety:

  • Practice relaxation techniques such as deep breathing, meditation, or yoga.
  • Consider speaking with a mental health professional if you feel overwhelmed or anxious.

Additionally, you can use MDandMe to journal your symptoms, track your progress, and share your medical notes with your healthcare provider.

What you should look out for

While your symptoms are concerning, they do not appear to be immediately life-threatening. However, you should seek medical attention if you experience any of the following:

  • Severe or worsening chest pain
  • Difficulty breathing or shortness of breath
  • Fainting or dizziness
  • Unexplained weight loss or persistent fatigue

Remember, it's important to consult with a healthcare professional to receive a formal diagnosis and appropriate treatment. If you have any more questions or need further assistance, feel free to reach out.

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25 d ago


People Also Ask


What could be causing my bone pain and how can I alleviate it?

Bone pain can be caused by various factors including viral infections, anemia, or even stress. To alleviate it, rest and over-the-counter pain relievers like acetaminophen or ibuprofen may help. If the pain persists, consult a healthcare provider.


Could my symptoms be related to a thyroid issue given my family history?

Yes, thyroid issues can cause symptoms like fatigue, changes in appetite, and systemic symptoms. Given your family history of hyperthyroidism, it would be wise to discuss this with your doctor and consider a thyroid function test.


How can I differentiate between symptoms of stress and a physical illness?

Stress and physical illnesses can have overlapping symptoms such as fatigue and chest pain. Stress-related symptoms often improve with relaxation techniques and mental health support, while physical illnesses may require medical treatment. Monitoring symptom patterns and consulting a healthcare provider can help differentiate them.


What dietary changes can I make if I suspect anemia?

If you suspect anemia, incorporating iron-rich foods like spinach, red meat, and legumes into your diet can help. It's also important to consult with a healthcare provider for a blood test to confirm anemia and discuss appropriate dietary or supplement interventions.


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