[21F] With chronic fatigue, hot flashes, and neurological symptoms

What might be happening

Based on the symptoms you've described, several potential diagnoses could explain your condition. Here are the most likely ones:

1. Chronic Fatigue Syndrome (CFS)

   • Rationale: Your extreme fatigue lasting for more than six months, which worsens with physical activity and does not improve with rest, is a hallmark of CFS. Other symptoms like brain fog, lightheadedness, and unrefreshing sleep also align with this condition.
   • Typical Treatments/Testing: Diagnosis is often made by ruling out other conditions. Treatment focuses on symptom management, including graded exercise therapy, cognitive behavioral therapy, and medications to manage pain, sleep disturbances, and other symptoms.

2. Hormonal Imbalance (e.g., Thyroid Disorders)

   • Rationale: Given your family history of thyroid disorders and symptoms like fatigue, weight gain, and hot flashes, a thyroid disorder such as hypothyroidism could be a possibility.
   • Typical Treatments/Testing: Blood tests to measure thyroid hormone levels (TSH, T3, T4) are commonly used. Treatment usually involves thyroid hormone replacement therapy.

3. Postural Orthostatic Tachycardia Syndrome (POTS)

   • Rationale: Your lightheadedness, palpitations, and fatigue that worsen with standing or walking for extended periods could indicate POTS, a condition that affects blood flow and can cause these symptoms.
   • Typical Treatments/Testing: Diagnosis often involves a tilt table test. Treatment may include increasing fluid and salt intake, medications to regulate blood pressure and heart rate, and physical therapy.

4. Perimenopause

   • Rationale: Although less common at your age, the presence of hot flashes, night sweats, and irregular menstrual cycles while on Nexplanon could suggest hormonal changes related to perimenopause.
   • Typical Treatments/Testing: Blood tests to measure hormone levels (FSH, estradiol) can help diagnose perimenopause. Treatment may include hormone replacement therapy (HRT) and lifestyle changes.

What you can do

Fatigue and Tiredness

• See a doctor: Given the severity and duration of your fatigue, it's important to consult a healthcare provider for a thorough evaluation. They may recommend blood tests, a sleep study, or a referral to a specialist.
• Lifestyle changes: Ensure you get adequate rest, maintain a balanced diet, and engage in gentle, regular exercise as tolerated.
• Symptom tracking: Use MDandMe to journal your symptoms, track progress, and share longitudinal medical notes with your provider.

Lightheadedness and Palpitations

• Hydration and diet: Increase your fluid and salt intake, especially if POTS is suspected. Avoid caffeine and alcohol, which can exacerbate symptoms.
• Compression stockings: Wearing these can help improve blood flow and reduce lightheadedness.
• Symptom tracking: Document episodes of lightheadedness and palpitations using MDandMe to identify potential triggers and patterns.

Hot Flashes and Night Sweats

• Cooling techniques: Use fans, wear light clothing, and keep your living space cool. Cold packs on your neck can also help.
• Hydration: Stay well-hydrated to help manage hot flashes.
• Consult a doctor: Discuss your symptoms with a healthcare provider to explore potential hormonal treatments or other interventions.

Weight Gain and Acne

• Healthy diet and exercise: Focus on a balanced diet rich in fruits, vegetables, and whole grains. Regular physical activity can help manage weight.
• Skincare routine: Use non-comedogenic skincare products and consult a dermatologist if acne persists.

What you should look out for

Given the complexity and severity of your symptoms, it's important to seek medical care as soon as possible. Reasons to seek care even more urgently include:

• Severe or worsening symptoms: If your fatigue, lightheadedness, or palpitations become more severe or frequent.
• New symptoms: Any new or unexplained symptoms, such as chest pain, shortness of breath, or fainting.
• Mental health concerns: If you experience worsening mental health symptoms, such as depression or anxiety, seek help from a mental health professional.

Remember, while I can provide information and suggestions, it's crucial to consult with real healthcare professionals to receive a formal diagnosis and appropriate treatment. If you have more questions or need further assistance, feel free to continue the conversation.