[22F] Experiencing dizziness, clammy skin, tiredness, and weakness

Patient Description

A 22-year-old female presents with symptoms of dizziness described as lightheadedness and an out-of-body feeling, which have been persistent throughout the day and worsen upon standing up and walking. She rates her dizziness as 8/10 in severity. Additionally, she reports clammy skin even while at rest, significant fatigue, and weakness rated 7/10, which have been present for approximately 2 days. The patient has a history of diabetes, diagnosed in December, and migraines diagnosed 5-6 years ago. She is currently on a monthly Ajovy injection for migraines, an unspecified antidepressant, and an A1C lowering medication. She also reports a small amount of chest pain and shortness of breath for a few days, as well as irregular heartbeats, but no fainting episodes. The patient has a family history of heart disease but no known drug allergies and does not consume alcohol or smoke. She also mentions jaw pain but considers it unrelated to her current symptoms.

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Arora's Assessment

What might be happening

Based on your symptoms, the following conditions could be possible:

  • Orthostatic Hypotension: This condition is characterized by a sudden drop in blood pressure when you stand up from a sitting or lying position, leading to dizziness and lightheadedness. It can be caused by dehydration, certain medications, or underlying conditions.

    • Treatment typically involves lifestyle modifications such as standing up slowly, staying hydrated, and avoiding alcohol.
  • Anemia: This is a condition where your body lacks enough healthy red blood cells to carry adequate oxygen to your tissues, causing fatigue and weakness. Given your diabetes, you may be at a higher risk for anemia.

    • Treatment usually involves dietary changes and iron supplements.
  • Heart Conditions: Given your family history of heart disease, symptoms of chest pain, and palpitations, it's important to consider conditions like heart disease or arrhythmias.

    • Treatment for these conditions can range from lifestyle changes to medications and procedures, depending on the severity and type of heart condition.
  • Hypoglycemia: As a diabetic, you may experience low blood sugar levels, which can cause symptoms like weakness, fatigue, and dizziness.

    • Treatment involves consuming 15-20 grams of glucose or simple carbohydrates, rechecking your blood sugar after 15 minutes, and repeating until your blood sugar is at a safe level.
  • Side Effects from Medication: Some of your symptoms could be side effects from your medications, such as the Ajovy injection or your antidepressants.

    • Treatment would involve discussing these symptoms with your doctor, who may adjust your medication regimen.

What you can do

  1. Make sure you're staying hydrated and eating regular, balanced meals.
  2. Stand up slowly from a sitting or lying position.
  3. Keep track of your blood sugar levels and manage them according to your doctor's instructions.
  4. Rest and avoid overexertion until you can see a doctor.
  5. Schedule an appointment with your doctor to discuss your symptoms.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms worsen or don't improve.
  • You experience severe chest pain or shortness of breath.
  • You faint or lose consciousness.
  • You have difficulty breathing or swallowing.

Please remember that while I strive to provide accurate information, I'm not a doctor. It's important to consult with a healthcare professional who can provide a formal diagnosis and appropriate treatment options.

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9 mo ago


People Also Ask


What is orthostatic hypotension and how can it be managed?

Orthostatic hypotension is a condition where blood pressure drops significantly when standing up, causing dizziness and lightheadedness. It can be managed by standing up slowly, staying hydrated, and avoiding alcohol.


How does anemia relate to diabetes, and what are its common treatments?

Anemia in diabetics can occur due to various factors, including kidney disease or nutritional deficiencies. It is treated with dietary changes and iron supplements to increase red blood cell count.


What are the potential heart conditions that could cause chest pain and palpitations?

Potential heart conditions include arrhythmias or heart disease, which can cause chest pain and palpitations. Treatment varies from lifestyle changes to medications or procedures, depending on the condition's severity.


Can medications like Ajovy or antidepressants cause dizziness and fatigue?

Yes, medications like Ajovy for migraines or certain antidepressants can cause side effects such as dizziness and fatigue. It's important to discuss these symptoms with a doctor, who may adjust the medication regimen.


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