[23F] Experiencing chronic fatigue and headaches

Patient Description

A 23-year-old female reports experiencing chronic fatigue and headaches for over a year. The fatigue worsens with physical activity and affects daily activities, requiring midday breaks. It typically lasts all day until 5 pm. Sleep disturbances include difficulty falling and staying asleep, with Benadryl providing no relief. Headaches are located at the front of the head and around the eyes, without sensitivity to light or sound. Cognitive difficulties such as trouble concentrating are present. The patient reports increased appetite and weight gain, with difficulty losing weight. Thyroid function tests returned normal. Family history includes depression. Current medications are Wellbutrin 150mg daily and Lutera, with no changes in symptoms since starting these medications. No use of substances like alcohol or caffeine that might affect energy levels. Medical history includes eczema and mixed anxiety depression, diagnosed in 2020. No known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Your symptoms of chronic fatigue and headaches could be related to several factors:

  1. Chronic Fatigue Syndrome (CFS): This condition is characterized by extreme fatigue that doesn't improve with rest and may worsen with physical or mental activity. It often includes cognitive difficulties and headaches.

  2. Depression and Anxiety: These can contribute to fatigue, sleep disturbances, and cognitive issues. Since you have a history of mixed anxiety depression, this might be a contributing factor.

  3. Medication Side Effects: While you haven't noticed changes since starting Wellbutrin and Lutera, some people experience fatigue or headaches as side effects.

  4. Hormonal Imbalances: Even with normal thyroid tests, other hormonal imbalances could contribute to your symptoms.

Typical treatments might include lifestyle changes, cognitive behavioral therapy, or medication adjustments. Testing might involve further blood work or sleep studies.

What you can do

For Fatigue:

  • Prioritize Sleep Hygiene: Establish a regular sleep schedule, create a restful environment, and avoid screens before bed.
  • Manage Stress: Practice relaxation techniques like meditation or yoga.
  • Physical Activity: Engage in gentle exercise, like walking, to boost energy levels without overexerting yourself.

For Headaches:

  • Hydration: Ensure you're drinking enough water throughout the day.
  • Eye Strain: Take breaks from screens and consider an eye exam if needed.

General Health:

  • Balanced Diet: Focus on a nutritious diet rich in fruits, vegetables, and whole grains.
  • Symptom Tracking: Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

What you should look out for

Seek medical attention if you experience:

  • Worsening fatigue or headaches
  • New symptoms like vision changes or severe pain
  • Any side effects from medications

Remember, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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2 mo ago

People Also Ask

What are the common symptoms of Chronic Fatigue Syndrome (CFS)?

Common symptoms of Chronic Fatigue Syndrome (CFS) include severe fatigue that doesn't improve with rest, cognitive difficulties, headaches, muscle or joint pain, and unrefreshing sleep. Symptoms often worsen with physical or mental activity.

Can depression and anxiety cause physical symptoms like fatigue and headaches?

Yes, depression and anxiety can cause physical symptoms such as fatigue, headaches, sleep disturbances, and difficulty concentrating. These conditions can affect energy levels and overall well-being.

What lifestyle changes can help manage chronic fatigue?

Lifestyle changes that can help manage chronic fatigue include establishing a regular sleep schedule, practicing good sleep hygiene, engaging in gentle physical activity like walking, managing stress through relaxation techniques, and maintaining a balanced diet.

How can I differentiate between a headache caused by eye strain and other types of headaches?

Headaches caused by eye strain often occur after prolonged screen time or reading and may be accompanied by tired eyes or blurred vision. They typically improve with rest and eye breaks. Other types of headaches, like tension or migraine headaches, may have different triggers and symptoms, such as sensitivity to light or sound.

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