[23F] Experiencing episodes of dizziness, nausea, and fatigue

Patient Description

A 23-year-old female has been experiencing episodes of severe dizziness, nausea, vomiting, fatigue, sweating, and occasional confusion for the past six months. These episodes are often paired with dizziness and are exacerbated by physical activity, particularly during her work as a housekeeper or while in the car. The patient reports that the dizziness is characterized by lightheadedness and a spinning sensation, rating its severity as a 10 on a scale from 1 to 10. The fatigue worsens with physical activity but improves with rest, and the patient is on sleep medicine to help manage it. The nausea is aggravated by physical activity and sometimes by eating, leading to vomiting, which occurs up to three times on a bad day and is closely associated with the dizziness episodes. The patient also experiences episodes of sweating, which can be significant enough to soak through clothing, and these may be accompanied by a feverish feeling, although it is unclear if an actual fever is present. The patient has been covid tested, and the results of that test are not specified in the information provided.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, several possibilities could be considered:

  • Autonomic Dysfunction: This condition affects the autonomic nervous system, which controls bodily functions like heart rate, blood pressure, digestion, and body temperature. Symptoms can include fatigue, dizziness, nausea, vomiting, and fluctuations in blood pressure and blood sugar.

    • Treatment typically involves managing the symptoms. For example, increasing fluid and salt intake can help with low blood pressure.
  • Chronic Fatigue Syndrome (CFS): This is a complex 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. Other symptoms can include loss of memory or concentration, unexplained muscle or joint pain, and extreme exhaustion lasting more than 24 hours after physical or mental exercise.

    • There's no single test to confirm a diagnosis of CFS. You may need a variety of medical tests to rule out other health problems that have similar symptoms. Treatment is focused on symptom relief.
  • Gastrointestinal disorders: Certain gastrointestinal conditions like gastritis or peptic ulcer disease can cause nausea, vomiting, and fatigue. These conditions often worsen with physical activity or certain foods.

    • Treatment typically involves medications to decrease stomach acid and lifestyle modifications.
  • Endocrine disorders: Conditions like hypothyroidism or Addison's disease can cause fatigue, nausea, vomiting, and changes in blood pressure and blood sugar. These conditions often require blood tests for diagnosis.

    • Treatment typically involves hormone replacement therapy.

What you can do

  1. Consult a healthcare professional: Given the severity and duration of your symptoms, it's important to seek medical attention. They can provide a proper diagnosis and appropriate treatment.

  2. Rest and hydrate: Make sure you're getting enough sleep and staying hydrated, especially if you're experiencing vomiting.

  3. Monitor your symptoms: Keep track of when your symptoms occur, their severity, and any potential triggers. This information can be helpful for your healthcare provider.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Blood in your vomit or stool
  • Severe dizziness or fainting
  • A fever over 100.4°F (38°C)
  • Rapid, unexplained weight loss

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult with a healthcare professional for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common symptoms of autonomic dysfunction?

Common symptoms of autonomic dysfunction include dizziness, fatigue, nausea, vomiting, fluctuations in blood pressure, and changes in heart rate. These symptoms occur because the autonomic nervous system, which controls involuntary bodily functions, is not working properly.


How is Chronic Fatigue Syndrome diagnosed?

Chronic Fatigue Syndrome is diagnosed primarily through a process of exclusion, as there is no specific test for it. Doctors will typically conduct a variety of tests to rule out other conditions with similar symptoms, such as sleep disorders, mental health issues, and other medical conditions.


What lifestyle changes can help manage gastrointestinal disorders?

Lifestyle changes that can help manage gastrointestinal disorders include eating smaller, more frequent meals, avoiding foods that trigger symptoms, reducing stress, and avoiding alcohol and smoking. Staying hydrated and maintaining a balanced diet can also be beneficial.


What are the signs of endocrine disorders like hypothyroidism or Addison's disease?

Signs of endocrine disorders like hypothyroidism include fatigue, weight gain, cold intolerance, and depression. Addison's disease may present with symptoms such as fatigue, weight loss, low blood pressure, and darkening of the skin. Blood tests are often required to diagnose these conditions.


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