[23F] Experiencing persistent fatigue, dizziness, and headaches

Patient Description

A 23-year-old female reports experiencing persistent fatigue, dizziness, and throbbing headaches over the past two months. The fatigue worsens with minimal physical activity and is accompanied by episodes of lightheadedness and blurry vision, especially when standing up from a seated position. The patient also describes feeling hot internally for the past week. She experiences palpitations or irregular heartbeats approximately once or twice a month. There have been noticeable changes in body weight, but no changes in appetite, menstrual cycle, or swelling in the legs or ankles. The patient has also observed the development of small skin tags on the neck. The intensity of the headaches is rated as 5 out of 10, and they have not been relieved by typical pain management strategies.

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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:

  1. Orthostatic Hypotension: This condition occurs when your blood pressure drops significantly when you stand up from sitting or lying down, leading to dizziness or blackouts. It can be caused by dehydration, prolonged bed rest, or certain medications.

  2. Chronic Fatigue Syndrome (CFS): This is characterized by extreme fatigue that doesn't improve with rest and may worsen with physical or mental activity. The cause is not well understood, but it can be associated with headaches, dizziness, and other symptoms.

  3. Anemia: A condition where you don't have enough healthy red blood cells to carry adequate oxygen to your body's tissues, leading to fatigue, dizziness, and palpitations.

  4. Thyroid Disorders: Both hyperthyroidism and hypothyroidism can cause fatigue, changes in weight, and palpitations.

  5. Anxiety or Stress: These can manifest physically as palpitations, dizziness, and a feeling of being hot inside.

Typical treatments or testing might include blood tests to check for anemia or thyroid function, monitoring blood pressure, and possibly an ECG to assess heart rhythm.

What you can do

Fatigue, dizziness, and headaches:

  • Stay Hydrated: Ensure you're drinking enough water throughout the day.
  • Balanced Diet: Eat a well-balanced diet rich in iron and vitamins to help combat potential anemia.
  • Rest: Ensure you're getting adequate rest and not overexerting yourself.
  • Monitor Symptoms: Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

Feeling hot inside and palpitations:

  • Relaxation Techniques: Practice deep breathing, meditation, or yoga to help manage stress and anxiety.
  • Avoid Triggers: Identify and avoid any potential triggers for your palpitations, such as caffeine or stress.

General Health:

  • Regular Check-ups: Schedule a visit with your healthcare provider to discuss your symptoms and get appropriate tests done.
  • Symptom Tracking: Keep a detailed record of your symptoms, including when they occur and any potential triggers, to help your doctor with diagnosis.

What you should look out for

While your symptoms are concerning, they may not be immediately life-threatening. However, you should seek medical attention if you experience:

  • Severe chest pain or pressure
  • Fainting or loss of consciousness
  • Severe shortness of breath
  • Sudden, severe headache

Remember, it's important to consult with a healthcare professional to receive a formal diagnosis and appropriate treatment.

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2 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 or fainting. It can be managed by staying hydrated, rising slowly from sitting or lying positions, and wearing compression stockings. In some cases, medication may be prescribed.


How is chronic fatigue syndrome diagnosed and treated?

Chronic fatigue syndrome is diagnosed based on symptoms and ruling out other conditions. There is no specific test for it. Treatment focuses on symptom management, including lifestyle changes, cognitive behavioral therapy, and graded exercise therapy.


What are the common symptoms of anemia and how is it treated?

Common symptoms of anemia include fatigue, dizziness, palpitations, and pale skin. It is treated by addressing the underlying cause, which may involve dietary changes, supplements like iron or vitamin B12, or treating any underlying medical conditions.


What are the signs of thyroid disorders and how are they tested?

Signs of thyroid disorders include fatigue, weight changes, palpitations, and temperature sensitivity. They are tested through blood tests that measure levels of thyroid hormones (TSH, T3, T4) and sometimes imaging tests like an ultrasound.


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