[23F] Experiencing severe fatigue and a range of other symptoms

Patient Description

A 23-year-old female presents with a constellation of symptoms persisting for about a month, including severe, unrelenting fatigue that does not improve with rest, headaches that are a deep ache with throbbing behind the eyes or at the base of the skull, night sweats despite a consistent feeling of being cold, bone pain that migrates between various locations such as the left arm, right shin, and hips, and daily nosebleeds lasting 5-10 minutes. The patient also reports a sore throat and a general feeling of unwellness. She has a history of depression and anxiety treated with 100mg of sertraline daily, takes Zyrtec for allergies, a multivitamin, and has a known allergy to penicillin. No recent injuries or other known health conditions were reported that could account for the current symptoms.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are several possibilities:

  • Chronic Fatigue Syndrome (CFS): This condition is characterized by extreme fatigue that doesn't improve with rest and can't be explained by an underlying medical condition. The fatigue may worsen with physical or mental activity. People with CFS often report additional symptoms like headaches, sore throat, and unrefreshing sleep.

    • There is no specific test for CFS. Diagnosis is usually made based on symptoms and by ruling out other potential causes of fatigue. Treatment typically involves managing symptoms, with a focus on improving sleep quality and managing pain.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It amplifies painful sensations by affecting the way your brain processes pain signals.

    • There is no specific test for fibromyalgia. Diagnosis is usually made based on symptoms and by ruling out other potential causes of pain and fatigue. Treatment typically involves a combination of medications, exercise, stress management and healthy lifestyle habits.
  • Anemia: This is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. Having anemia can make you feel tired and weak. Other symptoms can include feeling cold and having headaches.

    • Anemia is usually confirmed with a complete blood count (CBC) test. Treatment depends on the type and cause of anemia, but may include dietary changes, supplements, and in severe cases, transfusions or medication.
  • Leukemia: This is a type of cancer of the body's blood-forming tissues, including the bone marrow and the lymphatic system. Some forms of leukemia are more common in children, but most types of leukemia occur in older adults. Leukemia can cause fatigue, frequent infections, and easy bleeding or bruising, among other symptoms.

    • Diagnosis is usually made by blood tests and bone marrow tests. Treatment depends on many factors, including the type of leukemia, the patient's age and overall health.

Please note that these are just possibilities based on the symptoms you've described. It's very important to consult with a healthcare professional who can evaluate your symptoms and medical history in person, perform a physical exam, and order appropriate tests.

What you can do

Given the range of your symptoms and their persistence, it's important to seek medical attention. Here are some steps you can take:

  1. Schedule an appointment with your primary care doctor. If you don't have one, consider going to an urgent care clinic.
  2. Write down all your symptoms, including when they started, how often they occur, and anything that makes them better or worse.
  3. Bring a list of all medications you're currently taking, including over-the-counter drugs and supplements.
  4. Be prepared to discuss your medical history, including any conditions you have and any tests you've had done recently.

What you should look out for

If your symptoms worsen or if you develop new symptoms, seek medical attention immediately. This includes:

  • Severe pain
  • Difficulty breathing
  • High fever
  • Sudden weakness or numbness on one side of your body
  • Sudden confusion or difficulty speaking
  • Severe headache or vision changes

Remember, while this advice provides some guidance, it's very important to consult with a healthcare professional who can provide a diagnosis and treatment plan based on a thorough evaluation.

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11 mo ago

People Also Ask


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

Common symptoms of Chronic Fatigue Syndrome (CFS) include extreme fatigue that doesn't improve with rest, headaches, sore throat, unrefreshing sleep, and sometimes muscle or joint pain. The fatigue often worsens with physical or mental activity.


How is fibromyalgia diagnosed and treated?

Fibromyalgia is diagnosed based on symptoms such as widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. There is no specific test for fibromyalgia, so diagnosis involves ruling out other conditions. Treatment typically includes medications, exercise, stress management, and healthy lifestyle habits.


What are the signs and symptoms of anemia?

Signs and symptoms of anemia can include fatigue, weakness, pale or yellowish skin, irregular heartbeats, shortness of breath, dizziness, or lightheadedness. Some people may also experience headaches and cold hands and feet.


What tests are used to diagnose leukemia?

Leukemia is usually diagnosed with blood tests, such as a complete blood count (CBC), and bone marrow tests. These tests help determine the presence of abnormal white blood cells and assess the overall health of the blood and bone marrow.


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