[23F] Experiencing shakiness, sinus headache, and fatigue

Patient Description

A 23-year-old female reports noticeable shakiness in her hands that started around the morning and is usually relieved by sugar intake, although it did not improve today. She also experiences a sinus pressure-like headache above her eyes, which she rated as moderate in severity, and fatigue. The headache is a recurring issue for her. Additionally, she feels weak and slightly dizzy, and has been having trouble with her eyes. She is currently on Depo-Provera injections every three months and has not noticed any side effects. She does not have a history of recreational drug or alcohol use that could affect her blood sugar levels, nor does she have a family history of tremor or migraine. There are no known allergies or adverse reactions to medications, and she is not on any other prescription drugs, over-the-counter medications, or supplements.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Hypoglycemia: This is a condition characterized by low blood sugar levels. It can cause symptoms like shakiness, weakness, fatigue, and headaches. You mentioned that your shakiness usually improves after eating something sugary, which is a common way to manage hypoglycemia.

    • Treatment typically 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.
  • Migraines: These are severe headaches that can cause symptoms like throbbing pain, light sensitivity, and nausea. They can also cause visual disturbances, which you mentioned experiencing.

    • Treatment usually involves taking pain relievers and other medications to stop the migraines before they start.
  • Sinusitis: This is an inflammation or swelling of the tissue lining the sinuses, which can cause symptoms like a sinus headache, fatigue, and dizziness.

    • Treatment typically involves using nasal decongestants and pain relievers.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

Here are some steps you can take to manage your symptoms:

  1. Monitor your blood sugar levels: If you suspect that your symptoms are related to low blood sugar, try to eat regular meals and snacks that contain a balance of proteins, fats, and carbohydrates.

  2. Stay hydrated: Drinking plenty of fluids can help to alleviate headaches and fatigue.

  3. Rest: If you're feeling fatigued, try to get plenty of sleep and take breaks throughout the day as needed.

  4. Over-the-counter medications: For your headache, you might find relief from over-the-counter pain relievers. Just be sure to follow the package instructions.

What you should look out for

Watch out for the following symptoms, as they might indicate a more serious condition:

  • Severe headache or headache that doesn't improve with rest or over-the-counter medications
  • Persistent or worsening shakiness
  • Confusion, difficulty speaking, or difficulty walking
  • Severe fatigue or weakness

If you experience any of these symptoms, seek medical attention immediately.

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1 yr ago

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People Also Ask


What are the common symptoms of hypoglycemia and how can it be managed?

Common symptoms of hypoglycemia include shakiness, sweating, dizziness, fatigue, and headaches. It can be managed by consuming 15-20 grams of glucose or simple carbohydrates, rechecking blood sugar after 15 minutes, and repeating until blood sugar levels are safe.


How can I differentiate between a sinus headache and a migraine?

A sinus headache is often associated with sinusitis and presents with pressure-like pain above the eyes or in the forehead, while a migraine typically involves throbbing pain, light sensitivity, and nausea. Migraines can also cause visual disturbances.


What are the potential side effects of Depo-Provera injections?

Potential side effects of Depo-Provera injections include changes in menstrual periods, weight gain, headaches, and mood changes. However, not everyone experiences side effects, and they can vary from person to person.


When should I seek medical attention for headaches or shakiness?

You should seek medical attention if you experience a severe headache that doesn't improve with rest or over-the-counter medications, persistent or worsening shakiness, confusion, difficulty speaking or walking, or severe fatigue or weakness.


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