[24F] Experiencing extreme daytime sleepiness, night sweats, and memory loss

Patient Description

A 24-year-old female has been experiencing extreme daytime sleepiness for 2 years, which is constant and not alleviated by any means, including adequate night-time sleep. Additionally, the patient has been having night sweats approximately twice a week for the past 4 months, without any noticeable weight change. She also reports occasional memory loss over the past year, which has not significantly impacted her daily tasks or important events. The patient feels cold sometimes, even in warm environments, and has been feeling a bit irritated or depressed, although her menstrual cycle remains unchanged. Her medical history includes anemia diagnosed 4 years ago. She is currently taking Cymbalta, Wellbutrin, and Loestrin, with no known drug allergies.

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Arora's Assessment

What might be happening

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

  • 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. The cause of chronic fatigue syndrome is still unknown.

    • Treatment typically focuses on symptom relief.
  • Hypothyroidism: This is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones. Hypothyroidism may not cause noticeable symptoms in the early stages. Over time, untreated hypothyroidism can cause a number of health problems, such as obesity, joint pain, infertility and heart disease.

    • Treatment generally involves daily use of the synthetic thyroid hormone levothyroxine.
  • Depression: Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. It affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

    • Treatment often involves a combination of medication and psychotherapy.
  • Sleep Apnea: This is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full night's sleep, you might have sleep apnea.

    • Treatment can include lifestyle changes, such as losing weight or quitting smoking. If these measures don't improve your signs and symptoms or if your apnea is moderate to severe, a number of other treatments are available.
  • 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.

    • Treatment depends on the cause of the anemia, but may include dietary changes, iron supplements, medications, and procedures to treat underlying conditions.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to narrow relieve your symptoms or figure out what's going on:

  1. Maintain a regular sleep schedule. Go to bed and wake up at the same time every day, even on weekends.
  2. Stay active. Regular physical activity, such as walking, can help reduce fatigue.
  3. Eat a healthy diet. A well-balanced diet can increase your energy level. Avoid caffeine and alcohol, which can interfere with sleep.
  4. Manage stress. Stress and anxiety can increase fatigue. Consider trying stress-reduction techniques, such as yoga, meditation or tai chi.

What you should look out for

Reasons to see a doctor more urgently:

  • If your fatigue is so severe that you can't manage your daily activities
  • If your fatigue is getting worse
  • If you have other symptoms, such as unexplained weight loss or fever
  • If you feel depressed, suicidal, or are struggling to cope

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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1 yr ago

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People Also Ask


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

Common symptoms of Chronic Fatigue Syndrome include extreme fatigue that doesn't improve with rest, sleep disturbances, muscle or joint pain, headaches, sore throat, and problems with memory or concentration.


How is hypothyroidism diagnosed and treated?

Hypothyroidism is typically diagnosed through blood tests that measure levels of thyroid hormones (TSH and T4). Treatment usually involves daily use of synthetic thyroid hormone levothyroxine to normalize hormone levels.


Can depression cause physical symptoms like fatigue and memory loss?

Yes, depression can cause physical symptoms such as fatigue, changes in appetite, sleep disturbances, and memory problems. It can also lead to a lack of energy and motivation.


What are the potential side effects of taking Cymbalta and Wellbutrin together?

Potential side effects of taking Cymbalta and Wellbutrin together include increased risk of serotonin syndrome, high blood pressure, and seizures. It's important to monitor for any unusual symptoms and consult with a healthcare provider.


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