[25F] Pregnant with severe headaches and systemic symptoms

Patient Description

A 25-year-old female, currently 8 weeks pregnant, presents with severe, constant, pulsating headaches for the last 2 weeks, affecting various areas including the eyes, ears, base of the neck, temples, back of the head, and upper jaw. The pain is exacerbated by movement but somewhat alleviated by cool washcloths on the forehead. Accompanying symptoms include a low-grade fever of approximately 99.5 degrees, persistent for 2 weeks, significant fatigue, body weakness, nausea, vomiting, lack of appetite, and dizziness. The patient has lost 3 pounds in one week. Visual disturbances include floaters. Neck stiffness is present without rash. The patient has a history of hypothyroidism, diagnosed in 2021, and is currently on 0.075 mcg Levothyroxine daily. No known allergies. No other medications, substances, or exposure to toxins reported. The patient's mother has a history of migraines.

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Arora's Assessment

What might be happening

Based on the information you've provided, a few conditions could be causing your symptoms:

  • Pregnancy-related changes: Pregnancy can cause a variety of symptoms, including fatigue, nausea, vomiting, and dizziness. These symptoms are often most intense during the first trimester. Hormonal changes during pregnancy can also trigger migraines in some women.

    • Treatment: Rest, hydration, and small frequent meals can help manage these symptoms. Over-the-counter treatments like ginger or vitamin B6 may also help with nausea and vomiting. If your symptoms are severe, your doctor may prescribe medication to help manage them.
  • Thyroid disease: You mentioned that you have hypothyroidism. If your thyroid hormone levels are not well-controlled, this could cause symptoms like fatigue, weakness, and weight loss. It could also potentially contribute to your headaches.

    • Treatment: Regular monitoring of your thyroid hormone levels and adjusting your levothyroxine dosage as needed can help manage your symptoms.
  • Infection: Your low-grade fever and recent use of antibiotics suggest that you may have an infection. Some infections can cause symptoms like fatigue, weakness, and loss of appetite.

    • Treatment: If you have an infection, your doctor may prescribe antibiotics or other medications to help your body fight off the infection.

What you can do

You should definitely discuss these symptoms with your doctor, as they can do a more thorough evaluation and order tests if necessary. In the meantime, here are some things you can try:

  1. Rest and hydrate: Make sure you're getting enough sleep and drinking plenty of fluids. This can help with many of your symptoms, including fatigue, weakness, and headaches.
  2. Eat small, frequent meals: This can help manage nausea and vomiting, and ensure you're getting enough nutrients.
  3. Monitor your symptoms: Keep track of when your symptoms occur, how severe they are, and anything that makes them better or worse. This information can be helpful when you talk to your doctor.
  4. Continue taking your medications as prescribed: It's important to continue taking your levothyroxine and antibiotics as directed by your doctor.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

  • Severe headache or a headache that is different from your usual migraines
  • Sudden or severe abdominal pain
  • High fever (over 101°F)
  • Difficulty breathing or shortness of breath
  • Any other symptoms that are severe or concerning to you

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare provider for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


Can pregnancy cause severe headaches and how can they be managed?

Yes, pregnancy can cause severe headaches due to hormonal changes, increased blood volume, and stress. Management includes rest, hydration, applying cool compresses, and consulting a doctor for safe pain relief options.


How does hypothyroidism affect pregnancy and what symptoms should be monitored?

Hypothyroidism can affect pregnancy by causing fatigue, weight changes, and potentially impacting fetal development. It's important to monitor thyroid hormone levels regularly and adjust medication as needed under a doctor's guidance.


What are the common causes of low-grade fever during pregnancy?

Common causes of low-grade fever during pregnancy include infections, hormonal changes, and sometimes dehydration. It's important to consult a healthcare provider to rule out any serious conditions.


What should I do if I experience visual disturbances like floaters during pregnancy?

Visual disturbances like floaters can occur due to changes in blood flow or pressure during pregnancy. It's important to report these symptoms to a healthcare provider to rule out any serious conditions like preeclampsia.


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1 Comments


Tate McEwan#4033

10 mo ago

The big thing you don't want to miss is pre-eclampsia and related conditions. Definitely see or call an OB-GYN. Measure your blood pressure and get a urine test.

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