[26M] Experiencing fatigue, sweating, and cardiac symptoms

Patient Description

A 26-year-old male presents with a long-standing history of fatigue, stating he wakes up tired and lacks energy throughout the day, a condition persisting for approximately 8 years. The patient also reports excessive sweating of the palms, lower back, and buttocks, which occurs even in cool environments and has been ongoing for 4 years. Additionally, the patient experiences red and irritated eyes, insomnia, and occasional chest pain accompanied by irregular heartbeat. The patient has been on Trazodone 100 mg nightly for 5 years to aid with sleep, which results in morning grogginess. There are no known allergies or adverse reactions to medications, and no other medications, supplements, or herbal remedies are being taken. The patient does not report any pre-existing conditions or chronic illnesses and has not noticed any recent changes in weight.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Hyperthyroidism: This condition occurs when your thyroid gland produces too much of the thyroid hormones. Common symptoms include unexplained weight loss, rapid or irregular heartbeat, sweating, and irritability. Fatigue and difficulty sleeping are also common.

    • Treatment typically involves medication to slow down your thyroid, and in some cases, surgery may be necessary.
  • Anxiety Disorders: These are a group of mental health disorders characterized by feelings of anxiety and fear. Symptoms can include restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbances.

    • Treatment typically involves psychotherapy (talk therapy), medication, or both.
  • Insomnia: This is a sleep disorder that can make it hard to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. Chronic insomnia can lead to daytime fatigue or sleepiness.

    • Treatment can involve improving sleep habits, behavior therapy, and medications.

Please note that these are just possibilities and not a definitive diagnosis. You should consult with a healthcare professional who can evaluate your symptoms more thoroughly.

What you can do

  1. Schedule an appointment with your primary care physician to discuss your symptoms. They may refer you to a specialist or order further tests to help determine the cause of your symptoms.
  2. Keep a symptom diary: note down when your symptoms occur, their severity, and any potential triggers. This can be helpful information for your doctor.
  3. Try to maintain a regular sleep schedule and practice good sleep hygiene. This includes going to bed and waking up at the same time every day, keeping your bedroom dark and quiet, and avoiding caffeine and heavy meals close to bedtime.
  4. Regular exercise can help regulate your sleep patterns and reduce anxiety. Aim for at least 30 minutes of moderate-intensity exercise most days of the week.

What you should look out for

You should seek immediate medical attention if you experience:

  • Severe chest pain or discomfort
  • Trouble breathing
  • Fainting or loss of consciousness
  • Severe or worsening irregular heartbeat

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, diagnosis, and treatment.

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1 yr ago

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People Also Ask


What are the common symptoms of hyperthyroidism?

Common symptoms of hyperthyroidism include unexplained weight loss, rapid or irregular heartbeat, sweating, irritability, fatigue, and difficulty sleeping.


How can anxiety disorders affect sleep and energy levels?

Anxiety disorders can lead to restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbances, all of which can significantly affect sleep and energy levels.


What are some effective treatments for chronic insomnia?

Effective treatments for chronic insomnia include improving sleep habits, behavior therapy, and medications. It's important to maintain a regular sleep schedule and practice good sleep hygiene.


When should I seek immediate medical attention for chest pain?

You should seek immediate medical attention for chest pain if it is severe, accompanied by trouble breathing, fainting, loss of consciousness, or a severe or worsening irregular heartbeat.


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