[27F] Experiencing a range of chronic symptoms

Patient Description

A 27-year-old female presents with a complex medical history, including a persistent low-grade fever with a consistent pattern, chronic watery diarrhea occurring multiple times daily for the past 3 years, daily fatigue, severe dull muscle aches in the back and neck for 5 years, chills, sharp and achy lower back pain rated 10/10 for 3 years, intermittent aching neck pain rated 10/10 for 6 months, and vomiting for 4 months triggered by a choking sensation. Additionally, the patient reports severe insomnia, difficulty waking up, depression, anxiety, and weight gain. The patient was diagnosed with PCOS, an autoimmune disease, anxiety, and depression in the past year. Current medications include Prolate, morphine, Rexulti, busprione, Lexapro, diclofenac, and gabapentin. No known drug allergies. The patient's symptoms significantly impair daily functioning.

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Arora's Assessment

What might be happening

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

  • Chronic Fatigue Syndrome (CFS): This condition is 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. Other symptoms can include loss of memory or concentration, sore throat, enlarged lymph nodes in your neck or armpits, unexplained muscle or joint pain, headaches, and unrefreshing sleep.

  • 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.

  • Polycystic Ovary Syndrome (PCOS): This hormonal disorder common among women of reproductive age can lead to irregular periods, weight gain, and depression, among other symptoms.

  • Autoimmune Disease: You mentioned you have an autoimmune disease. Many autoimmune diseases can cause symptoms like fatigue, muscle aches, and low-grade fever.

  • Depression and Anxiety: These mental health conditions can cause physical symptoms like fatigue, difficulty sleeping, and weight gain.

  • Side Effects of Medication: Some of your symptoms may also be side effects of the medications you're taking. For example, Rexulti can cause weight gain and insomnia, and morphine can cause nausea and vomiting.

What you can do

  1. Consult with your healthcare provider: Given the range and severity of your symptoms, it's important to discuss these with your healthcare provider. They can help determine the underlying cause and appropriate treatment.

  2. Monitor your symptoms: Keep a symptom diary noting when each symptom occurs, its severity, and any potential triggers. This can help your healthcare provider identify patterns and potential causes.

  3. Maintain a healthy lifestyle: Regular exercise, a balanced diet, and adequate sleep can help manage symptoms of many conditions, including PCOS, fibromyalgia, and depression.

  4. Mental health support: If you're not already doing so, consider seeking support for your depression and anxiety. This could include therapy, medication, or both.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe pain or discomfort
  • High fever (over 103°F or 39.4°C)
  • Difficulty breathing
  • Severe vomiting or diarrhea
  • Thoughts of harming yourself or others

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 accurate information.

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11 mo ago

People Also Ask


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

Chronic Fatigue Syndrome (CFS) is characterized by extreme fatigue that doesn't improve with rest and worsens with physical or mental activity. Other symptoms include loss of memory or concentration, sore throat, enlarged lymph nodes, unexplained muscle or joint pain, headaches, and unrefreshing sleep.


How does fibromyalgia affect the body and what are its symptoms?

Fibromyalgia affects the body by causing widespread musculoskeletal pain, fatigue, and issues with sleep, memory, and mood. It amplifies painful sensations by affecting the way the brain processes pain signals.


What are the potential side effects of taking medications like Rexulti and morphine?

Rexulti can cause side effects such as weight gain and insomnia, while morphine can lead to nausea and vomiting. It's important to discuss any side effects with a healthcare provider to manage them effectively.


How can Polycystic Ovary Syndrome (PCOS) impact mental health?

Polycystic Ovary Syndrome (PCOS) can impact mental health by contributing to symptoms like depression and anxiety. The hormonal imbalances and physical symptoms associated with PCOS can affect mood and emotional well-being.


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