[28F] Experiencing excessive sleepiness and nutritional deficiencies post-gastric sleeve
Patient Description
A 28-year-old female reports excessive sleepiness, sleeping all night and taking two 3-hour naps during the day, which began suddenly about two months ago. This has impacted her work schedule, and she experiences low energy levels. She has a dark or purplish discoloration on the sides of her forehead, present for about a year and gradually darkening. She experiences shortness of breath with exertion but denies chest pain or palpitations. No headaches or lightheadedness are reported.
The patient has a history of gastric sleeve surgery 8 years ago, affecting her dietary intake. She has low vitamin D and iron levels, with slight improvement in iron after IV infusions but no improvement in vitamin D levels. She takes Trazodone at night and Bupropion in the morning, along with occasional heartburn medication, though she is unsure of the dosage or name of the heartburn medication. No other pre-existing conditions or chronic illnesses are reported.
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Arora's Assessment
What might be happening
Your symptoms could be related to several issues:
-
Excessive Sleepiness and Low Energy:
- Nutritional Deficiencies: Low vitamin D and iron can cause fatigue and low energy. Iron is crucial for carrying oxygen in your blood, and vitamin D is important for overall health.
- Medication Side Effects: Trazodone and Bupropion can sometimes cause drowsiness or fatigue.
-
Discoloration on Forehead:
- Skin Changes: This could be related to hormonal changes, sun exposure, or other dermatological conditions. It's best to have this evaluated by a dermatologist.
-
Shortness of Breath with Exertion:
- Anemia: Low iron levels can lead to anemia, which might cause shortness of breath during physical activity.
- Cardiovascular or Respiratory Issues: These should be evaluated by a healthcare provider.
What you can do
For Excessive Sleepiness and Low Energy:
- Follow Up on Nutritional Deficiencies: Continue with your supplements and discuss with your doctor about adjusting doses if needed.
- Monitor Medication Effects: Talk to your doctor about the side effects of Trazodone and Bupropion. They might adjust your dosage or try different medications.
For Discoloration on Forehead:
- Consult a Dermatologist: They can provide a proper diagnosis and treatment options.
For Shortness of Breath:
- Seek Medical Evaluation: It's important to rule out anemia or other underlying conditions. Your doctor might perform blood tests or other assessments.
General Tips:
- Healthy Diet: Focus on a balanced diet rich in iron and vitamin D. Foods like leafy greens, fish, and fortified cereals can help.
- Regular Check-Ups: Keep up with regular medical appointments to monitor your condition.
Consider using MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.
What you should look out for
Seek medical attention if you experience:
- Worsening shortness of breath or chest pain.
- Significant changes in skin discoloration.
- Increased fatigue or new symptoms.
Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.
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8 mo ago
