[29F] Experiencing extreme fatigue and new sensitivity to smells

Patient Description

A 29-year-old female has been experiencing extreme fatigue for a couple of weeks, which has significantly impacted her daily activities. Alongside the fatigue, she reports a new onset of high sensitivity to smells, making it difficult for her to eat due to food aversion. She finds some relief from nausea by laying down. Her last menstrual period was in September. The patient has a medical history of high cholesterol, diagnosed in August, and is currently taking Buspar (10mg three times a day) and Effexor (150mg every other day). She denies any recent changes in lifestyle, diet, or significant life events and has no known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Pregnancy: Given your symptoms of extreme fatigue, nausea, food aversions, sore breasts, nipple discharge, visible veins, and missed menstrual period since September, pregnancy is a possibility. These symptoms are common in early pregnancy due to hormonal changes.

    • Testing: A home pregnancy test or a visit to your healthcare provider for a blood test can confirm pregnancy.
    • Treatment: If you are pregnant, prenatal care is important for your health and the baby's health.
  2. Hormonal Imbalance: Conditions such as thyroid disorders or other hormonal imbalances can cause fatigue, changes in menstrual cycles, and breast changes.

    • Testing: Blood tests to check hormone levels, including thyroid function tests, can help diagnose these conditions.
    • Treatment: Treatment depends on the specific condition but may include medication to balance hormone levels.
  3. Side Effects of Medication: Effexor (venlafaxine) can sometimes cause fatigue, nausea, and changes in appetite. It's important to discuss any side effects with your healthcare provider.

    • Treatment: Your doctor may adjust your medication dosage or suggest an alternative if side effects are significant.

What you can do

  1. Consult a Healthcare Provider: It's important to see a healthcare provider to discuss your symptoms and get appropriate tests, such as a pregnancy test or hormone level tests.
  2. Track Your Symptoms: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider. This can help in identifying patterns or triggers.
  3. Rest and Nutrition: Ensure you get adequate rest and maintain a balanced diet. Small, frequent meals may help with nausea and food aversions.
  4. Stay Hydrated: Drink plenty of fluids, especially if you're experiencing nausea and food aversions.

What you should look out for

  • Seek Immediate Care: If you experience severe abdominal pain, heavy bleeding, or any other concerning symptoms, seek medical attention promptly.
  • Monitor Symptoms: Keep an eye on your symptoms, especially if they worsen or new symptoms develop.

Remember, while this information can be helpful, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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1 mo ago


People Also Ask


Could my symptoms be related to pregnancy?

Yes, your symptoms such as extreme fatigue, nausea, food aversions, and a missed menstrual period could be indicative of pregnancy. A home pregnancy test or a blood test at your healthcare provider's office can confirm this.


What are the possible causes of extreme fatigue and nausea?

Extreme fatigue and nausea can be caused by several factors, including pregnancy, hormonal imbalances like thyroid disorders, or side effects from medications. It's important to consult with a healthcare provider to determine the exact cause.


Can my current medications cause these symptoms?

Yes, Effexor (venlafaxine) can sometimes cause side effects such as fatigue, nausea, and changes in appetite. It's important to discuss any side effects with your healthcare provider, who may adjust your medication or suggest alternatives.


What tests should I consider to determine the cause of my symptoms?

To determine the cause of your symptoms, you should consider a pregnancy test and blood tests to check hormone levels, including thyroid function tests. These can help diagnose conditions like pregnancy or hormonal imbalances.


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