[30F] Experiencing dizziness and nausea after medication lapse

Patient Description

A 30-year-old female is experiencing severe dizziness, rated 7 out of 10, along with nausea, vomiting, weakness, sweating, headache, and jaw pain for the past three days. The dizziness began suddenly and is exacerbated by movement. The patient has not found relief from these symptoms. There is no history of chest pain, ear infections, changes in hearing, recent head injuries, significant stress, viral infections, or changes in vision or balance issues. The patient ran out of levothyroxine and Lexapro a few weeks ago and has not taken them since, but has not experienced similar symptoms in the past when missing doses. The patient is currently taking birth control and has no known allergies or adverse reactions to medications. No pre-existing conditions or chronic illnesses were reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations:

  1. Vestibular Neuritis or Labyrinthitis: These conditions involve inflammation of the inner ear, which can cause sudden dizziness (vertigo), nausea, and imbalance. They are often viral in origin and can occur without prior ear infections.

  2. Medication Withdrawal: Since you've stopped taking levothyroxine and Lexapro, it's possible that withdrawal or the absence of these medications is contributing to your symptoms. Lexapro, in particular, can cause withdrawal symptoms like dizziness, nausea, and headaches if stopped abruptly.

  3. Migraine-Associated Vertigo: This condition can cause dizziness, headaches, and nausea, even without a typical migraine headache. The jaw pain could be related to muscle tension associated with migraines.

  4. Thyroid Dysfunction: Running out of levothyroxine could lead to symptoms of hypothyroidism, such as fatigue, weakness, and dizziness, although these typically develop more gradually.

What you can do

Dizziness and Nausea:

  • Try to minimize sudden movements and rest in a comfortable position.
  • Stay hydrated by drinking clear fluids like water or ginger tea, which can also help with nausea.
  • Over-the-counter medications like meclizine (for dizziness) or anti-nausea medications may provide some relief, but consult a healthcare provider before use.

Medication Management:

  • Contact your healthcare provider or pharmacy to refill your prescriptions for levothyroxine and Lexapro as soon as possible. Restarting these medications under medical guidance may help alleviate some of your symptoms.

General Well-being:

  • Keep a journal of your symptoms using MDandMe to track any changes or patterns. This can be helpful for your healthcare provider to understand your condition better.
  • Ensure you are eating regular, balanced meals to maintain energy levels.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening symptoms, such as increased dizziness, vomiting, or headaches.
  • New symptoms like chest pain, shortness of breath, or fainting.
  • Any signs of dehydration, such as reduced urination, dry mouth, or extreme thirst.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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1 mo ago


People Also Ask


Can stopping Lexapro suddenly cause dizziness and nausea?

Yes, stopping Lexapro suddenly can lead to withdrawal symptoms, including dizziness, nausea, headaches, and other flu-like symptoms. It's important to consult a healthcare provider before discontinuing any medication.


What are the symptoms of vestibular neuritis or labyrinthitis?

Vestibular neuritis or labyrinthitis can cause sudden dizziness (vertigo), nausea, vomiting, imbalance, and sometimes hearing changes. These conditions are often due to viral infections affecting the inner ear.


How can missing doses of levothyroxine affect my health?

Missing doses of levothyroxine can lead to symptoms of hypothyroidism, such as fatigue, weakness, dizziness, and weight gain. However, these symptoms usually develop gradually over time.


What should I do if I experience severe dizziness and nausea?

If you experience severe dizziness and nausea, try to rest in a comfortable position, avoid sudden movements, and stay hydrated. Over-the-counter medications may help, but it's best to consult a healthcare provider for advice. Seek medical attention if symptoms worsen or new symptoms develop.


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