[30F] Experiencing persistent postpartum nausea and lightheadedness

Patient Description

A 30-year-old female presents with ongoing nausea since giving birth in September 2021, described as unrelenting 'morning sickness.' Additionally, she experiences lightheadedness, characterized by 'fainting spells,' which have been occurring for a few years. The patient reports constant fatigue from morning until night, worsening with exercise, and not alleviated by rest. She has a history of anemia and asthma, diagnosed in 2004, and is currently taking a daily multivitamin and the birth control pill Vienva. The patient also notes a recent weight change and a runny nose. No recreational drug use, alcohol, or tobacco products are reported. The patient cannot take iron pills and requires transfusions for iron supplementation.

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Arora's Assessment

What might be happening

Based on the information you provided, possible explanations for your symptoms include:

  • Chronic Fatigue Syndrome: 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. This could explain your constant tiredness and difficulty focusing.

  • Postural Orthostatic Tachycardia Syndrome (POTS): This is a condition that affects circulation and can cause lightheadedness or fainting. It's often associated with an increase in heart rate when standing.

  • Pregnancy: Even though you mentioned you're not currently pregnant, the symptoms of nausea, fatigue, and lightheadedness are common in early pregnancy. If there's a chance you could be pregnant, it might be worth taking a home pregnancy test.

  • Side effects of birth control: Some women experience side effects from birth control pills, which can include nausea, weight gain, and changes in mood or energy levels.

  • Anemia: As you mentioned you have a history of anemia, this could also be contributing to your fatigue and lightheadedness.

What you can do

  1. Consult a healthcare professional: Given the range of possible causes for your symptoms, it's important to seek a formal diagnosis from a healthcare provider. They can order tests, refer you to a specialist if necessary, and suggest appropriate treatment options.

  2. Monitor your symptoms: Keep a symptom diary noting when you experience each symptom and any potential triggers. This can help your healthcare provider in diagnosing your condition.

  3. Maintain a healthy lifestyle: Regular exercise, a balanced diet, and adequate sleep can help manage symptoms of fatigue. However, don't push yourself if you're feeling unwell.

  4. Stay hydrated: This can help manage your symptoms of lightheadedness.

What you should look out for

If your symptoms worsen, or you experience new symptoms such as severe headache, chest pain, difficulty breathing, or severe abdominal pain, seek immediate medical attention.

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, testing, and care recommendations.

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10 mo ago

People Also Ask


What are the common symptoms of Chronic Fatigue Syndrome?

Common symptoms of Chronic Fatigue Syndrome include severe fatigue that doesn't improve with rest, sleep disturbances, muscle or joint pain, headaches, sore throat, and difficulty concentrating or remembering things.


How is Postural Orthostatic Tachycardia Syndrome (POTS) diagnosed?

POTS is typically diagnosed through a combination of medical history, physical examination, and tests such as a tilt table test or active stand test, which measure heart rate and blood pressure changes when moving from lying down to standing.


Can birth control pills cause nausea and fatigue?

Yes, birth control pills can cause side effects such as nausea, fatigue, weight gain, and mood changes. These symptoms can vary depending on the individual and the type of birth control pill used.


What are the alternatives to iron pills for someone with anemia?

For individuals who cannot take iron pills, alternatives include dietary changes to increase iron intake, intravenous iron therapy, or blood transfusions, depending on the severity of the anemia and the underlying cause.


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