[31F] Experiencing chronic fatigue and fluctuating heart rate

What might be happening

Based on the symptoms and history you've shared, there are a few potential explanations for what you might be experiencing:

1. Postural Orthostatic Tachycardia Syndrome (POTS) or Dysautonomia: Your symptoms of dizziness, fluctuating heart rate, fatigue, and nausea, especially when changing positions, could suggest a condition like POTS, which is a form of dysautonomia. This condition affects the autonomic nervous system and can cause the heart rate to increase significantly upon standing. Testing often involves a tilt table test or active stand test.

2. Chronic Fatigue Syndrome (CFS): Given your long-standing fatigue that disrupts daily life, CFS could be a consideration. This condition is characterized by severe, persistent fatigue that doesn't improve with rest and is often accompanied by other symptoms like headaches and muscle pain. Diagnosis is typically based on symptom criteria, as there is no specific test for CFS.

3. Liver Function Abnormalities: Your low ALT and AST levels, while not typical indicators of liver disease, could still suggest some liver function irregularities. It's important to follow up with your healthcare provider to understand these results in the context of your overall health.

4. Cardiovascular Issues: The combination of chest pain, fluctuating heart rate, and blood pressure changes could indicate a cardiovascular issue. While your echocardiogram was normal, it's important to continue monitoring these symptoms with your healthcare provider.

What you can do

Managing Symptoms:

• Fatigue and Dizziness: Try to pace your activities and take breaks as needed. Staying hydrated and increasing salt intake (if advised by your doctor) can help manage dizziness.
• Nausea: Eating small, frequent meals and avoiding triggers like strong odors or spicy foods may help. Ginger or peppermint tea can also be soothing.
• Headaches: Ensure you're staying hydrated and consider relaxation techniques like deep breathing or meditation to help manage stress-related headaches.

Lifestyle Adjustments:

• Heart Rate and Blood Pressure: Monitor your heart rate and blood pressure regularly. Keep a journal of your symptoms, noting any patterns or triggers, and share this with your healthcare provider.
• Exercise: Engage in gentle, regular exercise like walking or swimming, which can help improve circulation and overall well-being. However, avoid overexertion.

Medical Follow-Up:

• Consult Specialists: Consider seeing a cardiologist or a neurologist for further evaluation of your symptoms. They may recommend additional tests or treatments.
• Medication Review: Discuss your current medications with your healthcare provider to ensure they are appropriate and not contributing to your symptoms.

Use MDandMe: Utilize the MDandMe app to journal your symptoms, track your progress, and share detailed notes with your healthcare provider. This can help in identifying patterns and making informed decisions about your care.

What you should look out for

It's important to seek medical attention if you experience any of the following:

• Severe chest pain or pressure that doesn't go away
• Fainting or severe dizziness
• Significant swelling in your legs or other parts of your body
• Any new or worsening symptoms

Remember, while I can provide information and suggestions, it's crucial to work closely with your healthcare provider to receive a formal diagnosis and appropriate treatment.