[32F] Experiencing chronic fatigue, mild heartburn, and tachycardia

Patient Description

A 32-year-old female has been experiencing chronic fatigue for several years, which intensifies in the afternoon and after being active all day. The fatigue is somewhat managed by taking naps. She has also gained weight and suspects it may be contributing to her mild heartburn, especially at night and after eating red meat. Additionally, the patient has been diagnosed with tachycardia since 2016. Other symptoms include perioral dermatitis, persistent hunger, and lack of motivation. The patient's current medications include Trentillix, certirizine, lo loestrin, spironolactone, clairvee, pepcid, multivitamin, azelastine, allergy shots, and Clindamycin. There are no known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Chronic Fatigue Syndrome: This is a complex disorder 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 condition is diagnosed by ruling out other potential causes of fatigue.

    • Treatment typically involves a combination of medications, therapy, and lifestyle changes to help manage symptoms.
  • Hypothyroidism: This is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones. Hypothyroidism may not cause noticeable symptoms in the early stages, but over time, untreated hypothyroidism can cause a number of health problems, such as obesity, joint pain, infertility and heart disease.

    • Treatment typically involves daily use of the synthetic thyroid hormone levothyroxine.
  • Depression: Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. It affects how you feel, think and behave and can lead to a variety of emotional and physical problems.

    • Treatment typically involves a combination of medications, therapy, and lifestyle changes.
  • Gastroesophageal Reflux Disease (GERD): This is a chronic condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In severe cases, prescription medication or surgery might be necessary.
  • Tachycardia: This is a common type of heart rhythm disorder (arrhythmia) in which the heart beats faster than normal while at rest.

    • Treatment options include vagal maneuvers, medications, cardioversion, catheter ablation, surgery or an implantable device.

Please note that these are potential diagnoses and you should consult a healthcare professional for a formal diagnosis.

What you can do

  1. Consult a healthcare professional: They can provide a formal diagnosis and treatment plan. They may also refer you to a specialist if necessary.

  2. Lifestyle changes: Regular exercise, a healthy diet, and adequate sleep can help manage your symptoms. Avoid foods that trigger your heartburn.

  3. Mental health support: If you're feeling depressed, it's important to seek help. This could be a mental health professional, a trusted person in your life, or a support group.

  4. Medication: Continue taking your current medications as prescribed by your doctor. If you're experiencing side effects or your symptoms aren't improving, consult your healthcare professional.

What you should look out for

If your symptoms worsen or you experience new symptoms, seek medical attention immediately. This includes severe chest pain, difficulty breathing, severe abdominal pain, or thoughts of harming yourself or others.

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1 yr ago

Top picked over-the-counter products for POTS: Heart Rhythm Society Treatment Consensus

People Also Ask


What are the common symptoms of Chronic Fatigue Syndrome?

Common symptoms of Chronic Fatigue Syndrome include severe fatigue that worsens with physical or mental activity, sleep problems, difficulty with memory or concentration, muscle or joint pain, headaches, and sore throat. These symptoms can vary in intensity and may come and go.


How can weight gain contribute to heartburn or GERD?

Weight gain can contribute to heartburn or GERD by increasing abdominal pressure, which can push stomach contents back up into the esophagus. This is especially true when lying down or after eating large meals, particularly those high in fat, like red meat.


What are the potential side effects of taking multiple medications for different conditions?

Taking multiple medications can lead to potential side effects such as drug interactions, increased risk of side effects from individual medications, and difficulty in managing the timing and dosage of each medication. It's important to regularly review all medications with a healthcare provider to ensure they are necessary and to manage any side effects.


How is tachycardia typically managed or treated?

Tachycardia is typically managed with lifestyle changes, medications to control heart rate, and in some cases, procedures like cardioversion or catheter ablation. In severe cases, surgery or an implantable device may be necessary. It's important to work with a healthcare provider to determine the best treatment plan.


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