[33F] Experiencing chronic hives, foot cramps, nausea, and sadness

Patient Description

A 33-year-old female has been experiencing chronic hives for over 10 years, which manifest as raised, red, and itchy lesions on her back, sides, stomach, butt, legs, arms, neck, wrist, and hands. These hives appear within a minute of skin being scratched or exposed to water and can last from 5 minutes to several hours. She also reports severe cramps in her left foot for the past 2 days, rating the pain as an 8 out of 10, which is somewhat alleviated by holding her foot. Additionally, she has been feeling slightly nauseous for 2 days, affecting her appetite, and has felt sad since stopping Zyrtec, which also coincided with an increase in itching. One side of her face is swollen, but there is no difficulty breathing or swallowing. She also experiences occasional muscle weakness in her hands and legs. Her current medications include Prozac 40mg, Vyvanse 50mg, and Trazodone 100mg, which she takes daily. There is no recent history of new medications, allergies, or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Chronic Urticaria (Hives): This is a condition where hives or welts appear on the skin, last for more than six weeks, and often come and go. The hives are usually itchy and can also burn or sting. Some people also experience swelling beneath the skin, known as angioedema. This could explain your hives and facial swelling. The fact that your hives have worsened since stopping Zyrtec, an antihistamine, also supports this diagnosis.

    • Treatment typically involves antihistamines to control the itching. In some cases, other medications may be needed.

  • Muscle Cramps: These are sudden, involuntary contractions that occur in various muscles. These contractions are often painful and can occur in any muscle group. Your foot cramps could be due to a variety of causes, including dehydration, muscle fatigue, or lack of certain nutrients.

    • Treatment often involves stretching and massaging the muscle, and ensuring adequate hydration and nutrition.

  • Depression: This is a mood disorder that causes a persistent feeling of sadness and loss of interest. It can lead to a variety of emotional and physical problems. Your feelings of sadness and lack of appetite could be signs of depression.

    • Treatment typically involves psychotherapy (talk therapy), medications, or a combination of both.

Please note that this is not an exhaustive list of possible conditions, and these conditions may not fully explain all of your symptoms. It's also possible that you could be experiencing side effects from your medications.

What you can do

  1. Consult with a healthcare provider: They can provide a formal assessment, order relevant tests if necessary, and guide you on the next steps for management.
  2. Monitor your symptoms: Keep track of when your symptoms occur, how long they last, and any potential triggers. This information can be helpful for your healthcare provider.
  3. Self-care: Ensure you're eating a balanced diet, staying hydrated, getting regular exercise, and getting enough sleep. These can all help improve your overall health and may help alleviate some of your symptoms.

What you should look out for

Contact a healthcare provider immediately if you experience:

  • Difficulty breathing or swallowing
  • Hives or swelling that doesn't improve with over-the-counter antihistamines
  • Severe depression symptoms, such as thoughts of harming yourself or others
  • Severe or persistent muscle cramps that don't improve with self-care measures

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 accurate information.

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9 mo ago

People Also Ask

What are the common triggers for chronic hives and how can they be managed?

Common triggers for chronic hives include stress, certain foods, medications, insect stings, and environmental factors like heat or cold. Management typically involves avoiding known triggers, taking antihistamines, and sometimes using other medications like corticosteroids or biologics under a doctor's guidance.

What could be causing muscle cramps and how can they be relieved?

Muscle cramps can be caused by dehydration, muscle fatigue, or deficiencies in minerals like potassium, calcium, or magnesium. Relief can often be achieved through stretching, massaging the affected muscle, staying hydrated, and ensuring a balanced diet.

How can stopping an antihistamine like Zyrtec affect chronic hives?

Stopping an antihistamine like Zyrtec can lead to a rebound effect, where symptoms such as itching and hives may worsen temporarily. This is because the body has become accustomed to the medication's effects, and it may take time to adjust after discontinuation.

What are the potential side effects of medications like Prozac, Vyvanse, and Trazodone?

Prozac can cause side effects like nausea, dizziness, and changes in appetite. Vyvanse may lead to decreased appetite, insomnia, and anxiety. Trazodone can cause drowsiness, dizziness, and dry mouth. It's important to discuss any concerning side effects with a healthcare provider.

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