[35F] With chronic shortness of breath and lightheadedness

Patient Description

A 35-year-old female has been experiencing shortness of breath and lightheadedness for 2-3 years, exacerbated by walking and standing. Episodes occur a few times a month and resolve spontaneously. Previous evaluations were unremarkable. Indigestion with burning sensation in the stomach and throat has been present for about a year and a half, worsened by alcohol and caffeine. Random bouts of lightheadedness and a racing heart rate of 125 bpm occur, with heart palpitations happening inconsistently for a couple of years. Stress appears to exacerbate these symptoms. Hair loss has been gradual over the past two years, with brittleness and 45-50% loss, especially around the ears and right side of the head. Family history includes thyroid issues, but thyroid function tests are normal. The patient is temperature-sensitive, with worsening lightheadedness in heat and cold sensitivity. Ferritin and iron saturation levels were normal last year. Current medications include Prozac 30 mg daily, omeprazole as needed, quercetin, and B12. No medication allergies reported.

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Arora's Assessment

What might be happening

Your symptoms could be related to several underlying issues:

  1. Anxiety or Panic Disorders: Your heart palpitations, racing heart, and shortness of breath could be related to anxiety, especially since stress seems to affect these symptoms. Anxiety can also cause lightheadedness and indigestion.

  2. Gastroesophageal Reflux Disease (GERD): Your indigestion and burning sensation in your stomach and throat may be due to GERD, which can be exacerbated by certain foods and stress.

  3. Iron Deficiency or Anemia: Although your iron levels were considered normal, symptoms like hair loss, fatigue, and lightheadedness can sometimes be related to low iron stores.

  4. Thyroid Issues: Despite normal tests, your family history and symptoms like hair loss and temperature sensitivity could suggest a thyroid imbalance.

  5. Autonomic Dysfunction: This could explain your heart rate changes, lightheadedness, and temperature sensitivity.

What you can do

For Shortness of Breath and Lightheadedness:

  • Consult a healthcare provider: It's important to rule out any serious conditions. They may suggest further cardiac or pulmonary evaluations.
  • Practice stress-reduction techniques: Consider mindfulness, meditation, or yoga to help manage stress and anxiety.

For Indigestion and Bloating:

  • Dietary changes: Avoid alcohol, caffeine, and other trigger foods. Eat smaller, more frequent meals.
  • Continue omeprazole: As needed, but discuss long-term use with your doctor.

For Heart Palpitations:

  • Monitor your heart rate: Keep a journal of when palpitations occur and any associated activities or stressors.
  • Limit stimulants: Reduce caffeine and alcohol intake.

For Hair Loss:

  • Consult a dermatologist: They can evaluate for conditions like alopecia or nutritional deficiencies.
  • Consider supplements: Discuss with your doctor if supplements like biotin might help.

For Overall Health:

  • Regular check-ups: Ensure regular follow-ups with your healthcare provider to monitor symptoms and adjust treatments as needed.
  • Use MDandMe: Journal your symptoms, track progress, and share insights with your provider.

What you should look out for

  • Seek immediate care if you experience severe shortness of breath, chest pain, or fainting.
  • Monitor for new symptoms: Such as significant weight changes, increased fatigue, or worsening palpitations.
  • Regularly review your medications with your healthcare provider to ensure they are still appropriate for your symptoms.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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4 mo ago

Top picked over-the-counter products for Tingling or Cold Sensations at the Back of Your Head

People Also Ask


What could be causing my shortness of breath and lightheadedness?

Your shortness of breath and lightheadedness could be related to anxiety or panic disorders, autonomic dysfunction, or other underlying conditions. It's important to consult a healthcare provider to rule out serious issues and consider stress-reduction techniques.


How can I manage my indigestion and burning sensation in the stomach and throat?

Indigestion and burning sensations may be due to Gastroesophageal Reflux Disease (GERD). Managing this can involve dietary changes, such as avoiding alcohol and caffeine, eating smaller meals, and using medications like omeprazole as needed.


Why am I experiencing heart palpitations and a racing heart rate?

Heart palpitations and a racing heart rate can be symptoms of anxiety or autonomic dysfunction. Monitoring your heart rate, reducing stress, and limiting stimulants like caffeine and alcohol can help manage these symptoms.


What might be the reason for my gradual hair loss and brittleness?

Gradual hair loss and brittleness could be related to nutritional deficiencies, thyroid issues, or other conditions. Consulting a dermatologist and considering supplements like biotin, under a doctor's guidance, may be beneficial.


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