[36F] Experiencing persistent fatigue and other symptoms

Patient Description

A 36-year-old female reports persistent fatigue and lack of energy, which has worsened over the past few months. She experiences daily episodes of lightheadedness, sweating, and shakiness, which last most of the day. The patient also reports recent occurrences of hot flashes over the past few weeks. Additionally, she describes significant changes in her menstrual cycle, with severe mood swings and depression leading up to her period. She has difficulty falling asleep, itchy skin, acne, and hair shedding. The patient recalls a sudden weight gain of 15 lbs two years ago, which resolved after a week, and a history of an emergency C-section in 2014 due to placental abruption. Recently, she experienced dizziness and sweating with a blood pressure reading of 86/64, followed by acid reflux and constipation. No recent blood tests or evaluations have been conducted to investigate these symptoms. The patient has not been tested for thyroid function and has no known exposure to radiation or neck surgeries.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Thyroid Dysfunction: Your symptoms, including fatigue, lightheadedness, sweating, shakiness, difficulty sleeping, itchy skin, acne, and hair shedding, could be related to an underactive thyroid (hypothyroidism) or other thyroid issues. The thyroid gland regulates many body functions, and imbalances can lead to these symptoms. A simple blood test can evaluate your thyroid function.

  2. Hormonal Imbalances: Given the changes in your menstrual cycle and the presence of hot flashes, hormonal imbalances such as perimenopause or other endocrine disorders could be contributing to your symptoms. Hormonal fluctuations can affect mood, energy levels, and skin health.

  3. Adrenal Insufficiency: This condition occurs when the adrenal glands do not produce enough hormones, leading to symptoms like fatigue, low blood pressure, and dizziness.

  4. Nutritional Deficiencies: Deficiencies in certain vitamins and minerals, such as iron, vitamin D, or B vitamins, can lead to fatigue, mood changes, and skin issues.

  5. Chronic Fatigue Syndrome: This is a complex disorder characterized by extreme fatigue that doesn't improve with rest and may worsen with physical or mental activity.

What you can do

  1. Consult a Healthcare Professional: It's important to see a doctor for a thorough evaluation, including blood tests to check your thyroid function, hormone levels, and nutritional status. They can provide a proper diagnosis and treatment plan.

  2. Track Your Symptoms: Use MDandMe to journal your symptoms, track progress, and get insights. This information can be valuable for your healthcare provider to understand your condition better.

  3. Maintain a Balanced Diet: Ensure you're getting a nutritious diet rich in essential vitamins and minerals. Consider taking a multivitamin if recommended by your doctor.

  4. Manage Stress: Practice stress-reducing techniques such as meditation, yoga, or deep breathing exercises to help manage mood changes and improve sleep quality.

  5. Stay Hydrated: Drink plenty of water throughout the day to help manage lightheadedness and support overall health.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening symptoms
  • New or unusual symptoms
  • Difficulty breathing or chest pain
  • Persistent dizziness or fainting

Remember, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment. If you have any more questions or need further assistance, feel free to ask!

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10 d ago

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People Also Ask


What are the common symptoms of thyroid dysfunction?

Common symptoms of thyroid dysfunction, particularly hypothyroidism, include fatigue, weight gain, cold intolerance, dry skin, hair loss, constipation, and depression. Hyperthyroidism can cause weight loss, heat intolerance, anxiety, and palpitations.


How can hormonal imbalances affect menstrual cycles and mood?

Hormonal imbalances can lead to irregular menstrual cycles, severe mood swings, depression, and physical symptoms like hot flashes. These changes are often due to fluctuations in estrogen and progesterone levels, especially during perimenopause.


What are the signs of adrenal insufficiency?

Signs of adrenal insufficiency include chronic fatigue, muscle weakness, loss of appetite, weight loss, low blood pressure, dizziness, and sometimes darkening of the skin. It can also cause salt cravings and abdominal pain.


Which nutritional deficiencies can lead to fatigue and skin issues?

Nutritional deficiencies such as iron deficiency can cause fatigue and pale skin, vitamin D deficiency can lead to fatigue and bone pain, and B vitamin deficiencies can result in fatigue, mood changes, and skin issues like acne or rashes.


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