[37F] With sweating, chills, and gastrointestinal symptoms

Patient Description

A 37-year-old female presents with severe sweating, chills, diarrhea, loss of appetite, and crampy stomach pain. The sweating started six days ago, is severe enough to soak clothes, and is exacerbated by movement or overheating. The patient reports no fever, with normal temperature readings. The abdominal pain, rated 5/10, is located near the upper part of the belly button and is somewhat relieved by Pepto Bismol. Severe diarrhea occurred on the first day, with no bowel movements since then. The patient also experiences nausea but no vomiting or blood in the stool. There are no signs of dehydration. The patient has a history of fibromyalgia (diagnosed 18 years ago), arthritis (7 years ago), bursitis (diagnosed 5 years ago but symptomatic for 18 years), insomnia (25 years ago), and hypothyroidism. Medications include Adderall (30mg twice a day), Wellbutrin (300mg in the morning, 150mg in the afternoon), gabapentin (800mg 4x a day), Prozac (20mg once a day), Clonazepam (1mg 2x a day as needed), Methadone (65mg in the morning and evening), levothyroxine (75mcg once a day), baclofen (10mg 2x a day as needed), and a Qvar inhaler (80mg, 2 puffs twice a day). The patient also takes ibuprofen (600mg every 4-6 hours) and Pepto Bismol as needed. The patient has irregular menstrual periods but recently had two periods within 30 days, with the last one ending three days ago. No recent travel, exposure to sick individuals, or consumption of unusual foods. The patient has a cat that has shown no signs of illness.

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Arora's Assessment

What might be happening

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

  • Gastroenteritis: This is an inflammation of the stomach and intestines, often caused by a viral or bacterial infection. Symptoms can include diarrhea, stomach pain, nausea, vomiting, chills, and sweating. It often resolves on its own but can be severe in some cases.

    • Treatment: Typically involves staying hydrated, resting, and eating bland foods. In some cases, antibiotics or antiviral medications may be necessary.
  • Thyroid Imbalance: Given your history of hypothyroidism and the medications you are on, it's possible that your thyroid levels are not well-controlled, which can cause symptoms like sweating, chills, and gastrointestinal issues.

    • Treatment: Adjusting your thyroid medication under the guidance of a healthcare provider.
  • Medication Side Effects: Some of the medications you are taking, such as Wellbutrin and Methadone, can cause gastrointestinal symptoms, sweating, and chills as side effects.

    • Treatment: Discussing with your healthcare provider to adjust dosages or switch medications.
  • Fibromyalgia Flare-Up: While fibromyalgia primarily causes musculoskeletal pain, it can also lead to gastrointestinal symptoms and sweating.

    • Treatment: Managing stress, getting adequate rest, and possibly adjusting your fibromyalgia medications.

What you can do

While you should consult a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

  1. Stay Hydrated: Drink plenty of fluids like water, herbal teas, and clear broths to stay hydrated, especially if you had severe diarrhea.
  2. Eat Bland Foods: Stick to bland, easy-to-digest foods like bananas, rice, applesauce, and toast (the BRAT diet) until your stomach feels better.
  3. Rest: Make sure to get plenty of rest to help your body recover.
  4. Monitor Symptoms: Use MDandMe to journal your symptoms, track your progress, and share this information with your healthcare provider.
  5. Avoid Triggers: Pay attention to any foods or activities that seem to worsen your symptoms and try to avoid them.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

  • Severe Abdominal Pain: If your stomach pain becomes severe or unbearable.
  • Persistent Symptoms: If your symptoms do not improve or worsen over the next few days.
  • Signs of Dehydration: Such as dry mouth, dark urine, or dizziness.
  • High Fever: If you develop a fever over 100.4°F.
  • Blood in Stool: If you notice any blood in your stool.

Remember, while this advice can help you manage your symptoms, it is not a substitute for professional medical care. Please consult a healthcare provider for a formal diagnosis and treatment plan.

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3 mo ago


People Also Ask


What are the common causes of severe sweating and chills without a fever?

Severe sweating and chills without a fever can be caused by a variety of factors, including anxiety, hormonal imbalances, medication side effects, and conditions like hyperhidrosis. It's important to consult a healthcare provider to determine the underlying cause.


Can hypothyroidism cause gastrointestinal symptoms like diarrhea and stomach pain?

Yes, hypothyroidism can sometimes cause gastrointestinal symptoms such as constipation, but if thyroid levels are not well-controlled, it can lead to a range of symptoms, including diarrhea and stomach pain. It's important to have thyroid levels monitored regularly.


How can medication side effects contribute to symptoms like sweating and nausea?

Medications like Wellbutrin and Methadone can have side effects that include sweating, nausea, and gastrointestinal disturbances. These side effects can vary based on the individual and the dosage, so it's important to discuss any concerning symptoms with a healthcare provider.


What dietary changes can help alleviate gastrointestinal symptoms like diarrhea and stomach pain?

To alleviate gastrointestinal symptoms, it's often recommended to follow a bland diet, such as the BRAT diet (bananas, rice, applesauce, toast). Staying hydrated and avoiding foods that are spicy, fatty, or high in fiber can also help manage symptoms.


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