[39F] Experiencing chills in leg, headaches, and blurred vision

Patient Description

A 39-year-old female presents with chills in the right leg resembling goosebumps, occurring off and on for about an hour at a time, predominantly at rest. These episodes happen throughout the day. She also experiences headaches that have been present for many years, described as throbbing to aching, originating from the neck and affecting the front of the head, with a current intensity of 6 out of 10. Occasionally, Motrin provides relief. Blurred vision has been noted, particularly when looking at a distance after using her phone without glasses, and has worsened over the past year. The patient also reports brain fog, with a decline in memory and difficulty finding the right words. She has a history of Hashimoto's thyroiditis diagnosed 2 years ago and anxiety since her teenage years. Currently, she is on 25mcg of levothyroxine and 75mg of Zoloft. She has a known allergy to penicillins. No recreational drug use is reported.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible explanations for your symptoms include:

  • Migraines: Your description of throbbing to aching headaches that seem to stem from your neck and affect the front of your head is consistent with migraines, especially considering your family history of migraines. Migraines can sometimes be accompanied by other neurological symptoms like blurred vision and brain fog.

    • Treatment typically involves medication to relieve symptoms and prevent future attacks. Lifestyle modifications, such as stress management and regular sleep, can also be beneficial.
  • Thyroid-related issues: As you have Hashimoto's disease, an autoimmune condition that can cause hypothyroidism, some of your symptoms like brain fog and feeling cold could be related to your thyroid function. It's possible that your levothyroxine dose may need adjustment.

    • Treatment involves regular monitoring of your thyroid function tests and adjusting your levothyroxine dose as needed.
  • Anxiety: Chronic anxiety can manifest with physical symptoms, including headaches, brain fog, and even sensations like chills. Your ongoing use of Zoloft indicates that you are managing this condition, but if your symptoms have worsened, it may be worth discussing with your doctor.

    • Treatment typically involves a combination of medication and cognitive behavioral therapy.
  • Digital Eye Strain: Spending a lot of time on your phone, especially without your glasses, can cause digital eye strain, which can result in blurred vision and headaches.

    • Treatment involves taking regular breaks from screen time, ensuring you have the correct prescription for your glasses, and possibly using special glasses designed to reduce eye strain.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may want to check your thyroid levels to see if your levothyroxine dose needs adjustment.
  2. Try to identify any triggers for your headaches and avoid them if possible. This could include certain foods, lack of sleep, or stress.
  3. Practice good eye hygiene. Take regular breaks from screen time, ensure you have the correct prescription for your glasses, and consider using glasses designed to reduce eye strain.
  4. Continue taking your prescribed medications as directed by your doctor.

What you should look out for

Please seek immediate medical attention if you experience:

  • A sudden, severe headache that is different from your usual headaches.
  • Any sudden changes in vision, such as loss of vision or double vision.
  • Any new or worsening neurological symptoms, such as weakness, numbness, or difficulty speaking.
  • Any signs of a severe allergic reaction, such as difficulty breathing, swelling of the face or throat, or a widespread rash.

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 appropriate examination, testing, and care recommendations.

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10 mo ago

People Also Ask


What are the common symptoms of migraines and how can they be managed?

Migraines often present as throbbing or pulsing headaches, usually on one side of the head, and can be accompanied by nausea, vomiting, and sensitivity to light and sound. Management includes medications to relieve symptoms and prevent attacks, as well as lifestyle changes like stress management and regular sleep.


How can Hashimoto's thyroiditis affect my overall health and what are the signs that my medication might need adjustment?

Hashimoto's thyroiditis can lead to hypothyroidism, causing symptoms like fatigue, weight gain, cold intolerance, and brain fog. If you notice worsening symptoms, it may indicate that your levothyroxine dose needs adjustment. Regular monitoring of thyroid function tests is essential.


What is digital eye strain and how can I prevent it?

Digital eye strain is caused by prolonged screen use, leading to symptoms like blurred vision, headaches, and eye discomfort. Preventive measures include taking regular breaks, using the correct prescription glasses, and possibly using glasses designed to reduce eye strain.


How does anxiety manifest physically and what are effective ways to manage it?

Anxiety can cause physical symptoms such as headaches, muscle tension, and chills. Effective management often involves a combination of medication, such as SSRIs, and cognitive behavioral therapy, along with lifestyle changes like regular exercise and mindfulness practices.


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