[43F] Experiencing nausea, dizziness, and excessive sweating

Patient Description

A 43-year-old female has been experiencing significant nausea, dizziness, and excessive sweating for several months. The nausea is most severe in the mornings, rated at a severity of 7 out of 10, and is somewhat managed with Zofran 4mg as needed. The patient also reports feeling lightheaded upon waking, a sensation that persists even while lying down, rated at a severity of 6 out of 10. Excessive sweating is noted throughout the day, particularly at night, causing clothes to become wet. Additionally, the patient experiences a racing heart and occasional chest pain described as a squeezing, sharp pain, sometimes radiating to the left arm, with these symptoms present for about six months and exacerbated by any physical activity. The patient has a history of mental health issues diagnosed at age 16, fibromyalgia diagnosed in 2014, back issues since 2004, and stomach issues. Current medications include Ativan 1mg three times a day, Cymbalta, Trazadone, Atarax, hormones for early menopause, Vitamin B12, Vitamin D 1,000 units, and Flexeril. The patient also mentioned experiencing anxiety and stress, which could be contributing to some symptoms.

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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:

  • Anxiety Disorders: Given your history of anxiety and panic disorder, it's possible that your symptoms of heart racing, chest pain, and sweating could be related to these conditions. Anxiety can cause physical symptoms like these, especially if it's more intense or frequent than usual.

    • Treatment typically involves a combination of psychotherapy (talk therapy), behavioral therapy, and medications.
  • Menopause: You mentioned that you're taking hormones for early menopause. Menopause can cause a variety of symptoms, including hot flashes (which might explain your sweating), heart palpitations, and dizziness.

    • Treatment can involve hormone replacement therapy, as well as lifestyle changes and medications to manage specific symptoms.
  • Side Effects of Medications: Some of the medications you're taking, such as Ativan and Cymbalta, can cause side effects like dizziness, sweating, and nausea.

    • If you suspect your medications might be causing your symptoms, it's important to speak with your doctor before making any changes to your medication regimen.
  • Gastrointestinal Issues: Your symptoms of nausea, especially in the morning, could be related to a gastrointestinal issue, especially given your history of stomach problems.

    • Treatment would depend on the specific issue, but might involve dietary changes, medications, or in some cases, surgery.

Please remember that these are just possibilities, and it's important to speak with a healthcare provider for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may want to review your medications and possibly adjust dosages or try different medications.
  2. Keep a symptom diary. Note when each symptom occurs, its severity, and any potential triggers. This can help you and your healthcare provider identify patterns and better understand what's going on.
  3. Practice good sleep hygiene. This includes maintaining a regular sleep schedule, making your sleeping environment comfortable and free of distractions, and establishing a relaxing pre-sleep routine.
  4. If you're not already doing so, consider therapy or counseling to help manage your anxiety and panic disorder. Cognitive-behavioral therapy, in particular, can be effective for these conditions.
  5. Stay hydrated and eat small, frequent meals to help manage your nausea. Avoid foods that are high in fat, greasy, or sweet.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe chest pain or chest pain that spreads to your jaw, left arm, or back
  • Shortness of breath or difficulty breathing
  • Fainting or loss of consciousness
  • Sudden, severe headache
  • Sudden difficulty speaking or understanding speech, or sudden weakness or numbness in one side of your body

These could be signs of a serious condition, such as a heart attack or stroke.

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8 mo ago


People Also Ask


Can anxiety cause physical symptoms like nausea, dizziness, and sweating?

Yes, anxiety can cause a range of physical symptoms, including nausea, dizziness, sweating, heart palpitations, and chest pain. These symptoms can be more pronounced during periods of intense anxiety or panic attacks.


How can menopause contribute to symptoms like excessive sweating and heart palpitations?

Menopause can lead to symptoms such as hot flashes, which may cause excessive sweating, and heart palpitations. Hormonal changes during menopause can also contribute to dizziness and other physical symptoms.


What are the potential side effects of medications like Ativan and Cymbalta?

Ativan and Cymbalta can cause side effects such as dizziness, sweating, nausea, and changes in heart rate. It's important to discuss any concerning side effects with a healthcare provider, as they may need to adjust the medication or dosage.


What are some common gastrointestinal issues that could cause morning nausea?

Common gastrointestinal issues that could cause morning nausea include acid reflux, gastritis, or peptic ulcers. These conditions can be influenced by diet, stress, and other factors, and may require dietary changes or medication for management.

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