[56F] Experiencing extreme fatigue, difficulty swallowing, and other symptoms

Patient Description

A 56-year-old female presents with a one-year history of extreme fatigue, not alleviated by rest and constant throughout the day. She reports significant weight gain of 30 lbs over the past year. She experiences difficulty swallowing, including her own saliva, for the past 6 months. Numbness has been noted in her hands, legs, and face for approximately 4 months. She describes lightheadedness when standing for over 6 months, with a severity of 6 out of 10. Cognitive impairment has been present for over a year, including forgetfulness in performing familiar tasks. The patient also describes intense hot flashes and sweating that occur throughout the day for over a year. She experiences muscle and bone pain, rating it as an 8 out of 10 in severity, which has been present for 3 years. The patient has a history of epilepsy diagnosed at age 20 and is currently on medications including Depakote, Lamotrigine, Hydrocodone, Lorazepam, B12, and Folic Acid. No known drug allergies are reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, several conditions could be causing your symptoms:

  • Chronic Fatigue Syndrome (CFS): This condition is characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity but doesn't improve with rest. This could explain your constant fatigue, muscle pain, and cognitive impairment.

  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It could explain your muscle pain, fatigue, cognitive impairment, and numbness in your hands and feet.

  • Hypothyroidism: This is a condition in which your thyroid gland doesn't produce enough thyroid hormones. It can cause fatigue, weight gain, cold intolerance, and cognitive impairment.

  • Menopause: This is the time that marks the end of your menstrual cycles. It's diagnosed after you've gone 12 months without a menstrual period. Menopause can cause hot flashes, night sweats, sleep problems, and mood changes.

  • Dysphagia: This is a term that means "difficulty swallowing." It takes more effort and time to move food or liquid from your mouth to your stomach. Dysphagia may also be associated with pain.

Please note that this is not an exhaustive list and other conditions could also be causing your symptoms.

What you can do

Given the number and complexity of your symptoms, it's important to seek medical attention. Here are some steps you can take:

  1. Schedule an appointment with your primary care provider. They can perform a physical examination and order tests to help determine what's causing your symptoms.

  2. Keep a symptom diary. Note when each symptom occurs, its severity, and any factors that seem to trigger it. This can provide valuable information to your healthcare provider.

  3. Continue taking your prescribed medications as directed by your healthcare provider.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms worsen significantly
  • You have difficulty breathing
  • You have severe chest pain
  • You experience sudden, severe pain in any part of your body
  • You have signs of a severe allergic reaction, such as difficulty breathing, hives, or swelling of your face, lips, tongue, or throat

Please remember that while I strive to provide accurate information, I'm an AI and this advice should not replace a consultation with a healthcare professional.

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11 mo ago

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People Also Ask


What are the common symptoms of hypothyroidism?

Common symptoms of hypothyroidism include fatigue, weight gain, cold intolerance, dry skin, hair loss, constipation, depression, and cognitive impairment. It's important to consult a healthcare provider for a proper diagnosis.


How is fibromyalgia diagnosed?

Fibromyalgia is diagnosed based on a combination of symptoms, including widespread pain lasting more than three months, fatigue, and cognitive difficulties. There is no specific test for fibromyalgia, so doctors often rule out other conditions first.


What lifestyle changes can help manage chronic fatigue syndrome?

Lifestyle changes that can help manage chronic fatigue syndrome include maintaining a balanced diet, engaging in gentle exercise, managing stress through techniques like meditation or yoga, and ensuring good sleep hygiene. It's important to work with a healthcare provider to develop a personalized plan.


What are the treatment options for dysphagia?

Treatment options for dysphagia depend on the underlying cause but may include swallowing therapy with a speech-language pathologist, dietary changes, medications to reduce acid reflux, or, in some cases, surgery. A healthcare provider can recommend the best approach based on individual needs.


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