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Dr K
Dr K, Doctor (MD)
Category: Health
Satisfied Customers: 2986
Experience:  Board certified physician
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Ive had ongoing health issues for a year now and I feel like

Customer Question

I've had ongoing health issues for a year now and I feel like it has to be anxiety because 1, the symptoms are so multifaceted and get better and worse and 2, I've had tons of blood work and it's all normal. Here are my symptoms:
-The most constant symptom is that I feel like my blood sugar gets low when it doesn't. I need to eat at least every 2 hours or I'll get really faint, and sometimes I will get lightheaded right after eating.
-I stay nauseous a lot and it's hard for me to make myself eat sometimes. Usually late at night I feel better and can eat more. Sometimes I get really bloated and crampy and feel like I can't digest food, and it makes me feel weak all over and lightheaded.
-I usually wake up feeling really weak and sluggish even after a lot of sleep.
-I am almost constantly lightheaded/dizzy, but not usually as bad at night. Sometimes my vision is a little blurry and I can't focus on things.
-My skin and hair has changed. My hair was falling out a lot over the summer and my skin is super dry, especially on my hands between my fingers. And my skin looks thinner, I have veins in my face (under my eyes and in my temples) that were never visible before and I'm only 22, and this only happened since I got sick a year ago.

This basically all started in March of 2012. I was getting a lot of nauseous and tired spells and then in April I came down with what seemed like a viral illness, I was really sick for a week with fatigue, nausea and vomiting, back and rib pain, and lightheadedness. Then I got better but a couple weeks later I started getting dizzy spells, then started throwing up almost every morning, and was constantly dizzy/lightheaded. I pretty much stayed in bed most of the summer, but I did have days where I felt a lot better.

Do physical illnesses ever present like that? Would I have such a variety of symptoms and feel better some days and worse others with an illness or would it just be getting worse and worse?
Submitted: 1 year ago.
Category: Health
Expert:  Dr K replied 1 year ago.

DrK99 :

Hello, this is Dr K99. Answers are not medical advice and do not constitute a Dr/patient relationship. Please consult your Dr for medical advice.

DrK99 :

Hello and welcome to Just Answer. You do have significant physical symptoms. This does not sound like just anxiety. Can you tell me what blood work you have had done and what the results were,normal or not?

Customer:

All of the blood work I've had has been normal. I've had CBC and complete chemical profile multiple times, checks for ANA antibodies, blood sugar checked, ultrasound of my liver, galldbladder, kidneys, and pancreas, thyroid hormones, and more.

Dr K :

Do you know what your Tsh was?

Customer:

it has ranged from 0.34-0.71 but most recently it was 0.68

Dr K :

It appears then, that you have a general feeling of overall lightheadness. that tsh is normal

Dr K :

Have you considered seeing a neurologist?

Customer:

No I haven't. I have many symptoms beyond the lightheadedness that don't seem like neurological issues... it's not really typical lightheadedness and it comes and goes a lot

Dr K :

Some of your symptoms are suggestive of pots, postural orthostatic tachycarida syndrome

Dr K :

You may need a 24 hour holter monitor and/or ekg and an evaluation. I think your next best step is to see a neurologist.

Dr K :

Other syndromes that are possible involve the inner ear and cerebellum. I do see the other symptoms but they are less prominent and may not be related

Dr K :

Are you near a larger city with a large referral center for a second opinion?

Customer:

No, I'm in a pretty small area. Would a neurological disorder get better and worse like that?

Dr K :

Yes it could. I would suggest that you consider traveling to a larger referral center for comprehensive evaluation. What city is within a few hours?

Customer:

None really. I live in a rural area.

Customer:

I have been told by most doctors I've seen that this is probably anxiety. Is it not possible for anxiety to cause these symptoms?

Dr K :

Its possible, but I am concerned about the significance of the symptoms. You should at least see a neurologist. Possibly a cardiologist or have the 24 hour holter monitor.

Dr K :

Where are you located?

Customer:

Okay. I am in Huntington, West Virginia. It is very hard for me to travel because of the physical symptoms and the anxiety.

Dr K :

Yes, I realize that but you are near some referral centers and would only need to go one time

Dr K :

You are 2.5 hours from Columbus Ohio and the center associated with the medical school at Ohio State University. That would be an excellent choice. My daughter attends college there.

Customer:

okay, thank you. it is just confusing because I have had such a wide variety of symptoms, I do not even know where to start or how to explain them.

Dr K :

http://www-neuro.med.ohio-state.edu/patientcare.html

Dr K :

heres the link. I would suggest making both an internal med and neurology appt the same day at Wexler Center there. It may be very worth your time to take a family member or friend and spend the time doing that.

Customer:

Okay, thank you. Are there any other possibilities for my symptoms besides a neurological disorder?

Dr K :

Heart, cardiac.

Dr K :

Or gi related in terms of absorption, that why the suggesting starting with internal med first

Customer:

Okay. I don't have any vitamin deficiencies or anything so I wouldn't think it would be absorption

Dr K :

Sometimes the best advice we can give you is where to go next in terms of your medical care. When I talk with patients in remote areas, its often a good plan to get to a large referral center and see several specialists in the same day.

Dr K :

You may be absorbing too quickly. Gluten intolerance is a possibility

Customer:

Okay. thank you. My regular doctors and all the doctors I've seen don't seem to think there's a major problem. so they are probably wrong?

Dr K :

I am not sure they are wrong, but you seem to have significant symptoms and I would not want something missed. Rare and uncommon diseases can be missed if you do not see them on a regular basis.

Customer:

Thanks. My symptoms mainly started suddenly after a viral illness in April. I felt really bad over the summer, better in the fall/winter, now am feeling a little worse again. Are there any illnesses that would cause that pattern?

Dr K :

Many viral illnesses can do that they would need to be persistant and affecting some body system

Customer:

with a viral illness could I have a few days of feeling better followed by a few days of feeling worse? that seems to be the cycle lately

Customer:

there was a dramatic difference in how I felt over the weekend vs. monday and today

Dr K :

I dont think this is really related to that.

Dr K :

Many patients with chronic disease have this type of pattern. Many benign diseases do this as well

Customer:

Okay. wouldn't most chronic illnesses show in blood work though?

Dr K :

Only if you test for them

Customer:

what other blood tests are there left to do?

Dr K :

There are multiple tests that can be done for infection and immune issues, etc. but you really need to see both an internal medicine Dr and a neurologist to have the appropriate tests done. You cannot just "oder everything" Thats what your Drs have already attempted.

Customer:

okay, thank you. I tried an anxiety med last weekend and it seemed to make me feel a lot better, then I ran out of it sunday and monday and got the refill yesterday. I think some of it is definitely related to anxiety if not all of it. are there any other specific conditions that could cause my symptoms besides the neurological issues, gluten and absoprtion problems?

Dr K :

Yes, a cardiac condition could. If you were better on an anxiety med, then you may do well on something like low dose Zoloft. Taken daily, it is great for treating generalized anxiety disorder.

Customer:

Thanks. The med I have been taking is buspirone but after two doses yesterday I am not seeing the same improvement. I felt better last night but my symptoms usually improve at night anyway.

Dr K :

You would not really see much change after only 2 days. That medication could also be effective.

Dr K :

I see you are not in the chat. Thanks for coming to Just Answer and best of luck. Please click on a positive rating as we are not compensated for our time until you do so. Thank you.

Expert:  Dr K replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Customer: replied 1 year ago.

I went back to sleep and I just woke up feeling very weak, shaky, and sick. This does not feel like a neurological disorder, it feels like I am very ill with something else.

Expert:  Dr K replied 1 year ago.
Weak shaky and sick really sounds like 1. low blood sugar, hard to pick up on a single blood test you need a glucose tolerance test., 2. low blood pressure, see about getting a home monitor, 3 cardiac, 4. infection.

I do still think it is worth your time to see an internal medicine Dr at Ohio State. save the neurology recommendation for later.
Customer: replied 1 year ago.

Thank you. I have been concerned about something else, the day before yesterday I cleaned out the cat litter box and breathed a lot in, then a few hours after that I was short of breath and my chest and throat were sore. I felt better that night but when I went to class the next day and had been walking around it got irritated again. Then today I woke up with some pains in my chest and under my arms, and pains in my back. Could the anxiety from that be leading to the other physical symptoms?

Expert:  Dr K replied 1 year ago.
That I would assume to be anxiety. You really cannot harm yourself by some dust from the cat litter box. Not to worry. :)
Customer: replied 1 year ago.

Thank you. Are the upper back pains likely to be anything serious or just anxiety?

Expert:  Dr K replied 1 year ago.
thats fairly common in anxiety and often from hyperventilating and stress. Hang in there.
Customer: replied 1 year ago.

Thank you. I am also getting some underarm pains but I don't think my glands are swollen or anything. Is this likely to be anxiety too?

Expert:  Dr K replied 1 year ago.
Yes, and thats also from rapid breathing. :) You may benefit from seeing a counselor and learning some controlled breathing and relaxation techniques.
Dr K, Doctor (MD)
Category: Health
Satisfied Customers: 2986
Experience: Board certified physician
Dr K and other Health Specialists are ready to help you
Expert:  Dr K replied 1 year ago.
Hello Lindsay. I have spent quite a bit of time helping you and am available for followup questions if you choose to leave positive feedback. But i do see you are now working on the same question with a different Dr so I think its time to end. Best of luck to you.
Customer: replied 1 year ago.

Thank you, XXXXX XXXXX the help. I was trying to get a second opinion by making a more detailed post. It seems like the whole time I've been sick it starts wit one thing, then I will worry about it and other symptoms will appear. Is anxiety the most likely cause? I have a family history of it and I'm only 22.

Expert:  Dr K replied 1 year ago.
Hello, and you are certainly welcome to ask for a second opinion. Yes after working with you for a while it does seem like you have anxiety. I do still feel it is worth your time to see a Dr in Columbus for a consult. You may find someone really great and feel its worth your while to travel there once or twice a year if it makes you more functional and improves your life quality, you are only 22. Dr K.
Customer: replied 1 year ago.

Thank you, XXXXX XXXXX definitely look into it. Does anxiety commonly make people so physically sick all over?

Expert:  Dr K replied 1 year ago.
Yes, it sure can, good luck.
Customer: replied 1 year ago.

Thanks. I'm still worried about the lung/cat litter issue. My lungs have been feeling worse today, not better, and like I said I'm having the back and underarm pain. I've never had these symptoms from anxiety. Could it just be irritation still? Will it go away?

Expert:  Dr K replied 1 year ago.
There is just dust in the cat litter so even if you did breathe it in, it is just an irritation of the bronchial tubes. It does not get into the lungs. Its not a serious issue. Not to worry.
Customer: replied 1 year ago.

Okay, thank you. But could the symptoms get worse before they get better?

Expert:  Dr K replied 1 year ago.
no you really should start to feel much better by tomorrow. )
Customer: replied 1 year ago.

Thank you. It was just odd because it happened the night before last and the symptoms were probably most noticeable as soon as I woke up today.

Expert:  Dr K replied 1 year ago.
Sure. I expect you will be much better tomorrow. Have a good evening.
Customer: replied 1 year ago.

Thank you. Could the underarm pain by any chance be related to breast tenderness from menstruation? I am on my period and I started nuvaring a month ago and it seems to be making some of the period symptoms worse.

Expert:  Dr K replied 1 year ago.
Yes, sure it could be from that. I wouldnt worry too much about underarm pain.
Customer: replied 1 year ago.

Thanks! Could the NuvaRing be making all of my symptoms worse? I know it was giving me cramps for a long time after putting it in and I had the worst cramps of my life on Sunday, which was the second day of my period. So I am wondering if it just might not be agreeing with me.

Expert:  Dr K replied 1 year ago.
Yes it does take some time to get used to it. It really is a good method of birth control though so I would try hard to give it 2 months before you say you really dont like it. Any new birth control takes a little time to get used to.
Customer: replied 1 year ago.

Thank you! I was wondering if hormones could cause any shortness of breath. My shortness of breath has been pretty constant for a few days, especially when I eat.

Expert:  Dr K replied 1 year ago.
Well shortness of breath is a rare side effect of hormones if they cause blood clots to the lungs. If this happens, there is severe shortness of breath, coughing and pain. It is not just a little shortness of breath and does not change with eating at all.
Customer: replied 1 year ago.

Thank you. Today I woke up feeling very nauseous, and then I started feeling very weak and still do. I feel so sick. Is this probably just anxiety?

Expert:  Dr K replied 1 year ago.
If you are only weak and nauseated, it could certainly be anxiety. It may also be a virus. You could benefit from some counseling and learning a relaxation and stress relief strategy. Think about possibly trying to make an appointment with a good therapist.
Dr K, Doctor (MD)
Category: Health
Satisfied Customers: 2986
Experience: Board certified physician
Dr K and other Health Specialists are ready to help you
Customer: replied 1 year ago.

Thanks. For the past couple of days my throat has been sore, but it's mainly in the back of my throat, roof of my mouth, and tongue. Today I woke up feeling short of breath and having chest discomfort when I took a deep breath, then I went back to sleep and woke back up covered in sweat. My nose is a little stuffy and it hasn't been until today. Could this just be a cold or something more serious?

Expert:  Dr K replied 1 year ago.
It does sound like an upper respiratory infection. This is usually a virus and does not require antibiotics. You can use an over the counter cold remedy such as Dayquil/Nyquil. Be sure to take your temperature so that you can take a fever reducer like Advil or Tylenol if needed. Feel better. :)
Customer: replied 1 year ago.

Thank you. I tried to eat and it made my chest hurt and my throat feels tighter, and I also felt like I as going to throw up. The nasal stuffiness is gone now, it was only there when I woke up so I'm not sure what this could be... I've never had symptoms like this before.

Expert:  Dr K replied 1 year ago.
It does sound like you have a virus. That can make you nauseated as well.
Customer: replied 1 year ago.

Okay, so the chest pain is probably nothing to worry about?

Expert:  Dr K replied 1 year ago.
Not likely as you are otherwise young and healthy.
Customer: replied 1 year ago.

Thanks. It's kind of feeling like my throat is swollen and my throat and chest are extremely tight. Is there anything I can do about this?

Expert:  Dr K replied 1 year ago.
This can happen with an allergic reaction to a food or medication. If you think this is the case, you should seek medical treatment If not, it is also a common anxiety symptom. Good luck
Customer: replied 1 year ago.

Would the allergic reaction be immediate or could it be delayed? I did start Zoloft a few days ago.

Expert:  Dr K replied 1 year ago.
I doubt that is the cause as allergy to that is not common. I would give your Dr a call. Its likely to be anxiety.
Customer: replied 1 year ago.

Even the sore throat and mouth soreness?


I have also been feeling like I have a UTI. Sometimes I get the symptoms when I don't have a UTI but it usually goes away if I drink a lot of water. Could this be interstitial cystitis or a symptom of an allergy?

Expert:  Dr K replied 1 year ago.
If the symptoms go away when you drink alot of water, its not a uti or interstitial cystitis or allergy.

No the sore throat is likely a viral illness
Customer: replied 1 year ago.

Thanks. It's just so different from anything I've had. It feels like my airways are swollen but it's not really painful. Yesterday my mouth was very sore but it's not as bad today, it's more the throat tightness and shortness of breath today.

Expert:  Dr K replied 1 year ago.
I doubt its an allergic reaction to anything. I would give your Dr a call tomorrow. If things worsen, you will want to go to the emergency room today.

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