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Dr.Anil, Doctor
Category: Medical
Satisfied Customers: 8012
Experience:  M.B.B.S.M.D with over 30 years of experience in this medical field.
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I have been having fatigue, nausea, and brain fog/dizziness

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I have been having fatigue, nausea, and brain fog/dizziness along with burping constantly and on and off diarrhea for the past 2 months. My blood work results are as follows:

UIBC 356 range 150-375
Iron, Serum 46 range 35-155
Iron Saturation 11 range 15-55
Ferritin, Serum 27 range 13/150

Hemoglobin 12.2 range 11.5 - 15
Hemocrit 38.8 range 34-44
MCV 85 range 80-98
MCH26.7 range 27-34
MCHC 31.4 range 32-36

TSH 1.8 range .45-4.5
T4 11.4 range 4.5 - 12
T3 Uptake 22 range 24-39
Free Thyroxine Index 2.5 range 1.2-4.9

C Reactive Protein Cardiac 3.33 HIGH range 0-3

I haven't had b12 or folate tested yet. I am concerned I am having a stomach absorption issue or that my iron or something related to iron is low. I am also very concerned at the C reactive protein. All parasite tests and celiac disease test came back negative.

Any ideas on what is going on?
Submitted: 5 years ago.
Category: Medical
Expert:  Dr.Anil replied 5 years ago.
Welcome to and thanks for your question.
Do you have associated stomach pain and it's location ?
Do you have intermittent constipation and diarrhea?
Stress and anxiety?
Bloating and flatulence ?
Alcohol and smoking ?
Have you monitored your BP and blood sugar?
When you feel dizziness (throughout the day or at certain positions)?
Any associated clogged ears, stuffy nose ?
Heartburn ?
Are you taking any medications?

Edited by Dr Anil Kumar on 2/16/2011 at 6:37 AM EST
Customer: replied 5 years ago.
I am no longer having stomach pain. But when the symptoms started I was having stomach pain and loss of appetite for a couple of weeks. I have had mostly diarrhea, not constipation. Even when I am not having diarrhea the stool seems softer than normal. I've been having burping, cannot eat without burping after. Gas not as much. Right before this all started I was drinking a lot of alcohol, especially the week right before for my birthday I had a few glasses of wine, then a few more the next night, then about 8 drinks in one night, and another few glasses the next night. I don't smoke. Since not feeling well I have almost completely cut out the alcohol except for maybe 1 or 2 glasses total over the past 2 months. Have not had a fever. My fasting blood sugar was normal, 81. My blood pressure seems normal too but my doctor said it decreased when I went from lying down to standing which apparently isn't normal. The dizziness is more like brain fog, feeling mentally a little slow and disconnected. My nose has had slight blood in it whenever I blow it, but I think that is due to being dry from allergies and my ears feel okay for the most part. I have had some heartburn, mainly the burping, some acid/liquid comes up from time to time, and I tend to get a lot of mouth ulcers. No vomiting. The only medication I take regularly is Yaz birth control however I was going to start taking b12 sublingual drops and fish oil pills due to the advice of my chiropracter who said fish oil would help the c reactive protein because that means some sort of inflammation. Also in the past 2 months I have had 2 yeast infections, bacteral vaginosis once, but have treated them both and they are gone.
Expert:  Dr.Anil replied 5 years ago.
Thanks for providing more information .
Well firstly about your symptoms of burping , heartburn , nausea , loss of appetite , mouth ulcer , there may be possibility of Gastroesophageal reflux disease , Peptic ulcer .
And CRP (c reactive protein)is basically a non specific test and raised when there is any infection or inflammation in body .
And it can be raised due to inflammation of lining of stomach caused by GERD , peptic ulcer .
So you should take OTC Prilosec, Simethicone and metamucil .
Keep yourself hydrated with plenty of fluids and oral rehydration solution .

Diarrhea can be caused due to medications usually antibiotics (prescribed to treat bacterial vaginosis ) as you have no parasitic infection and Celiac disease .
Other possible cause may include Irritable Bowel disease and it is a functional disorder with no objective findings in investigations like Blood work , stool examination .
So if your symptoms 'll not relieve then you should consult a Gastroenterologist for further evaluation and management .

Apart from this , even though you have a normal serum iron level, the low iron saturation level indicates that you are still have iron deficiency.

low iron saturation means that your body has less iron utilization than normal and may indicate anemia and resulting in symptoms of fatigue, tiredness , lightheadedness, low blood pressure, irritability, sore tongue and abdominal pain, dizziness .

it can be caused due to blood loss (as you have recurrent nosebleeds , infection ).

However as you have also postural orthostatic hypotension ( drop in BP from changing position from sitting /lying position to standing ) so it is a possible cause of dizziness in your case.
So keep yourself hydrated and increase salt intake .
You will have to take iron supplements orally in the form of iron sulphates or hydroxides.
Also you need to undergo ENT examination to rule out then undelying cause of recurrent nose bleeds .
You should avoid blowing your nose .
You can use Liquid Parafffin drops in nose.
Also you should use OTC decongestant spray(oxymetazoline- Afrin) however not for long term use.

I hope this helps.

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