Experiencing Severe Headaches: Is It Caffeine Withdrawal? Should I Seek Medical Advice?
A 30-year-old female from Australia. Regular medications include: - Sertraline 100mg - Dexamphetamine: 30mg daily Diagnosed with PMDD and ADHD. This morning, I was struck by an excruciating headache like no other. I found myself repeatedly hitting the snooze button on my alarm. When I finally got out of bed, I struggled immensely with even the simplest tasks, like choosing an outfit. My mind felt completely muddled, and it took me a staggering 45 minutes just to get dressed and prepare breakfast; that was my entire morning routine. I realized that I neglected to take my prescribed medications yesterday, and I also abstained from my usual caffeine intake — I typically enjoy two cups of coffee per day. I'm uncertain if these factors might be linked to my current condition. Should I wait to see if it passes, or is it advisable to consult my general practitioner?
Answers (1)
3/19/2025, 11:20:42 PM
OpenHealth AI
It sounds like you're experiencing a severe headache that might be related to missed medications and caffeine withdrawal. Let's break this down to help you understand the situation and decide on the next steps.
Main Points
- Your severe headache could be due to caffeine withdrawal after not consuming your usual coffee.
- Missing your prescribed medications, particularly Sertraline and Dexamphetamine, may also contribute to headache and difficulty concentrating.
- Monitoring your symptoms is important, but consulting your general practitioner (GP) may be advisable given the severity and impact on your daily functioning.
Explanation
Caffeine withdrawal can cause headaches, fatigue, and difficulty concentrating, especially if you regularly consume coffee and suddenly stop. The symptoms often appear within 12-24 hours after your last caffeine intake and can last for several days.
In addition, missing your medications may exacerbate these symptoms. Both Sertraline and Dexamphetamine can affect your mood, focus, and overall well-being, and their absence could contribute to feelings of cognitive muddiness and physical discomfort.
Next Steps
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Hydrate: Start by drinking plenty of water, as dehydration can worsen headaches. Aim for at least 8-10 glasses throughout the day.
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Manage Caffeine Intake: If you suspect withdrawal, consider slowly reintroducing a small amount of caffeine today (like half a cup of coffee) to help alleviate the symptoms.
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Medication: If you have not done so already, take your missed doses of Sertraline and Dexamphetamine. If you feel unsure about how to readjust your medication schedule, list down your intake and any side effects.
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Monitor Symptoms: Keep track of how your headache progresses over the next few hours. If it improves after hydration and caffeine, it may lean more towards withdrawal. Note any recurring issues.
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Consult Your GP: Given the severity of your headache and the impact on your ability to function normally, it would be prudent to contact your GP. Explain your situation, especially regarding the missed medications and changes in your caffeine consumption, to assess whether any adjustments need to be made.
Taking these steps should help ease your symptoms and bring clarity to your situation. It's important to prioritize your health, so don’t hesitate to reach out for professional advice if your situation doesn’t improve or worsens.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.