Unusual Night Sweats and Persistent Fatigue
I am a 22-year-old woman, 5’6” tall and weighing 46 kg. My current medications include Sertraline, which I've been on for five years, along with omeprazole and Nortriptyline at a dosage of 10 mg. In 2023, I also had an IUD inserted. Over the past year, I have been experiencing gastrointestinal problems characterized by abdominal pain and nausea after meals, though lying flat tends to alleviate some discomfort. Additionally, I have a diagnosis of hypermobile Ehlers-Danlos syndrome (hEDS), which may be relevant to my situation. For the past few months, I have had a troubling issue that intermittently disrupts my daily life. Most nights, I wake up multiple times, drenched in sweat. My pajamas become damp, and I experience a peculiar combination of feeling cold and shivery, despite the excessive sweating. Alongside this, I’m plagued by intense and vivid dreams or nightmares and suffer from significant daytime fatigue. Even though I generally sleep around twelve hours each night, I find myself requiring naps in the afternoon or evening just to cope. I rarely feel revitalized upon waking; instead, I start my day already feeling drained. While fatigue isn't new for me, the combination of night sweats, disturbing dreams, and persistent nausea is profoundly affecting my well-being! Another troubling aspect is the unusual odor of my sweat, which differs from normal perspiration. It has a somewhat sweet, musty fragrance that lingers even after I take a shower—it's quite off-putting, to say the least. The sweating doesn’t follow the usual pattern; primarily, my legs, arms, and torso are drenched. I've attended regular check-ups with my doctor to monitor my weight, as my stomach issues hinder my ability to consume normal food portions, but it's been around three or four months since my last appointment. Blood tests taken in September showed normal results, except for low vitamin B12, for which I have been supplementing. My blood sugar levels generally hover at the lower end of normal, ruling out diabetes as a concern. A CT scan of my abdomen conducted in December returned clear results. Additionally, and perhaps unrelated, I have noticed that my pupils will occasionally change size randomly for several hours before returning to their normal state. Headaches are also an ongoing problem for me. I mentioned these symptoms to my general practitioner during my last visit in November, but he didn't seem alarmed and didn’t provide any further insight. I'm reaching a breaking point with these issues and desperately seek a solution or any advice that could help alleviate my situation, as I would be incredibly grateful for any suggestions!
Answers (1)
3/29/2025, 3:01:04 PM
OpenHealth AI
It sounds like you are experiencing a complex set of symptoms that are significantly impacting your quality of life, including unusual night sweats, persistent fatigue, gastrointestinal issues, and changes in your symptoms like pupil size. I understand how distressing this must be for you. Let's break this down and prioritize some essential next steps.
Main Points:
- Night sweats and fatigue could indicate several underlying issues, including hormonal fluctuations, side effects from medications, or even potential autonomic dysfunction related to hypermobile Ehlers-Danlos syndrome.
- Your gastrointestinal symptoms, such as nausea and abdominal pain, could be interconnected and may contribute to your overall feelings of fatigue.
- Changes in sweat odor could potentially suggest metabolic concerns or a change in your body's chemistry.
Explanation:
Night sweats can be caused by various factors including hormonal changes (like those that might occur with an IUD), infections, anxiety, certain medications, or metabolic issues. Persistent fatigue, even with adequate sleep, can be a sign that your body is not absorbing nutrients properly, which may be influenced by your gastrointestinal symptoms and low vitamin B12.
Your description of the unusual odor of your sweat could be linked to multiple factors, including diet, metabolic conditions, or even dehydration, especially in conjunction with your gastrointestinal issues.
Next Steps:
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Monitor and Record Symptoms: Keep a detailed diary of your symptoms. Note when you experience night sweats, fatigue, gastrointestinal pain, and any changes in your diet or medication. This information could help identify triggers and patterns.
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Dietary Adjustments: Focus on a balanced diet rich in vitamins and minerals, especially as you are supplementing for low vitamin B12. Consider smaller, more frequent meals if large portions are causing discomfort, and aim to stay hydrated to minimize symptoms.
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Consult Your Doctor: Given the combination of symptoms and their impact on your life, it is important to arrange a follow-up appointment with your healthcare provider. Share your symptom diary and express your concerns about the night sweats, fatigue, and gastrointestinal problems. Ask if further investigations such as hormonal tests, liver function tests, or consultations with a specialist (like an endocrinologist or gastroenterologist) may be appropriate.
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Evaluate Medications: Discuss your current medications with your healthcare provider, particularly the possibility that either Sertraline or Nortriptyline may be contributing to your symptoms. Adjustments may help alleviate some of your issues.
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Stress Management: Implement relaxation techniques such as mindfulness, yoga, or gentle stretching exercises to help with overall stress and anxiety, which may be influencing your symptoms.
Take these steps one at a time, focusing on the most immediate actions like monitoring your symptoms and making dietary adjustments. It’s crucial to listen to your body and prioritize your well-being. If symptoms worsen or new concerning symptoms emerge, you may need to seek medical advice sooner. Please take care, and I hope you find relief soon.
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