Exhausted by Persistent Fainting Episodes
I’m a 24-year-old female with a complex medical background, but the core issue I’m facing involves persistent low blood pressure and episodes of fainting that have plagued me for the past eighteen months. The lowest blood pressure I’ve documented was a troubling 43/33 while lying down, and just in the past two weeks, I’ve been averaging around 75/50 while sitting. I’ll summarize my experience as clearly as I can: visiting numerous specialists over the last year has left me feeling truly exhausted. My medical history includes asthma, bipolar disorder type 2, anxiety and depression, as well as insomnia. Currently, I’m on a range of medications: venlafaxine (150 mg daily), lamotrigine (100 mg three times a day), seroquel (100 mg daily), zaleplon (5 mg on occasion for sleep), olanzapine (5 mg as needed for anxiety), and I use an albuterol inhaler as required. Last year, I relocated for a new job and was doing well until about four months into my position when I began experiencing episodes of lightheadedness and dizziness. This culminated in a fainting incident at work, which led to an ICU admission where I recorded my lowest blood pressure of 43/33. I have had several ER visits since then, and I noticed that my episodes seemed to happen more frequently around the time of my menstrual cycle, prompting me to consult a gynecologist. To outline my gynecological appointments: I began taking a progestin-only birth control (the mini-pill), which unfortunately only increased the frequency of my fainting spells, so I discontinued it. A transvaginal ultrasound didn’t reveal any abnormalities. I also had a brief consultation with a neurologist who confirmed there was no indication of seizures, thereby dismissing the need for additional follow-up. An endocrinologist assessed my hormones, but my TSH and cortisol levels were within normal ranges. Subsequently, I focused on cardiology. A 30-day Holter monitor showed only brief instances of tachycardia that did not coincide with my fainting episodes. Other cardiac tests, including an echo, chest x-ray, and CT scan, returned normal results. Most recently, I underwent a tilt table test, which did not indicate any orthostatic issues. My blood work reported mostly normal results, with the exception of low hemoglobin during menstruation and general iron deficiency. I received three iron infusions, which provided some temporary relief. My low blood pressure primarily emerges around the time of my menstruation and especially during premenstrual syndrome, although I do not experience heavy bleeding. What was once limited to one week per month has now extended to two weeks. My primary care physician has suggested an IUD, but I’m apprehensive given my negative experience with oral contraceptives. This situation is significantly affecting my life; I often have to take time off work due to extremely low blood pressure, and I feel faint even when short distances away from my office. I’m feeling quite lost and would appreciate any suggestions or insights. Thank you.
Answers (1)
6/15/2025, 9:40:42 PM
OpenHealth AI
I'm truly sorry to hear about the persistent fainting episodes and the challenges you're currently facing. Managing low blood pressure and the complexity surrounding it can be incredibly tough, especially with your detailed medical history. It's so understandable to feel exhausted after navigating multiple specialists without clear answers.
Main Points:
- Your Symptoms and Impact: You are experiencing frequent fainting episodes related to low blood pressure, particularly around your menstrual cycle.
- Underlying Factors: Your medical background, including low hemoglobin and iron deficiency, might be contributing to your symptoms.
- Next Steps to Consider: Focus on immediate lifestyle adjustments, nutrition to manage iron levels, symptom tracking, and discussing alternative treatment options.
Explanation:
Low blood pressure (hypotension) can cause fainting, particularly when it's exacerbated by hormonal fluctuations during your menstrual cycle. It’s also notable that you mentioned lightheadedness and dizziness. The fact that you have a history of iron deficiency could suggest that improving your iron levels might help stabilize your blood pressure.
Additionally, stress from previous healthcare visits and your mental health conditions can add layers to your symptoms, emphasizing the importance of a holistic approach to your wellbeing.
Next Steps:
-
Dietary Adjustments:
- Iron-Rich Foods: Focus on incorporating foods high in iron (like red meat, legumes, spinach, and fortified cereals) to improve your hemoglobin levels. Pairing these with vitamin C-rich foods (like oranges or bell peppers) can enhance iron absorption.
- Stay Hydrated: Increase fluid intake, especially when you anticipate fainting spells (like during your menstrual cycle) to help maintain blood volume.
-
Symptom Tracking:
- Keep a diary of your symptoms, noting when your fainting episodes occur, along with your blood pressure readings and menstrual cycle. This may help reveal patterns and assist any further medical evaluations.
-
Gradual Position Changes:
- When changing positions (from lying down to standing), do so slowly to minimize dizziness. Consider using compression garments (like stockings) which can help improve circulation.
-
Consulting on IUD Options:
- Discuss with your physician about alternative birth control methods that might be more fitting given your experiences, such as hormonal IUDs vs. other methods, if you remain concerned about side effects previously experienced with oral contraceptives.
-
Focus on Mental Wellbeing:
- Consider working with a counselor or therapist to manage anxiety and depression, as addressing mental health can also influence physical symptoms and improve overall wellness.
Conclusion:
Feeling lost in your medical journey is completely valid, and it’s important to ensure you’re supported holistically. These suggested steps should help you take control of your health situation gradually. Please let me know if you need more specific guidance on any of these points!
Related Questions
Understanding Kidney Pain: Should You Be Concerned?
As a 15-year-old assigned female at birth (AFAB), I've been dealing with acid reflux, although I've been neglecting to take any supplements. I also have scoliosis, which I doubt is linked to my current issue. Recently, I have been experiencing pain in my kidney area, specifically in my back, where my kidneys are situated. My mother suggested that this discomfort might indeed stem from my kidneys. For several months now, I haven't pinpointed the cause. I typically consume about 1 to 1.5 liters of water daily, and occasionally I drink cola, though I've reduced that due to my reflux. I sometimes have peach juice or plain tea, but those drinks have become quite infrequent. Despite my fluid intake, it seems my pain level remains consistent regardless of what I drink. The pain primarily affects my right kidney, but during more intense episodes, I also feel discomfort in my left kidney. I've tried lying down and applying gentle pressure to the area, which provides a bit of relief. Aside from occasional bladder discomfort today, I haven't experienced any additional pain that relates to my kidneys, aside from the persistent back pain from scoliosis and the usual stomach and chest pains from my reflux. Is it necessary for me to consult a doctor about this concern? 🥺 I am hesitant to go unless it's truly serious because I was hospitalized last summer due to undiagnosed tics and twitches—likely anxiety-related—and I spent the entire winter seeing doctors for this issue and my scoliosis. I’m also worried about missing school due to more medical appointments, especially since my doctor has a packed schedule, and I'm uncertain if she would prioritize my concern if it doesn't seem urgent. When I was hospitalized last summer, tests including urine and blood analysis showed no significant issues, so I'm unsure whether this warrants another visit now.
Experiencing Uncertainty: Possible Ischemic Attack?
Greetings, everyone, including healthcare professionals. For the past year, I've been managing high blood pressure, and I'm currently prescribed a regimen that includes Amlodipine at 10 mg and Bisoprolol at 5 mg. At 44 years old, I’m a woman who is classified as overweight and also deals with hypothyroidism, low ferritin levels, liver issues, and slightly elevated cholesterol levels. Typically, my medications maintain my blood pressure within a range of 110/70 to 140/80. However, two days ago, I experienced a stressful episode, causing my systolic pressure to spike to 155/95. Upon standing, I sensed weakness in my left arm, which felt as if it were slightly twisting. A wave of panic hit me, and I feared I might be incapacitated or having a stroke. Despite my anxiety, I was still able to grasp a glass and tightly close my fist. Briefly, my right arm felt a mild sensation that lasted only a second. This peculiar feeling persisted for roughly a minute. I then consumed some mint tincture mixed with alcohol and engaged in deep breathing exercises, which remarkably alleviated my symptoms and brought my blood pressure back to a stable level. I contacted my physician, who inquired about my symptoms and their duration. Aside from the discomfort in my arm, I wasn't experiencing any additional issues. A second doctor relieved me of any immediate concerns regarding the necessity for an MRI, and since I underwent one a month prior that showed no abnormalities in my cranial blood vessels, I felt some reassurance. Now, back home and with lingering fears of having experienced an ischemic attack, I wonder if an ultrasound of the neck arteries is warranted. Do my symptoms indicate a potential attack? What steps should I take next? Has anyone faced a similar situation? Thank you all for your insights.
Concerns About Potential Misdiagnosis
Hello everyone, I recently stumbled upon this subreddit and felt it would be the ideal platform to share my experience. I initially posted something similar under r/Asthma but soon realized that this community might be more appropriate for my concerns. To provide some context, I’m a 25-year-old woman with no personal history of smoking, although I have been heavily exposed to secondhand smoke throughout my life. There is a family history of asthma and COPD on my side. I was diagnosed with asthma during childhood but seemed to outgrow it as I got older. Throughout my younger years, I frequently battled respiratory and sinus infections, and in my teenage years, I suffered a severe case of walking pneumonia. Following that episode, my breathing worsened significantly, prompting my doctor to reinstate the asthma diagnosis and prescribe albuterol inhalers without performing any additional tests except for an X-ray to confirm the pneumonia had resolved. Over the years, I’ve noticed a gradual worsening of my symptoms. Each primary care physician I've consulted has prescribed various inhalers and medications, but the relief they provide has been minimal. For years, I have dealt with a persistent dry cough described as that of a seasoned smoker, yet my doctors continuously assured me it was merely asthma, claiming that my inhalers would alleviate it. When a coughing fit does occur, it can be so intense that I end up gagging, losing control of my bladder, and feeling dizzy. Fast forward to two weeks ago: my cough intensifies with physical activity, and I have a physically demanding job. Typically, my inhaler assists me with breathing, but in this instance, it was ineffective, and emergency services were called to administer oxygen. My oxygen saturation dropped to 93% until the oxygen and my rescue inhaler were applied. I declined hospitalization after feeling better with the oxygen. I took a day off work to recuperate. I managed to see my primary care doctor afterward. Having been on Advair and albuterol for years, I was also prescribed Singulair last year due to flare-ups. In my recent visit, my doctor substituted my Ventolin (albuterol) with Airsupra and introduced Spiriva, along with short courses of Mucinex and Prednisone. At the appointment, my lungs sounded clear, and my oxygen levels were between 99-100%. There was no wheezing, just persistent coughing. Returning to work the following Thursday proved challenging; within three hours, I experienced another severe coughing episode that felt as if my throat might rupture. I was gagging, tearing up, and struggling to remain upright, feeling dizzy and breathless. Several doses of my rescue inhaler provided little relief, and emergency services were contacted again; I was subsequently transported to the emergency room. My oxygen saturation was stable at 97-100%, yet I continued to feel breathless and my painful coughing persisted. Respiratory treatments seemed to exacerbate the coughing, and magnesium failed to provide relief. Both the paramedics and ER staff expressed concern when I mentioned my chronic cough that had persisted for years without improvement. Initially, emergency responders detected only a faint wheeze and diminished lung sounds on one side, although they later reported normal findings. No fluid or wheezing was noted, just continued coughing. CT scans and X-rays of my throat and chest returned normal results. After three days in the hospital, my lactic acid and CO2 levels returned to normal. Despite being treated with steroids and cough suppressants, I found no alleviation of my symptoms. I have now received urgent referrals to a pulmonologist, an ENT specialist, and an allergist, and I recently followed up with my primary care physician. Her only recommendation was cough drops and to wait for my upcoming Pulmonary Function Test (PFT). Additionally, the hospital prescribed Pantoprazole for potential GERD, which hasn't significantly helped. My follow-up blood tests revealed that while my CO2 levels improved, they still remain low, and there are no current indications of an autoimmune disorder, though I am awaiting several results. After undergoing the Pulmonary Function Test, the findings were unusual. Though I await an appointment with the pulmonologist, I reviewed the notes from my test. They indicated, "Spirometry is normal. Lung volumes demonstrate hyperinflation and air trapping. Diffusing capacity is normal. No substantial bronchodilator response observed." When I inquired with the technician who administered the test, she mentioned two possibilities: either my lungs weren't inflamed enough to demonstrate a response, which seemed unlikely considering my extensive coughing fits, or the underlying issue might be irreparable with medications. This situation has left me anxious that I may be dealing with more than just severe asthma. For years, I communicated to my doctors that my condition seems to deteriorate, and that none of the prescribed medications eased my cough, yet they continuously reassured me that it was manageable. Now, after being hospitalized, I recognize the critical need to take this seriously. I rarely experience wheezing or fluid but instead contend with a persistent cough similar to that of a long-term smoker. My cough worsens with movement, eating, drinking, taking deep breaths, lying down, waking up, laughing, excessive talking, exposure to extreme temperatures, dry or humid air, stress, and irritants such as dust, smoke, and potent odors. It feels like merely existing prompts my coughing. Although I always have a cough, the triggers mentioned intensify it. I frequently feel congestion in my throat and chest, accompanied by a tight and painful sensation. I have the incessant urge to clear out whatever feels obstructive, but nothing ever emerges. My coughing often leads to dizziness and incontinence. If I'm not actively coughing, I seem to be clearing my throat repeatedly to manage the mucus. During any illness, my cough tends to worsen, resulting in the need for prednisone. Antihistamines provide partial relief solely for nasal symptoms, without helping my throat and chest. When my rescue inhaler does work, its effectiveness lasts only for a short time before I revert to my previous condition. My lungs may feel momentarily unobstructed thanks to the albuterol, but the coughing inevitably returns until my chest aches again. An ER doctor suggested possible diagnoses of Chronic Rhinosinusitis, Post-Nasal Drip, or GERD; however, medications for allergies and acid reflux have not meaningfully addressed my coughing or breathlessness. It does not seem connected to my sinuses but rather feels like my airways are obstructed, hindering deep breaths. Until I meet with the pulmonologist, my best hypothesis has been Cough-Variant Asthma, but given the lack of response to bronchodilators in my PFT, my confidence in that is wavering. In reviewing my results, I cannot help but consider the early stages of COPD or emphysema, especially since my breathing seems to worsen over time, although my age typically mitigates those concerns given my extensive exposure. I've ordered a test for Alpha-1 antitrypsin deficiency from AlphaID to discuss with my pulmonologist just in case. I am certain I have asthma, but I’m beginning to suspect that there may be additional complications involved. For years, my primary care provider dismissed my concerns, despite my insistence that something felt off. It wasn’t until I required EMS intervention that she finally began the referral process to specialists. I find myself in a state of confusion and unease. Has anyone here experienced anything resembling my situation? I'm looking forward to consulting with the pulmonologist about my test results in the coming week or two, but I’m apprehensive that they will simply dismiss my concerns like previous practitioners have done.
Seeking Guidance on Ice Treatment Post-Surgery
I’m a 34-year-old male, weighing 158 pounds and standing 5 feet 6 inches tall. I lead a non-smoking lifestyle, consume three alcoholic drinks weekly, and do not have any known allergies. I'm currently recovering from right hand and wrist surgery, which took place five weeks ago. I need some advice regarding the use of ice for my treatment, as my wrist remains quite swollen. While I understand the advantages of icing, I find the experience quite intolerable. I attempt to immerse my hand and wrist in ice water completely, but the pain is so intense that I can barely last more than 15 seconds. Is this a challenge of mental resilience where I need to push through the discomfort for the sake of a proper 10-minute soak? In the past, I worked with racehorses, and we would apply ice to their legs for 30-minute sessions, significantly accelerating their recovery. I recognize the effectiveness of this method, yet the pain from the cold is unbearable. Should I endure this discomfort for longer periods?
Rash on My Arm: Should I Be Concerned?
Hi there! I’m a 65-year-old female, and for the past four days, I’ve been dealing with a strange rash on my arm. Unfortunately, I can’t visit a healthcare professional until Monday, so I’m hoping to get some clarity in the meantime. I’ll share some images. If they don’t upload here, I’ll post them in the comments instead. The first image, taken last night, is a bit out of focus, but this morning, the rash has appeared even redder. Although it doesn’t itch now, I did experience some itching during the initial two days. As for my health history, I generally don’t have major health concerns apart from elevated cholesterol levels and a recent A1C reading of 5.9, but I do not have diabetes. I keep fairly active for my age group. During the first couple of days, there was some pus, and I managed to clean it with an alcohol wipe, which helped remove it. Could this be related to a spider bite? I noticed some small spiders (specifically daddy long legs) in my bedroom, especially near the balcony door, and I eliminated a few of them today, so that could be a possibility. Should I be wary of any serious complications from this rash? Any advice would be immensely appreciated! My ER co-payment is quite steep, and there’s no urgent care facility nearby. My only option is to request an appointment with my primary care physician next week, but I’m uncertain if it’s something that warrants immediate attention.