Seeking Guidance on Necessary Investigations
I am a 23-year-old female weighing 78 kg (not very muscular, more on the chubby side) who has ADHD and is currently not on medication. Here’s a comprehensive list of my symptoms: - Extreme fatigue: I struggle to rise in the morning and often feel utterly unmotivated. After a long day at a monotonous office job, I find it hard to get moving for hours. - Reduced libido. - Hormonal fluctuations that are quite erratic, yet I experience semi-regular menstrual cycles. - Severe itchiness in my lower legs; my doctor attributed it to shaving, but I suspect it’s something more. - Persistent brain fog. - Bloating, though it typically doesn’t come with pain. - Constant sluggishness. - Anxiety symptoms. - A resting heart rate of 43 beats per minute. - A history of binge eating disorder, particularly with significant periods of restriction earlier this year; I would sometimes go without food for as long as 36 hours. However, in the past year, I have increased my food intake significantly after entering a relationship that includes shared meal times. After having my blood work analyzed, it seems my thyroid levels are normal, although my chloride level was slightly elevated, likely due to my recent takeout diet while helping to renovate my boyfriend's kitchen. My cholesterol reading, on the other hand, was unusually low at 0.9 mmol/L, which I find concerning. ChatGPT mentioned that my symptoms could be indicative of celiac disease or liver problems since my diet consists largely of fish, nuts, and other healthy fats, leaving little room for dietary causes. I’m confused as my GP seems to dismiss my low cholesterol as a good sign, yet I can't find clarity regarding my ongoing symptoms. I feel overlooked and am not convinced that I’m truly healthy. Can anyone advise me on what specific investigations I should pursue and what potential issues I might be facing? Thank you for your assistance!
Answers (1)
7/8/2025, 7:30:58 PM
OpenHealth AI
Your situation involves a variety of symptoms and existing medical history that suggest a deeper evaluation may be necessary. It's important to understand how various factors could be affecting your health, including underlying conditions, lifestyle, and nutrition.
Main Points:
- Your persistent symptoms, including fatigue and brain fog, deserve a thorough investigation.
- Low cholesterol and a resting heart rate of 43 bpm can indicate possible underlying issues.
- Investigating hormonal balance and vitamin/mineral deficiencies may be beneficial.
Explanation:
While your thyroid levels are normal, fatigue, brain fog, hormonal fluctuations, and low cholesterol could point to several underlying conditions, including potential hormonal imbalances, nutrient deficiencies, or other metabolic issues. Low cholesterol can sometimes indicate malnutrition or liver problems, and a consistently low resting heart rate (bradycardia) should also be evaluated further.
Next Steps:
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Nutritional Assessment: Consider a consultation with a dietitian. Evaluating your diet for potential deficiencies, particularly in essential fatty acids, vitamins (like B12 and D), and minerals (like iron) is crucial. You might benefit from testing specific nutrient levels.
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Hormonal Evaluation: Request tests for hormone levels (e.g., estrogen, progesterone, testosterone) and possibly consider checking for adrenal function. This could explain some of your symptoms related to fatigue and libido.
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Cardiac Evaluation: Given your low resting heart rate, it may be prudent to have a heart evaluation (like an EKG) to rule out any arrhythmias or other heart conditions.
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GI Investigation: If you suspect celiac disease or other digestive issues, consider tests like the tissue transglutaminase antibody test or an endoscopy if indicated. Discuss symptoms like bloating and itchiness with your healthcare provider.
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Mental Health Support: Since you have ADHD and anxiety symptoms, consider working with a mental health professional specializing in ADHD management. This might include therapy and potentially discussing medication options again based on your needs.
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Regular Monitoring: Start keeping a symptom diary — note the severity of symptoms, dietary intake, and lifestyle factors that could be contributing. This will provide useful information for your healthcare provider.
Your concerns are valid, and it's important that you feel heard in your health journey. Taking these steps can help clarify the underlying causes of your symptoms and guide you toward better health.
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