Seeking Guidance for Unexplained Health Issues
I’m a 24-year-old female dealing with a peculiar situation where my pupils occasionally present different sizes. Despite exhaustive tests, including MRIs, CT scans, and various blood analyses, all results have returned normal. I find that my symptoms tend to improve when I am lying down. Recently, I have been diagnosed with vestibular migraines. My experiences include persistent lightheadedness, dizziness, and a sense of imbalance, leaving me yearning to regain my normal self. I’ve consulted a wide range of specialists: cardiologists, pulmonologists, an ENT, my primary care doctor, ER staff, endocrinologists, neurologists, and neuro-ophthalmologists, not to mention a chiropractor. I’m reaching out for assistance as I have a complex medical history including Graves' disease, hypothyroidism (previously hyperthyroidism), Sjögren's syndrome, vestibular migraines, and potential postural orthostatic tachycardia syndrome (POTS). Any advice or insights would be greatly appreciated!
Answers (1)

7/11/2025, 12:02:30 AM
OpenHealth AI
It sounds like you are navigating a challenging and complex set of symptoms that have required extensive medical evaluation. Your situation involves multiple chronic conditions, and it’s understandable that you seek clarity and relief. Here is a focused response that acknowledges your concerns and offers some actionable steps.
Main Points:
- Pupil disparity (anisocoria) and vestibular migraines may be interconnected.
- Your legging down improves symptoms, hinting at potential issues with blood flow or autonomic function.
- Considering your complex history, prioritizing symptom management and lifestyle adaptations is key.
Explanation:
The fact that your pupils occasionally differ in size (anisocoria) can occur for various reasons, including migraine conditions, nerve issues, or sympathetic nervous system responses. Given your diagnosis of vestibular migraines, these may also contribute to your lightheadedness and balance issues.
Your previous and current health conditions, including Graves' disease and Sjögren's syndrome, can complicate your symptoms. It's not uncommon for symptoms to fluctuate while managing autoimmune and neurological conditions. The improvement you experience when lying down could suggest that positional changes influence your blood circulation or inner ear function, which aligns with considerations around POTS.
Next Steps:
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Track Symptoms: Maintain a detailed diary of your symptoms, noting the frequency and duration of lightheadedness, imbalance, and any pupil size changes. This can provide valuable insights in your ongoing treatment.
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Hydration and Diet: Ensure you're well-hydrated, especially since POTS can be aggravated by dehydration. Consider incorporating a balanced diet with electrolytes, and consult with a nutritionist if possible for tailored advice.
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Postural Management: If POTS is suspected or confirmed, practice slow positional changes—like moving from lying to sitting to standing—gradually to minimize dizziness. You may also consider wearing compression garments if recommended by a healthcare provider.
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Stress Reduction Techniques: Evaluate your daily stressors and consider integrating mindfulness, meditation, or relaxation exercises into your routine. These can help in managing migraine triggers and overall well-being.
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Engage with a Specialist: If you haven't already, a neurologist specializing in autonomic disorders may provide additional insights on managing symptoms related to POTS and vestibular issues.
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Support Networks: Connect with support groups for individuals facing similar autoimmune challenges. Sharing experiences and insights may offer emotional support and practical advice.
It’s important to stay proactive and communicate openly with your healthcare team about any changes you observe in your symptoms. You're not alone in this journey, and there are pathways to better management of your health. Let me know if you would like to explore specific areas in more detail.
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