Persistent Headache and Dizziness: Sinus Issues or Beyond?
Subject: 40-year-old assigned female at birth, now a trans man. Current Medications: Trintellix, lisdexamfetamine, metoprolol, atorvastatin, pantoprozole, testosterone cypionate, Singulair, meclizine, azelastine nasal spray, over-the-counter allergy relief medicines, Emesetrol. Lifestyle: No use of recreational drugs or alcohol. Medical Background: Diagnosed with asthma, environmental allergies, IBS, GERD, high cholesterol, and hypertension. I have consulted both my general practitioner and an allergist regarding my ongoing issues, and a sinus CT scan has been completed. Summary: Experiencing a daily headache localized on the right side of my head, accompanied by dizziness and occasional nausea or vomiting. There is no evidence of an obvious infection, and conventional allergy medications or pain relievers haven't been effective. What might be the underlying cause, and what further diagnostic actions should be considered? Since mid-February of this year, I've been suffering from headaches on the right side of my head daily. The pain isn't constant and can fluctuate in intensity from mild to moderate. Typically, I experience a pressure-like sensation or throbbing discomfort, along with sharp, stabbing pangs at times. Over the months, the discomfort has intensified somewhat. Generally, the ache stretches across a wide area, starting at my temple and reaching about two inches behind my ear. I occasionally experience pressure or discomfort in my right sinus area. Over-the-counter pain relievers have yielded little to no benefit; however, DayQuil has provided the best relief, though I find that using a percussion massager on my head where it aches seems the most effective. Am I risking damage to my brain cells? Not sure, but it truly helps. Starting around May, I began experiencing episodes of dizziness that occur daily with varying intensity, whether I'm having a headache or not. My doctor prescribed meclizine, which has been somewhat effective, although I find myself taking it as many as three times each day. In addition, I began noticing an unusual sensation in my throat—almost as if triggering a gag reflex or the stretching feeling during a deep yawn. While I experience nausea infrequently, I did vomit once during an intense episode. In the last few weeks, I've also faced sporadic symptoms of watery eyes and a runny nose, occurring on one side or both at times. The nasal discharge is generally clear and thin, and these symptoms appear to worsen if I forget to take my allergy medication at night. A complete blood count (CBC) was conducted in early March, indicating a white blood cell count of 11.6, which for me typically falls between 9.6 and 12. The results from the CT scan were not alarming according to my physician. The radiologist noted: "There is mild mucosal thickening observed in the left inferior maxillary sinus along with a trace of thickening in the right inferior maxillary sinus. A partial opacification of a left posterior ethmoid air cell is noted. The frontal sinuses show inadequate aeration. Remaining ethmoid air cells and sphenoid sinuses maintain a normal air pattern. The ostiomeatal units are clear. The middle meatus appear normal. There is slight left deviation of the nasal septum. The intraorbital contents are intact and visualized facial bones show no abnormalities, along with unremarkable soft tissues of the face. The posterior cells are well-aerated." From my doctor’s brief note and the radiologist's observations, it seems improbable that my sinuses alone are causing all of these symptoms. What other conditions should we explore? What steps are likely to be taken next to identify the root cause?
Answers (1)
8/7/2025, 6:50:57 PM
OpenHealth AI
You're experiencing a complex mix of symptoms, including persistent right-sided headaches, dizziness, and occasional nausea. While it seems that your sinus issues are ruled out as the primary cause based on the CT scan results, it’s important to further explore other potential underlying conditions.
Understanding Your Symptoms
Your symptoms could relate to several factors including, but not limited to:
- Migraine or Cluster Headaches: The nature of your headaches—throbbing, localized pain, and intermittent pressure—could suggest these types of headaches, which are known to cause nausea and dizziness.
- Vestibular Disorders: These can lead to dizziness and sometimes headaches due to balance issues originating from the inner ear.
- Medication Side Effects: Given your current medication list, it’s worth considering whether any of them might contribute to your symptoms. For instance, some antidepressants can have side effects that include dizziness or headache.
- Allergies or Sinusitis: Although the CT scan was not alarming, your ongoing allergic symptoms could still contribute to headaches or pressure sensations.
- Gastroesophageal reflux disease (GERD): Given your history of GERD, it might sometimes cause sensations in the throat that could trigger nausea.
Next Steps for Investigation
Here are some prioritized actions you can consider to help identify the root cause of your symptoms:
-
Headache Diary: Keep a detailed record of your headaches, including frequency, duration, intensity, any associated symptoms (like nausea or dizziness), and responses to treatments. This can help identify patterns and triggers.
-
Consult a Headache Specialist: A neurologist who specializes in headaches could provide further evaluation and possibly order additional imaging studies or tests to clarify whether you're experiencing migraines or other headache types.
-
Review Medications with a Healthcare Provider: Schedule a discussion with your prescribing doctor about your current medications. Consider whether any adjustments might alleviate your symptoms, especially focusing on the potential side effects of your medications.
-
Vestibular Assessment: If dizziness remains a significant concern, a referral to an ear, nose, and throat (ENT) specialist for a vestibular assessment might be helpful. They can evaluate the inner ear and balance systems.
-
Allergy Management: Since you're experiencing allergy symptoms, assessing your allergy treatment plan with an allergist might be worth considering. They can evaluate whether further management is needed, such as allergy testing or reconsideration of your current medications.
-
Hygiene and Triggers: Implement general self-care practices such as staying hydrated, maintaining a consistent sleep schedule, and avoiding known headache triggers (like certain foods, stress, or lack of sleep).
-
Regular Follow-Up: Ensure regular follow-up appointments to reassess your symptoms and the effectiveness of any changes made in your treatment plan.
Reassurance
It’s understandable to feel concerned about the persistence of your symptoms, but with structured evaluation and management, many patients find relief and can improve their quality of life. Please continue to communicate openly with your healthcare team, and don't hesitate to reach out if your symptoms worsen or if you have new concerns.
Related Questions
A Mysterious Illness That Resembles Strep Throat
As an 18-year-old college student, standing at 5'4" and weighing 140 pounds, I maintain an active lifestyle. I do not smoke or have any preexisting health issues, aside from the vitamins and supplements I take daily. Approximately five days ago, I began to feel unusually fatigued and achy. Within just a day, my symptoms escalated to include a high fever reaching between 101°F and 102°F that ibuprofen couldn’t seem to alleviate. I experienced extreme tiredness that kept me bedridden all day, along with a persistent headache and intense throat pain, which was compounded by swollen lymph nodes and the familiar white patches often associated with strep throat. Having dealt with strep throat before, I recognized a need for antibiotics. Two days into feeling unwell, I visited an urgent care facility for an assessment and received a rapid strep test, which unfortunately came back negative. I recalled a previous incident where my rapid strep test also indicated a false negative, only for the culture sent for further testing to confirm the presence of strep bacteria. Given my symptoms and the findings from the examination, the healthcare provider prescribed Cefdinir, as I am allergic to amoxicillin, despite the negative rapid test results. The antibiotics proved effective, and I felt nearly back to normal, leading me to believe that my culture results would also come back positive for strep, suggesting a recurrence of my previous infection. However, I received the culture results yesterday, and to my surprise, they came back negative for strep. While I lack medical expertise, I’ve been led to believe that false negatives in cultures are exceedingly rare. Now, I find myself puzzled about what kind of bacterial infection I might have had if it wasn’t strep. Any insights or information regarding my situation would be greatly appreciated. Thank you!
Bleeding Concerns with IUD and Yeast Infection Treatment
I’m a 20-year-old female, standing at 5’4” and weighing 155 pounds. Hello everyone! Approximately three weeks ago, I had the Kyleena IUD placed, and everything felt fine afterward—I can still feel the strings. I noticed some mild spotting that was brown for about a week, followed by my menstrual period, then continued with light spotting. Recently, I suspect that I might have developed a yeast infection, which I am currently addressing using Monistat 7. I applied the first dose yesterday. To clarify, I am certain that I am not dealing with a sexually transmitted infection. However, I’ve observed an increase in bleeding, significantly more than what I’ve experienced before. The blood appears to be light red, and I would compare the amount to the lightest day of my period. I could comfortably go an entire day without needing to change my pad, though I still do it for hygiene reasons. Is this a common occurrence? Most of the bleeding took place this morning after I woke up, coinciding with the Monistat cream leaving my body. Under what circumstances should I seek medical advice regarding this issue instead of waiting to see how the treatment progresses?
Understanding Recurrent Symptoms: Are They Histamine-Related?
Hello, health professionals, I am seeking your expertise regarding a variety of symptoms I have been experiencing intermittently over the years. While they appear linked, I'm having difficulty pinpointing their root cause. **Personal Summary:** - 27 years old, Female - Non-smoker (formerly vaped for about eight years, cessation initiated two years ago) - No diagnosed autoimmune conditions - Background of anxiety (which might exacerbate some symptoms, though it doesn't account for all) - Currently taking Flonase and a multivitamin **Skin Reactions:** - I've dealt with recurring itchy rashes and hive-like bumps since childhood. They manifest suddenly and usually resolve without intervention. - These rashes are often itchy, can be raised, and tend to appear sporadically without identifiable triggers. - Antihistamines provide consistent relief, leading me to suspect a role of histamines in these eruptions. - These episodes do not align with typical contact allergies or classic food allergies. - They can happen multiple times daily, and I've often dismissed them as merely anxiety-related rashes. - Sometimes the itching precedes the visible rash, while other instances present with a red, inflamed area that stirs inquiries about my well-being from others. **Foot Discomfort:** - Over the last few years, I’ve encountered severe itching on the soles of my feet. - These episodes typically include small pale or white spots with redness surrounding them, occasionally featuring a red center. - Itching intensity can be overwhelming, yet these lesions usually arise suddenly, - They frequently improve upon avoiding scratching and may resolve within a range of 30 minutes to two days. - The first episode was triggered after swimming in a freshwater lake, though I’ve also experienced it while wearing specific footwear like Crocs or boots, but not consistently. - Certain events coincide with my typical skin rash, hinting at a potential systemic condition rather than merely a localized issue. - The symptoms do not mirror those of warts, ringworm, or fungal infections. **Ear and Sinus Issues:** - Itchy ears have been a recurring issue for the past few years; I initially attributed it to overly aggressive cleaning with cotton swabs, which I realize is harmful. - I have a history of chronic sinus problems, including post-nasal drip and regular ear infections. - The inflammation appears to flare up sporadically rather than constantly. - Recently, I experienced a painful ear issue that began with what I thought was a pimple. The next day, my ear was swollen. After visiting a clinic, I was diagnosed with a double ear and sinus infection, treated with antibiotics. My pain persisted, leading to a follow-up with my primary care physician, who prescribed Flonase and noted ongoing nasal inflammation. Missing doses led to increased ear discomfort, prompting me to take Flonase more regularly. Unfortunately, a recent flare of swelling and discomfort in my ear led me to consider consulting an ENT specialist. **Gastrointestinal Symptoms:** - I was diagnosed with gastritis through an upper endoscopy procedure. - Testing for H. pylori returned negative. - I've since developed food sensitivities and gastrointestinal discomfort not previously experienced. - I saw significant improvement after removing gluten and dairy from my diet, with tests for celiac disease yielding negative results. - Symptoms tend to flare up in response to stress or specific food intake rather than being a constant presence. **Additional Context:** - A history of childhood asthma (now occurs infrequently) - Sensitivity to heat - Past instances of feeling lightheaded, resembling vasovagal symptoms, alongside vertigo - Symptoms across various systems often flare together, but not in every instance - While my anxiety can intensify symptoms, both antihistamines and diet modifications have had notable positive effects **My Inquiry:** While I don’t wish to self-diagnose, I'm curious if my range of symptoms might suggest: - Histamine intolerance - Mast-cell overactivity (not necessarily MCAS, but an increased reaction) - Physical or contact urticaria I'm primarily seeking: - Recommendations for a suitable specialist - Insight on whether this symptom pattern fits a recognized mechanism - A clearer understanding of what warning signs to be concerned about **Summary:** I contend with a long-standing pattern of episodic itchy rashes and hives, significant but transient foot itching along with bumps, persistent ear irritation coupled with sinus problems, and gastritis accompanied by food sensitivities that improved on an elimination diet. Antihistamines aid multiple symptoms. Could this suggest underlying histamine-related issues manifesting across multiple systems rather than in isolation?
Seeking Guidance on Persistent Chest Discomfort After Extensive Testing
I'm a 43-year-old male, standing at 5'11" and weighing 180 pounds. My journey began around March to April of 2025 when, despite regularly hitting the gym four times a week, I was struck by severe chest pain along with frequent belching and a tight feeling in my diaphragm. At times, the pain became so intense that I feared it might be a heart attack. **Medical History:** In May 2019, I received a diagnosis of **PVS** and have since been under the care of a cardiac electrophysiologist. Upon experiencing these new symptoms, I consulted my EP, who conducted an EKG right then and set me up with a 7-day heart monitor. The results showed no irregularities. Subsequently, I was directed to a cardiologist, who carried out both a **stress test** and an **echocardiogram**, both of which yielded normal findings. Afterward, I returned to my primary care physician, who speculated that my gallbladder might be involved. An **ultrasound** was performed but revealed no issues. I then requested a **chest X-ray**, which also came back normal. My PCP then considered the possibility of a **hiatal hernia** and referred me to a gastroenterologist; unfortunately, that appointment took almost **five months** to materialize. In the meantime, my symptoms persisted, prompting me to cease weightlifting and switch my focus to **cardio and running**. Surprisingly, these activities didn’t exacerbate my symptoms, though the chest pain remained constant. When I finally saw the gastroenterologist, they suggested an **upper endoscopy**, which took another roughly three months to arrange. During this procedure, I was diagnosed with **Eosinophilic Esophagitis (EOE)**, a condition I had not previously experienced. The doctors also placed a pH monitoring device for acid reflux assessment, which indicated **no unusual acid exposure**. Following this, I began a treatment plan that included a swallowed steroid inhaler and an increased dosage of **omeprazole**. Sixty days later, I underwent another endoscopy, which showed that the EOE had largely resolved, with minimal residual symptoms. Unfortunately, my chest discomfort persisted without any improvement. It has now been about **a year** since these issues emerged, and I still have not found substantial relief. A recent chest MRI completed at a dedicated imaging center revealed no abnormalities. I entertained the idea of **costochondritis**, but again, the MRI did not support that hypothesis. The only minor relief I find comes from consciously pulling my shoulders back and expanding my chest. I continue to experience discomfort around my **diaphragm** and tenderness in the area of the **xiphoid process**. My PCP prescribed a steroid pack, which was somewhat beneficial for the pain but failed to alleviate the pressure or constant discomfort. At this juncture, I feel quite lost and uncertain about my next steps. I would greatly appreciate any insights or experiences from others who have faced similar issues. Additionally, if there are any physicians here willing to offer advice, I am open to traveling to find the answers or relief I'm desperately seeking.
Understanding Mild Uncomplicated Diverticular Disease
I am a 29-year-old female, standing at 5'7" and weighing 130 pounds. Recently, a CT scan revealed that I have mild diverticulitis. About a week ago, I experienced significant discomfort, particularly in the pelvic region, along with pain in my right leg and hip, and some mild discomfort on the left side. After undergoing a CT scan, which confirmed the presence of mild diverticular disease, I was surprised that no one from my medical team provided any follow-up or acknowledged the condition. My blood tests returned normal results, and I was discharged without further information. While the pain subsided after about three days, it has unfortunately reappeared four days later. Is this something I should be worried about? What does this mean for me? I had a colonoscopy around 11 months ago, which indicated no issues.