Navigating Unexplained Symptoms: Searching for Answers
At 29 years old and weighing 75 kg with a height of 5'6", my current regimen includes a monthly depot injection of 75 mg paliperidone alongside aripiprazole at 5 mg, sertraline at 25 mg, and nortriptyline at 25 mg daily. I do not smoke or consume alcohol and generally follow a lacto-vegetarian diet, with occasional meat. My lab results show normal levels for most metrics, including a B12 concentration of 219 pg/ml, vitamin D at 36.4 ng/ml, but a low serum iron level of 50 mcg/dL. My life was relatively stable until 2016 when everything began to shift. I was engaged in activities such as attending college, studying, enjoying movies, cooking, photography, and reading newspapers and books regularly. However, from 2016 onward, I found myself losing interest in these hobbies and social interactions, gradually feeling as though life's vibrancy was draining away. The emotional highs and lows lost their significance, leaving me in a numb state, devoid of joy or fulfillment. By the conclusion of my academic journey in 2017, I began participating in a fellowship program. After attending three days of orientation in August, I became disillusioned by the low compensation relative to the workload and felt overwhelmed at the thought of committing six months to the program. Consequently, I withdrew and spent the following months at home, diverting my attention to platforms like Quora, Twitter, and other online activities. After four months with no direction for future study or work, my father sought guidance from a friend in academia, the head of pathology at Miraj Medical College. Following this, I was referred to an alternative medicine practitioner who ultimately directed me to a psychiatrist. Throughout this time, spanning from 2017 to 2025, I began developing additional symptoms, including frequent soft stools, a pervasive sense of being lifeless, diminished libido—which started deteriorating around 2016-2017 but grew more pronounced over the following years—and an overwhelming desire for quick, easy sources of gratification. I struggle to engage with serious content, often skimming through reading material and missing important details that don’t align with my immediate focus. There’s also persistent head pressure associated with these experiences, which tends to subside when the symptoms lessen temporarily. What could be the underlying causes of these symptoms, and what treatment options might be available? Is there a possibility that SIBO could be the source of my issues? I have endured these symptoms for approximately eight years. Additionally, could long COVID be influential in this situation? It's worth mentioning that I haven’t suffered from typical illnesses like cold or flu over the past five years since contracting COVID.
Answers (1)
8/26/2025, 7:36:28 AM
OpenHealth AI
It sounds like you are experiencing a deeply complex set of symptoms that have significantly impacted your quality of life over the past several years. Let's address your primary concerns: potential underlying causes of your symptoms, including the possibility of SIBO (Small Intestinal Bacterial Overgrowth) and long COVID.
Key Points:
- Complex Symptoms: Emotional numbness, diminished libido, changes in bowel habits, persistent head pressure, and cognitive difficulties.
- Potential Underlying Causes: These could include psychological factors (e.g., depression, anxiety), physiological issues (e.g., low iron, digestive disorders), and possibly even long COVID effects.
- Next Steps: Focus on managing symptoms, addressing iron levels, exploring psychological support, and considering dietary modifications to investigate SIBO.
Explanation:
- Emotional and Cognitive Symptoms: Conditions like depression, anxiety, or anhedonia (loss of interest) could be significant contributors to the numbness and lack of interest you describe, possibly influenced by the emotionally taxing years since 2016.
- Frequent Soft Stools and Gut Health: Your bowel changes may suggest a gastrointestinal issue like SIBO, where an overgrowth of bacteria in the small intestine can lead to digestive disturbances.
- Low Iron Levels: This could contribute to fatigue and cognitive difficulties, as iron is crucial for energy and overall brain function. Your normal B12 and vitamin D levels are encouraging, though it's important to check if these levels are kept in balance over time.
- Long COVID: Given your history, lingering effects from COVID-19 can't be ruled out, as they can affect multiple body systems, leading to persistent fatigue, cognitive fog, and other symptoms.
Prioritized Next Steps:
- Iron Supplementation: Since your serum iron level is low, consider discussing with a healthcare provider about iron supplementation or dietary adjustments (foods rich in iron and vitamin C to enhance absorption).
- Food Diary: Start a food diary to track your diet and bowel habits. This may help identify potential triggers for your digestive symptoms and assess if SIBO is a concern.
- Mental Health Check-in: Given your emotional states, it may be beneficial to reach out to your psychiatrist to discuss therapy options or adjustments in medication if you feel comfortable.
- Gastrointestinal Assessment: Consider requesting tests for SIBO, such as a breath test, from your healthcare provider. This can help determine if it’s contributing to your gastrointestinal symptoms.
- Holistic Evaluation: Look to integrate wellness activities that may reignite interest or joy—this may include classes or groups centered around your past hobbies.
Remember, addressing complex and interwoven symptoms takes time and collaboration across different areas of health. Allow yourself patience as you pursue evaluation and find suitable management strategies. If you have further questions or need more detailed action steps, feel free to ask.
Related Questions
Understanding a Small Left Retrocerebellar Arachnoid Cyst
I am a 21-year-old female. After undergoing a brain scan, I received the following findings: On the left side of my lower limb, there is mild weakness; specifically, my hip flexors and extensors show a strength level of 4 out of 5, while my knee flexion and extension are both at 4 out of 5 as well. There is no evidence of foot drop, but I'm still waiting for further assessment of my reflexes. Both the MRI of my head and the MRI of my cervical spine displayed normal results. Blood tests also returned normal levels. The MRI scans revealed that the brain parenchyma has normal signal encoding without any signs of demyelinating lesions or recent strokes. The ventricular system and the surrounding cerebrospinal fluid spaces appear clear, while the posterior fossa seems unremarkable. An incidental finding noted a small arachnoid cyst located on the left side of the retrocerebellar area. Additionally, the cervical spine shows proper alignment, with no signs of constriction in the canal or foramina, and there are no visible demyelinating lesions present. However, it was observed that some axial images were affected by motion artifacts, which might have impacted the quality of the results. In summary, there are no signs of demyelinating lesions or acute issues in either my brain or spine according to the MRI. I was advised for a medical follow-up. What does it imply to have a small left retrocerebellar arachnoid cyst? I was released from the hospital after all tests showed no abnormalities, but now, seeing this detail on my report, I feel anxious. Is there any cause for concern? My anxiety around health issues is at an all-time high right now.
Understanding Lymph Nodes in the Groin Area
As a 25-year-old woman who maintains a healthy lifestyle—abstaining from smoking and drinking and actively participating in sports—I've been dealing with slightly enlarged lymph nodes in my groin for the past year. While they aren't externally noticeable, I can feel them when I touch the area. To investigate further, I underwent an ultrasound, and the results indicated the following: FINDINGS: The analysis of both groin regions showed oval-shaped structures that exhibit a hypoechoic border with a brighter center, typically associated with blood vessels. On the right side, the sizes of these formations are measured at 2.6 mm x 6.4 mm, 5 mm x 8.4 mm, and 3 mm x 9.6 mm. On the left, similar formations are noted, measuring 4 mm, 4.6 mm, 3.5 mm x 8.6 mm, and 4 mm x 10.3 mm. These appearances suggest a non-specific lymphadenopathy, free from any alarming features, likely pointing to a reactive condition, possibly stemming from inflammation. My concern is that these findings could signify something more serious, potentially malignant, which is why I am considering requesting a biopsy. I would appreciate your thoughts on this matter.
Should I Restart Terbinafine Treatment for Ringworm After a Relapse?
I’m a 30-year-old woman dealing with a persistent ringworm condition on my hands for the past 18 months. Initially, I was prescribed terbinafine at a dosage of 250mg daily for a month, which resulted in significant improvement in my symptoms. However, my doctor concluded the treatment without any follow-up, asserting that four weeks would suffice, even though I communicated that I was still experiencing issues. After about 12 or 13 days, I noticed a slight deterioration in my condition and opted to resume the medication. Before restarting, the largest rash measured approximately 2cm, while the rest were generally smaller than 1cm; initially, I had numerous rashes varying from 5cm to 2cm. This situation is causing me considerable anxiety to the extent that it’s affecting my sleep, mostly due to concerns about the potential side effects of prolonged terbinafine use. I’m eager to understand what the process should look like following a relapse. I have a couple of questions: 1. Would it be feasible to add an extra four weeks of treatment to build on the progress made previously? 2. Am I required to restart the entire regimen from the beginning, potentially extending it to at least six weeks since the initial four weeks proved insufficient?
Intermittent Hives Concerns
M22, Height: 5’10, Weight: 170 Greetings, about three to four months back, I began experiencing an intense itchiness on my feet upon waking up one morning. The discomfort persisted throughout the day, worsening as time progressed. To alleviate the sensation, I opted for a hot bath, which provided some relief, albeit temporarily. The following night was troubling; I awoke to find myself drenched in sweat, suffering from mouth sores, and covered in hives on my feet and legs. This episode heightened my concern, especially since I have no known allergies that I'm aware of. Subsequently, I underwent blood tests, and a couple of days later, my clinic informed me of the results: my liver enzyme levels were alarmingly elevated, reaching around 600 when the normal range should be roughly 40, in addition to a deficiency in vitamin D. I then underwent an abdominal ultrasound, which thankfully returned normal results with only a mildly enlarged liver noted. The hives were erratic; one moment they would blanket my arms, legs, and feet, only to vanish an hour later. Notably, they never appeared on my upper body except for my arms, and this unusual skin reaction persisted for approximately two to three weeks. I'm curious to know if anyone else has faced a similar situation or might have insights into what this could be.
Persistent Pain During Right Forearm Supination
Hello, I’m an 18-year-old male weighing 150 pounds. On June 11th, I had an accident while riding my scooter (not electric) at a relatively high speed. I underwent an X-ray on June 13th, which showed no fractures. Approximately a month later, I had an MRI that provided somewhat ambiguous results, indicating inflammation of the supinator muscle and possibly a bone bruise near my wrist. Since then, I have been engaged in physical therapy for over a month, yet the pain I experience when I rotate my arm remains unchanged from the day of the fall, more than two months ago. The therapy has helped prevent muscle weakness, but the sharp discomfort persists, particularly on the outer side of my wrist and slightly above. The most intense pain is localized around my wrist area. Additionally, I have noticed a bump and a sensation of something clicking (without any sound) when I attempt to rotate my arm. While I do experience an increase in my range of motion with practice, the pain remains consistent throughout. Occasionally, after extensive rotation, the pain feels less intense, likely due to prior discomfort from the repeated movements. I can achieve a little over halfway rotation without any force without discomfort. I am feeling perplexed and deeply concerned, as despite my efforts, the pain continues to persist.