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.
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