OpenHealth Q&A

Navigating Chronic Nausea: Seeking Help

Hello everyone, I'm reaching out to seek advice and your insights regarding some persistent health challenges I've been facing. * I’m a 21-year-old female, standing at 5'8", weighing 160 lbs. * I have been struggling with chronic nausea for the past year and a half. * My only diagnosed medical issue is Polycystic Ovary Syndrome (PCOS). * I am not taking any medications at the moment. * I do not smoke and consume alcohol occasionally, but my intake has significantly decreased since the onset of symptoms. * Symptoms Overview: * Over the last 18 months, I have dealt with chronic nausea accompanied by a diminished appetite. * This began quite unexpectedly in February 2024. Initially, I attributed it to a potential stomach bug, as I was only experiencing nausea and mild stomach discomfort. * However, the nausea persisted daily for about three months. * Since then, my symptoms evolved into a more episodic experience, sometimes feeling fine and at other times enduring intense nausea. My appetite fluctuates, though I manage to eat even when feeling unwell. * Recently, I’ve noticed that my appetite loss has intensified alongside the nausea, and I often experience frequent burping. * Presentation of Symptoms: * Typically, I awaken with nausea, which can last throughout the day. The severity is unpredictable, with episodes stretching from a few days to a week, followed by a lull that may return unexpectedly weeks later. Some months are better, whereas others are riddled with discomfort. * I have conducted extensive research and have undergone numerous lab tests to uncover the underlying cause of these issues. Unfortunately, I feel as if I've hit a wall; some healthcare professionals have been dismissive, providing little hope for further exploration. Thus, I'm reaching out for any additional insights or recommendations from those who may have encountered similar situations. * A crucial piece of my medical history is that I had a suspected COVID-19 infection six months before the onset of nausea. This discovery came to light due to ongoing headaches that prompted blood testing, which revealed my COVID antibodies were significantly elevated, suggesting possible post-COVID symptoms. The headaches eventually subsided after four months, but shortly after that, I began experiencing nausea. Interestingly, I also had a confirmed COVID-19 infection six months after my nausea began (August 2024). I am beginning to wonder if this is a long COVID-related issue, as I’ve read it can disturb the gut-brain connection, microbiome, and vagus nerve. * Lab Results: I have undergone several tests, including: CBC with differential, ferritin, vitamin B12, folate, vitamin D, iron and total iron binding capacity, tests for Lyme disease, Epstein-Barr virus, Hepatitis C antibodies, lipid panel, thyroid (TSH with free T4), and hemoglobin A1c—all results returned normal. * The Comprehensive Metabolic Panel (CMP) was mostly normal, though my glucose was slightly elevated at 100, which may relate to my PCOS and insulin resistance. * I also completed an at-home H. pylori stool test which came back negative, but I might consider following up with a healthcare provider. * From what I’ve researched, I know that numerous factors can lead to nausea. However, given my lab results, I feel many possibilities have been eliminated, and my symptoms don't align with a number of other conditions. I don’t experience neurological or vestibular symptoms, nor do I have other endocrine or metabolic disorders (my CMP was normal), and I don’t have psychological issues or take any medications. I’m not pregnant, nor do I exhibit typical signs of dysautonomia, and I am free from pain, bloating, or feelings of fullness. * Consequently, I suspect a post-viral condition related to COVID-19 may be manifesting through gastrointestinal issues, possibly exacerbated by hormonal and blood sugar fluctuations due to PCOS. Prior to this, I had no digestive complaints and maintained a healthy appetite and lifestyle. * Other potential considerations include: * Small Intestinal Bacterial Overgrowth (SIBO) * Mild gastroparesis (although I have no early fullness or bloating) * Gallbladder or pancreas dysfunction * Latent food intolerance (perhaps gluten?) * Potential Addison's disease * Hyperparathyroidism (notably, my calcium levels were at 10, which is at the high-normal range) * I apologize for the lengthy message, but I am sincerely grateful for any thoughts, advice, or experiences shared by medical professionals or others who may recognize similar symptoms. Experiencing significant health concerns at such a young age without clear guidance from my healthcare providers has been incredibly frustrating. This situation has severely impacted my quality of life, and I am longing to return to better health. * Thanks to everyone who takes the time to read this and offers support; your kindness and willingness to share your insights are immensely appreciated!

Answers (1)

8/28/2025, 3:24:43 AM

OpenHealth AI

Thank you for sharing your detailed experience with chronic nausea. It’s understandable to feel frustrated when dealing with ongoing health issues and not receiving the guidance you need. Let's break down your situation and explore potential next steps to help manage your symptoms.

Main Points:

1. Chronic Nausea: You've been experiencing persistent nausea for over a year, which can significantly affect your quality of life.
2. Possible Post-Viral Syndrome: Your symptoms may be related to post-COVID conditions or other underlying gastrointestinal issues.
3. Next Steps: Focus on symptom management, dietary adjustments, and tracking any potential triggers while exploring further diagnostic options.

Explanation:

Chronic nausea can originate from various causes, including gastrointestinal disturbances, hormonal imbalances (given your PCOS), and potential post-viral syndromes like Long COVID. Your symptoms’ episodic nature and lack of clear medical findings can make this particularly challenging.

Given your comprehensive lab results show no immediate abnormalities, it may be worthwhile to consider functional gastrointestinal disorders, including conditions like Small Intestinal Bacterial Overgrowth (SIBO) or mild gastroparesis, even in the absence of typical symptoms.

Specific Next Steps:

1. Dietary Adjustments:

   • Keep a Food Diary: Track what you eat daily, along with your nausea fluctuations. Identifying patterns or specific food triggers can be helpful.
   • Small, Frequent Meals: Instead of large meals, eating smaller portions more frequently may ease nausea.
   • Ginger or Peppermint: Incorporate ginger tea or peppermint to potentially soothe your stomach.
   • Stay Hydrated: Ensure you're drinking enough fluids, especially if nausea affects your appetite.

2. Symptom Tracking:

   • Document the timing and severity of your nausea episodes, alongside any lifestyle factors (stress, sleep, diet) to help identify triggers or changes.

3. Follow-Up on Suspected Conditions:

   • Considering your suspicions about SIBO or mild gastroparesis, returning to a healthcare provider for renewed discussions about gastroparesis testing or SIBO breath testing could be beneficial.
   • If symptoms worsen or new ones develop, ensure to report these updates to your healthcare team.

4. Lifestyle Considerations:

   • Manage Stress: Stress can exacerbate gastrointestinal symptoms. Techniques such as mindfulness, yoga, or light exercise may help reduce anxiety and improve overall well-being.
   • Maintain a Regular Sleep Schedule: Adequate sleep is key for recovery and overall health management.

5. Support Systems:

   • Join support groups or forums focused on similar health issues, as connecting with others can provide comfort and additional insights.

Remember, you’re not alone in this journey, and it's okay to seek out second opinions if you feel your concerns aren't being taken seriously. Your health and quality of life matter, and finding the right support is crucial. If you have any further questions or need more specific guidance on any of the points, please feel free to ask.