Request for Insight on Persistent Symptoms
I am seeking advice while I await appointments with cardiology and gastroenterology. Over the past year, I have experienced various symptoms that remain unexplained. Age: 26 | Height: 5’4” | Weight: Approximately 10 stone Current Medications: Sertraline, omeprazole, and piritizine (an antihistamine) Medical History: Corrected B12 deficiency, anxiety, and obsessive-compulsive disorder **Key Symptoms:** - My resting heart rate usually fluctuates between 80 and 100 bpm but can exceed 150 bpm when I walk or am exposed to heat. - Upon standing, my heart rate sometimes increases by more than 30 bpm, though this isn't consistent. - I frequently feel fatigued, experience brain fog, suffer from headaches, and hear ringing in my ears (tinnitus). - I occasionally have tingling or numbness in my hands and legs, along with tremors. - I experience pain in my ribs and upper back, sometimes presenting sharply. - Despite taking omeprazole, I still struggle with acid reflux, congestion, difficulties swallowing, and a sensation of food being stuck. - My skin can become itchy and flushed at times. - There was a brief period where the entire upper right side of my back felt numb; while this has improved, I still contend with considerable itching in that area. **Tests Conducted Thus Far:** - Blood tests (including TSH, inflammatory markers, B12, and iron) returned mostly normal results, though my ferritin levels were low-normal but are improving. - An ultrasound of my liver and kidneys showed normal findings. - An MRI of my ear nerve also yielded normal results. - My elevated ALT levels have normalized, although gamma-GT remains mildly elevated but stable. - An ANA test returned negative. - An endoscopy is scheduled, but I feel quite anxious about that procedure. - A 72-hour heart monitor test is forthcoming. **Questions I Have:** 1. Do these symptoms suggest conditions like POTS or MCAS, or could they indicate something different? 2. Is it advisable to proceed with the endoscopy and mild sedation considering my heart rate issues? 3. Are there any other conditions I should discuss with my healthcare providers? I appreciate any insights you might offer.
Answers (1)
8/28/2025, 12:24:03 PM
OpenHealth AI
Thank you for sharing your detailed symptoms and medical history. It's understandable to feel anxious given the complexity and persistence of your symptoms. While I can’t diagnose your condition, I can provide some insights based on the information you've provided, along with actions you can take.
Overview of Key Points:
- Your symptoms could align with conditions like Postural Orthostatic Tachycardia Syndrome (POTS) or Mast Cell Activation Syndrome (MCAS), but further evaluation is necessary.
- Proceeding with the endoscopy is important and can typically be done safely even with your heart rate concerns, but please share your anxieties with your healthcare team beforehand.
- Considering additional conditions with your providers might be advisable based on your ongoing symptoms.
Explanation:
- POTS is characterized by an excessive heart rate increase upon standing and can include fatigue and other symptoms like brain fog and palpitations, which aligns with your experience. MCAS may explain symptoms like flushing, itching, and gastrointestinal issues, but diagnosis requires specific tests.
- Your heart rate fluctuations are significant and should be monitored closely, especially during procedures. It's good that you're scheduled for further evaluation with the heart monitor.
- It's normal to be anxious about an upcoming endoscopy. Mild sedation is usually safe, but it’s crucial to discuss your heart rate fluctuations and any concerns with your medical team. They may adjust your sedation or monitor you closely for safety.
Next Steps:
- Communicate with your healthcare team about your symptoms, especially the heart rate issues, before the endoscopy. This will help them tailor the procedure to your needs.
- Track your symptoms consistently leading up to your appointments. Note when symptoms worsen or improve, as it may help your doctors understand patterns that could point to a diagnosis more quickly.
- Discuss potential conditions like POTS, MCAS, or any other you feel might be relevant during your next appointments with your cardiologist and gastroenterologist. Bringing a list of your symptoms and their timing can support this discussion.
- Practice relaxation techniques or mindfulness to help manage anxiety, especially regarding your endoscopy. Techniques may include deep breathing, meditation, or guided imagery to help calm your mind.
Remember, while it’s normal to feel uncertain with undiagnosed symptoms, you're taking proactive steps by seeking further evaluations, which is essential. Let me know if you have questions about any specific symptoms or strategies.
Related Questions
Understanding the Increased Pain in My Foot While Reclining
At 30 years old, I am nearing the five-week mark since undergoing surgery on my metatarsals. I've encountered a troubling issue: I can’t seem to find comfort when lying down, whether it’s with my foot raised or lying flat. My pain level escalates to a severe 10 out of 10, unless my foot is making contact with the floor or I dangle my leg off the side of the bed so that my toes touch the ground. Is this situation typical for someone in my circumstances? Are there any suggestions that might assist me in getting a better night's sleep?
Assessing My Health Concerns: How Anxious Should I Be?
I’m a 32-year-old woman, weighing 124 pounds and standing at 5 feet 6 inches tall. For over a year, I have been experiencing bright red rectal bleeding. Initially, I attributed this issue to hemorrhoids that developed during my pregnancy two years ago. The bleeding occurs with most of my bowel movements, sometimes happens without one, and on a few occasions, has been enough to stain the toilet bowl significantly. The color of the blood is typically darker than what I observe during a hemorrhoid flare-up. There is a notable family history of bowel cancer on both sides; one family member was diagnosed at age 45, and another at 60. In the past six months, I have encountered several episodes of severe abdominal pain—3 to 4 instances—intense enough to consider a trip to the emergency room. However, the pain usually subsides within about an hour. It’s unusual for me to experience such acute pain, given my high tolerance for discomfort; for example, I once played rugby shortly after dislocating and fracturing my finger. Recently, I mustered the courage to consult with my doctor, who recommended a FIT test, which returned a positive result (30.1). Additionally, I underwent a complete blood test, and aside from having low ferritin levels (7 µg/L), all other results were normal. I have since been referred for a colonoscopy on a two-week waiting list to rule out any possible bowel cancer. Given these circumstances, how concerned should I be? Thank you for your input.
Understanding EEG Results for My 22-Month-Old Son: Insights Needed
Could someone help clarify this for me? My son, who is just 22 months old, hasn’t started walking yet, becomes tired easily, and has been experiencing behavioral outbursts. He had a febrile seizure in February 2025, followed by another unexplained seizure in April 2025, which led us to consult a neurologist. Since he was 3 months old, he has been receiving therapy from a physical therapist for torticollis. At birth, he spent five days in the NICU due to issues with meconium aspiration. A recent MRI showed normal results, and he also had a follow-up EEG after one conducted in July 2025. The results from this recent EEG were abnormal for a pediatric patient in awake, drowsy, and sleeping states. Notably, there were brief episodes of left frontotemporal delta slowing, which occurred mainly when he was awake and drowsy. There were no signs of epileptiform activity detected. In contrast, the EEG performed back on July 3, 2025, was deemed normal for both awake and drowsy states, again with no evidence of epileptiform irregularities, although it did not capture any sleep data. This examination was prompted by the child's existing history of febrile seizures. Importantly, he is not currently on any anti-seizure medications. The EEG procedure used standard electrode placements per the 10-20 system, conducted a single-lead EKG, and included continuous video monitoring. During the analysis, the background activity was symmetric, indicating some anterior-posterior (AP) organization, with a dominant rhythm of 50-80 microvolts at 7 Hz. His drowsy state was marked by a reduced amount of eye blink activity, less breathing motion interference, and a generalized slowing in theta/delta frequencies. Stage II sleep exhibited spindles and vertex waves patterns. Additionally, there were intermittent bursts of 250-300 microvolts in the left frontotemporal region with semi-rhythmic activity of 2-4 Hz, mostly observed during wakefulness and drowsiness. No definitive epileptiform discharge was noted. Photic stimulation during the test did not elicit a strong response, and hyperventilation was not conducted during this session.
INTENSE Spine Discomfort, Breathing Difficulties, Muscle Twitches, and Sweating
To elaborate on the situation mentioned in the title, I’ve been experiencing unusual muscle twitches and spasms for the past few days, along with some discomfort in my back. However, today, I felt an unexpected sharp pain shoot through my spine, which has left my legs feeling numb and made it impossible for me to sit up straight. Additionally, I’ve been dealing with cold sweats for the last hour and struggling to breathe properly. Perhaps I’m just overanalyzing things and it’s a common occurrence, but the intensity of the pain is overwhelming—it's truly unbearable. I’m shaking quite a bit, and unfortunately, my parents aren’t responding to my attempts to reach them for help. I have a history of a chronic heart condition and arthritis, yet I’ve never experienced pain this severe, especially in my spine. For context, I am nearly 15 years old and female. My current medications include pain relievers, anxiety medication, beta blockers, and some vitamins, though those specifics may not be particularly relevant. I don’t smoke; however, I have tried vaping a few times, which might not matter much, but I thought it was worth mentioning as it was requested.
28-Year-Old Male Experiencing Scalp Sensations Post-Amitriptyline Treatment
I am a 28-year-old man in generally good health, without any cardiac concerns. Approximately a month ago, I encountered intense pain localized to one side of my head, which was unresponsive to paracetamol. However, a single dose of a migraine treatment provided substantial relief. Following that, I began a regimen of amitriptyline, starting at a nightly dose of 10 to 25 mg. While my head pain has diminished significantly—by about 90 to 95%—I now experience occasional uncomfortable sensations on my scalp. These feelings include pins and needles, a cooling sensation, and some crawling feelings near my hairline and ears. There are fleeting moments where I feel brief throbs lasting a second, but I do not have any persistent headaches. To clarify, I do not experience any of the following: - Nausea - Weakness in my limbs - Numbness - Changes in my vision - Coordination difficulties - Seizures The symptoms I have are transient, shifting around and often intensifying when I become conscious of them or as the day progresses. I would like to know: Is it common to experience these sensations during the recovery stage following episodes of neuralgia or migraine-like discomfort? Additionally, could the amitriptyline potentially be causing these temporary paresthetic sensations? I am seeking some reassurance or advice on what is typically observed during this healing process. Thank you.