Confronting a Medical Enigma
Let’s start with the fundamentals: I’m a 17-year-old male weighing 66 kg, and my medical background includes Graves’ disease, autism, and obsessive-compulsive disorder (OCD). I’ve been prescribed 200 mg of sertraline, which I began taking after many of my current challenges had already emerged. Occasionally, I will take 1-2 mg of lorazepam, and I frequently use 2 mg of delayed-release melatonin. In January and February, I received a diagnosis of Graves’ disease, a condition that took a toll on me initially but showed signs of improvement relatively quickly, leading to a remission by October. So far, that status remains unchanged. While the stabilization of my hormones alleviated many symptoms, I found my overall condition continuing to deteriorate. I have been experiencing profound fatigue, resulting in my withdrawal from most activities and forcing me into a predominantly bed-ridden lifestyle. Alongside this, I am grappling with feelings of depression and irritability stemming from my physical limitations and lack of recovery. I also faced a noticeable weight loss, approximately 7 kg. Other troubling symptoms I’ve encountered include persistent headaches and various types of aches, sleep disturbances, excessive sweating, trembling, significant cravings for salt, difficulties with concentration, and memory lapses. I frequently feel dizzy or have moments of seeing spots when I stand. When I’ve had my blood pressure taken at the hospital, it consistently shows slightly elevated or borderline hypertensive readings. I'm also observing what may be oral hyperpigmentation: a white patch on the roof of my mouth with a dark bluish center and a peculiar gray discoloration on the underside and sides of my tongue. Recently, I’ve started noticing discomfort and bloating in my stomach after eating, often resembling reflux. My digestive issues include excessive gas and frequent burping. Despite undergoing various blood tests that returned mostly normal results, I continue to feel that everything I’m experiencing is rooted in a physical cause. Being autistic and having a history of depressive episodes, this level of distress feels entirely new and overwhelming for me. There’s a nagging doubt creeping in due to the often "helpful" suggestions I sometimes receive from healthcare professionals. It’s important to note that while my severe stress responses and salt cravings are long-standing issues, the majority of my new symptoms are more recent developments, gradually worsening over the years. If anyone has insights or further questions, I’d appreciate your feedback.
Answers (1)
12/16/2025, 9:50:43 PM
OpenHealth AI
Thank you for sharing your detailed medical background; it’s evident you're dealing with a lot right now. Your symptoms, including profound fatigue, mood changes, concentration difficulties, and digestive issues, are understandably overwhelming. Let's break this down and focus on the main points to help you gain some clarity and direction.
Key Observations:
- Fatigue, Mood Changes, and Concentration Difficulties: These can be tied to both your Graves’ disease and the medications you’re taking.
- Digestive Issues and Oral Changes: Your symptoms like bloating, gas, and changes in oral appearance warrant closer attention.
- Blood Pressure and Dizziness: Slightly elevated blood pressure and dizziness are concerning and could relate to underlying issues.
Explanation:
Graves’ disease can lead to various systemic effects, and even with remission, some patients experience lingering symptoms or new conditions. Additionally, medications like sertraline and lorazepam can sometimes contribute to fatigue and cognitive changes. Your weight loss and cravings for salt may also reflect adjustments your body is making post-treatment.
The oral changes you've described, particularly the white patch and discoloration, could indicate a number of things, including possible medication side effects. Digestive symptoms like bloating and reflux can arise from various factors, including dietary changes or anxiety-related responses, often exacerbated by medication.
Next Steps:
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Monitor Symptoms: Keep a diary of your symptoms, noting when they occur and any potential triggers (food, stress, etc.). This can help identify patterns or correlations.
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Dietary Adjustments:
- Maintain hydration and consider a balanced diet that includes fruits, vegetables, and whole grains to support your digestive health.
- Avoiding spicy or fatty foods may help with bloating and reflux.
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Manage Stress and Mental Health:
- Engage in relaxation techniques such as deep breathing, mindfulness, or gentle yoga, which can help manage both anxiety and physical symptoms.
- If you find it helpful, consider discussing re-evaluating your medication with your provider, as fatigue and mood changes require attention.
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Regular Check-Ups:
- It may be wise to schedule a follow-up with your healthcare provider to further address your oral symptoms, the persistent headache, and your digestive issues. This is crucial, particularly if your blood pressure remains elevated.
- Ask for specific evaluations that might explain your symptoms—such as testing for potential deficiencies (e.g., B12, iron) or thyroid hormone levels since thyroid imbalances can have widespread effects.
Reassurance:
It’s natural to feel lost with such a complex mix of symptoms, especially when the standard tests come back normal. Remember, it's okay to seek clarification and advocate for yourself within the healthcare system. You're looking for solutions, and it's important that your concerns are taken seriously. Making small adjustments and continuing to seek the right answers can lead to substantial improvements over time.
If you need further clarification on any of these steps or if new symptoms arise, please share them as they develop. You're not alone in this, and there is support available.
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