Which Medical Specialty Should You Consult for Persistent Symptoms?

Which department should I consult?

Hello Doctor, I have been experiencing various uncomfortable symptoms that come and go, but recently they have started to affect my daily life, and I would like to find out the cause.

1.
I often experience unexplained dizziness that lasts for several hours over consecutive days, and then it inexplicably resolves.
This dizziness is particularly common after meals, lasting anywhere from half an hour to three to four hours.

2.
In enclosed spaces, turning my head too frequently (not suddenly) causes dizziness.
After exercising (like jogging), I feel a heavy pressure in my head and sometimes feel nauseous and unable to eat.

3.
My hands and feet are very cold, and at times I feel chills and shivering, especially at night when I get so cold that I can't sleep (the cold sensation often starts from behind my ears or shoulders).
Sometimes, this is accompanied by palpitations and headaches.

4.
I have itchy skin all over my body, which can be so bothersome at night that it disrupts my sleep (I have already been using body lotion).
The itching is particularly intense around my hip bones and back, as well as my abdomen.

5.
I suffer from insomnia, sometimes due to palpitations and dizziness, other times because of itchy skin.
However, there are times when I just can't seem to fall into a deep sleep, tossing and turning, waking up frequently.
Sometimes I wake up with one side of my body feeling numb, and it feels like I haven't really slept at all, as I can hear my heartbeat and feel vibrations (heartbeat + headache), waiting for the moment when I can finally fall asleep without feeling anything.
However, cardiac examinations have shown no significant issues.

6.
I frequently experience tinnitus, especially after climbing two flights of stairs or brisk walking for five minutes.
Sometimes the tinnitus is accompanied by headaches.

7.
My menstrual cycle is irregular; sometimes it doesn't come at all, and other times the flow is light, but blood tests have shown no anemia.

8.
Staring at screens (phone, computer, projector) for too long makes me feel very dizzy, and sometimes reading does the same.

9.
I have stiffness in my shoulders and neck, and I cannot carry or hold things for long periods without pain, which eventually leads to dizziness.

I am unsure if these symptoms are related.
Which medical specialty should I seek assistance from? Or should I consider making adjustments to my diet and daily routine? I do not stay up late and usually go to bed early (between 10 and 11 PM, sometimes I am busy but I generally sleep before midnight).
However, due to various reasons, I often don't know what time I actually fall asleep.
This situation is really troubling me, as my sleep and daily activities have been affected.
I often feel dizzy and uncomfortable in public places and while using public transportation, and I also feel unwell after exercising.

me, 20~29 year old female. Ask Date: 2016/03/24

Dr. Liao Yaopan reply Family Medicine

Hello, based on your inquiry, all symptoms may potentially be caused by the same underlying issue.
It is advisable to further investigate this matter, and I recommend discussing it with your family physician.
You may also consider arranging a comprehensive health assessment at your own expense to rule out any systemic abnormalities.
Dizziness and tinnitus should be evaluated by an otolaryngologist.
Additionally, long-term sleep disturbances may contribute to various psychosomatic symptoms.
Changhua Hospital cares about your well-being.

Reply Date: 2016/03/24

More Info

Based on the symptoms you've described, it seems you are experiencing a complex interplay of issues that may involve multiple medical specialties. Here’s a breakdown of your symptoms and the appropriate specialists you might consider consulting:
1. Neurology: Given your persistent dizziness, headaches, and episodes of tinnitus (ear ringing), a neurologist would be a good starting point. They can evaluate for conditions such as vestibular disorders, migraines, or other neurological issues that could be causing your symptoms. The dizziness after meals and during physical activity could also be related to neurological factors.

2. Internal Medicine: An internist can help assess your overall health and look for underlying systemic issues that could be contributing to your symptoms, such as thyroid dysfunction, anemia, or metabolic disorders. They can also help coordinate care among different specialists.

3. Dermatology: Since you are experiencing widespread itching and skin discomfort, a dermatologist can evaluate your skin condition. They can help determine if there is an underlying dermatological issue or if the itching is related to systemic conditions.

4. Psychiatry or Psychology: Given your sleep disturbances and anxiety about your symptoms, consulting with a mental health professional may also be beneficial. They can help address any anxiety or stress that may be exacerbating your physical symptoms, particularly your insomnia and the sensation of your heart racing.

5. Endocrinology: If your irregular menstrual cycles persist, it may be worth consulting an endocrinologist. They can evaluate for hormonal imbalances that could be contributing to your symptoms.

6. Allergy/Immunology: If your itching and skin issues are suspected to be allergic reactions, an allergist can help identify potential allergens and recommend appropriate management strategies.

Lifestyle and Dietary Adjustments
In addition to seeking medical advice, there are several lifestyle adjustments you might consider:
- Diet: Keeping a food diary can help identify any food triggers that may be contributing to your symptoms, particularly the dizziness after meals. A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall health.

- Hydration: Ensure you are adequately hydrated, as dehydration can lead to dizziness and headaches.

- Sleep Hygiene: Establishing a consistent sleep routine can help improve your sleep quality. This includes creating a comfortable sleep environment, limiting screen time before bed, and practicing relaxation techniques.

- Stress Management: Techniques such as mindfulness, yoga, or meditation can help manage stress, which may alleviate some of your symptoms.

- Physical Activity: While you mentioned discomfort after exercise, gentle activities like walking or stretching may help improve circulation and reduce tension in your neck and shoulders.

Conclusion
Given the complexity of your symptoms, it may be beneficial to start with a primary care physician or an internist who can perform a comprehensive evaluation and refer you to the appropriate specialists based on their findings. They can help coordinate your care and ensure that all aspects of your health are being addressed. It's important to communicate openly about all your symptoms, as they may be interconnected. Seeking help is a crucial step towards understanding and managing your health concerns effectively.

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