Unexplained Dizziness, Fatigue, and Heat: Seeking Answers in Neurology

Q: Unexplained Dizziness, Fatigue, and Heat: Seeking Answers in Neurology

Hello： Your symptoms should first consider the possibility of an infection. <br>If the infection is caused by a virus, it has been a week since 5/28, and your body should be mostly recovered by now. <br>During the summer, due to increased fluid loss, it is important to stay well-

Headache, dizziness, head pressure, unexplained fever, irritability, fatigue?

Since May 20, after finishing breakfast, I suddenly felt very dizzy, similar to heat exhaustion.
My body felt unusually hot and restless, but I was also sweating cold.
My colleagues thought I was suffering from heat exhaustion and suggested I drink rehydration solution, which helped a lot! However, the next morning, on May 21, the symptoms returned.
I experienced the same issues, had very deep sleep, and felt like I couldn't get enough rest, with weakness in my limbs and a light-headed feeling.
Later, I tried gua sha therapy, and a lot of dark substances were scraped off, but there was no improvement, and the next day the symptoms were the same.
What could be wrong with me...? I visited an otolaryngologist twice, but they couldn't provide any answers and only prescribed pain relievers and antipyretics, which didn't help.
I also tried drinking electrolyte water, but it didn't work either.

Yi, 20~29 year old female. Ask Date: 2019/05/22

Dr. Jiang Junyi reply Neurology

Hello: Your symptoms should first consider the possibility of an infection.
If the infection is caused by a virus, it has been a week since 5/28, and your body should be mostly recovered by now.
During the summer, due to increased fluid loss, it is important to stay well-hydrated.
If your urine is darker in color and you are urinating less than five times a day (less than 1000 ml/day), you may need to consider dehydration.
If you have a fever lasting more than two weeks, it is advisable to consult an infectious disease specialist, as it could be tuberculosis, thyroid dysfunction, or other autoimmune diseases.
Wishing you good health and peace.
Dr.
Jiang from Taoyuan Medical Center cares about you.

Reply Date: 2019/05/22

More Info

Unexplained dizziness, fatigue, and sensations of heat can be quite distressing and may stem from a variety of underlying medical conditions. Given your symptoms, it’s essential to approach this situation methodically to identify potential causes and appropriate treatments.

Firstly, the sudden onset of dizziness and feelings of heat, especially after eating, could suggest several possibilities. One common cause is postprandial hypotension, where blood pressure drops after eating, leading to dizziness and fatigue. This can occur due to blood flow being redirected to the digestive system, which may not be adequately compensated by your cardiovascular system.
Another possibility is related to autonomic nervous system dysfunction, which can manifest as dizziness, fatigue, and temperature regulation issues. Conditions such as orthostatic hypotension, where blood pressure drops significantly upon standing, can also lead to similar symptoms. This is often exacerbated by dehydration or electrolyte imbalances, which might explain why drinking electrolyte solutions provided temporary relief.

Additionally, your symptoms could be indicative of a vestibular disorder, which affects balance and spatial orientation. Dizziness can also be a symptom of anxiety or panic attacks, especially if accompanied by sweating and feelings of heat. It’s worth noting that anxiety can sometimes manifest physically, leading to sensations of dizziness and fatigue.

Given that you have already consulted with an ENT specialist without resolution, it may be beneficial to seek further evaluation from a neurologist. A neurologist can assess for conditions such as migraines, vestibular disorders, or even more serious issues like multiple sclerosis or transient ischemic attacks (TIAs), which can present with dizziness and fatigue.

In terms of diagnostic tests, a thorough neurological examination is essential. This may include imaging studies such as an MRI or CT scan to rule out structural abnormalities in the brain. Blood tests to check for anemia, thyroid function, and electrolyte levels can also provide valuable information. Additionally, a tilt table test may be useful to evaluate how your body responds to changes in position, particularly if orthostatic hypotension is suspected.

As for treatment, it will largely depend on the underlying cause identified. If dehydration or electrolyte imbalance is a factor, increasing fluid and electrolyte intake may be necessary. If a vestibular disorder is diagnosed, vestibular rehabilitation therapy could be beneficial. In cases where anxiety is contributing to your symptoms, cognitive-behavioral therapy (CBT) or medication may be recommended.

In summary, your symptoms of dizziness, fatigue, and heat warrant further investigation, particularly from a neurologist. It’s crucial to keep a detailed record of your symptoms, including their frequency, duration, and any associated factors, as this information can aid in diagnosis and treatment. Remember, it’s important to advocate for your health and seek a second opinion if you feel your concerns are not being adequately addressed.

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