Which Specialist to See for Severe Headaches and Fatigue?

Which specialty should I see? Headache and poor mental condition?

Hello Doctor: Recently, my headaches have significantly increased, accompanied by pain around my eyes.
I often feel dizzy, weak, and have low energy, yet I still feel fatigued and yawn frequently despite maintaining a regular schedule.
When I am too busy, I also experience symptoms of chest tightness and shortness of breath.
Additionally, my appetite has decreased, and I often feel nauseous, but my weight has been increasing instead of decreasing.
I would like to know which specialty I should visit and what tests I should undergo.
I am very concerned about the possibility of a serious condition.
Thank you.

Xiao Mao, 30~39 year old female. Ask Date: 2020/03/28

Dr. Liao Yaopan reply Family Medicine

Hello, regarding your concerns, it is recommended that you first consult your family physician for an evaluation.
If necessary, they can refer you to other specialists.
Please note that online consultations are not equivalent to in-person visits and cannot provide diagnoses or treatment recommendations.
We encourage you to maintain a normal daily routine, along with proper diet and exercise habits.
Changhua Hospital cares about you.

Reply Date: 2020/03/28

More Info

When experiencing severe headaches accompanied by symptoms such as eye pain, dizziness, fatigue, and changes in appetite, it is crucial to seek medical attention to determine the underlying cause. Given your symptoms, the most appropriate specialists to consult would be a neurologist and possibly an internist or primary care physician.

Neurologist
A neurologist specializes in disorders of the nervous system, which includes the brain, spinal cord, and nerves. Since your symptoms include severe headaches, dizziness, and fatigue, a neurologist can conduct a thorough evaluation to rule out conditions such as migraines, tension-type headaches, cluster headaches, or more serious issues like intracranial hypertension or neurological disorders. They may recommend imaging studies such as an MRI or CT scan to visualize the brain and identify any abnormalities.

Internist or Primary Care Physician
An internist or primary care physician can also be a good starting point. They can perform a comprehensive evaluation of your overall health, including a physical examination and blood tests to check for underlying conditions such as anemia, thyroid dysfunction, or infections that could contribute to your symptoms. They can also assess your cardiovascular health, especially since you mentioned experiencing chest tightness and shortness of breath during periods of stress.

Recommended Tests
1. Blood Tests: A complete blood count (CBC) can help identify anemia or infection. Thyroid function tests can assess if your thyroid is functioning properly, as both hyperthyroidism and hypothyroidism can lead to fatigue and changes in appetite.

2. Imaging Studies: If neurological issues are suspected, an MRI or CT scan of the brain may be necessary to rule out structural problems.

3. Electrocardiogram (ECG): Given your symptoms of chest tightness and shortness of breath, an ECG can help evaluate your heart's rhythm and rule out any cardiac issues.

4. Sleep Study: If fatigue persists, a sleep study may be warranted to check for sleep disorders such as sleep apnea, which can significantly impact energy levels and overall health.

Lifestyle Considerations
In addition to seeking medical advice, consider evaluating your lifestyle. Stress management techniques, regular physical activity, and a balanced diet can play a significant role in alleviating symptoms of fatigue and headaches. Ensure you are getting adequate hydration and sleep, as both are crucial for overall health and can influence headache frequency and severity.

Conclusion
While it is understandable to be concerned about the possibility of a serious condition, many causes of headaches and fatigue are treatable. Early intervention is key, so scheduling an appointment with a neurologist and/or your primary care physician is advisable. They can guide you through the necessary evaluations and help develop a treatment plan tailored to your specific needs. Remember, your health is paramount, and addressing these symptoms sooner rather than later can lead to better outcomes.

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