Recurring Symptoms: Nausea and Dizziness Explained

Dizziness, nausea?

Hello Dr.
Yan, recently the symptoms that had not occurred for over five months have returned.
Previously, I sought help from Western medicine without resolution.
To avoid confusion in my explanation, I will list the symptoms in order of occurrence.

1.
(Usually occurs after work, feeling fatigued but sitting upright) I feel a gradual swelling or slight numbness in my scalp.
2.
I begin to feel anxious, and my face becomes warm.
The areas around my glabella, Yuyao, Jingming, Sibai, and Yingxiang start to swell.
3.
My nasal passages feel very warm, my blood pressure rises, and I feel slightly dizzy, but not to the point of vertigo (the increase in blood pressure may be due to anxiety, and antihypertensive medication is ineffective).
4.
I experience nausea and a feeling of discomfort in my stomach (which can vary in intensity).
These symptoms occur in sequence, but the onset of the second symptom does not cause the first symptom to disappear.
In other words, by the end, all symptoms seem to be present together.
Additionally, when the symptoms arise, I try to raise both hands, extend them straight out, touch my nose, move my eyes, and read aloud, all without any issues.
This may be somewhat difficult to interpret, but I hope you can provide some insights based on your expertise.
Thank you for your time and assistance.

Lao Zhang, 50~59 year old female. Ask Date: 2020/08/13

Dr. Yan Sumei reply Traditional Chinese Medicine

Hello, Mr.
Zhang~~ After work, you experience a feeling of head heaviness, dizziness, and nausea, which occurred five months ago.
This indicates that your body may produce these discomforts when you are overly fatigued.
As for the reasons behind it, further examination through observation, listening, inquiry, and palpation is necessary for a comprehensive assessment.
Wishing you clarity and relief! Best regards, Su-Mei Yen, Department of Traditional Chinese Medicine, Nantou Hospital.

Reply Date: 2020/08/13

More Info

Understanding recurring symptoms such as nausea and dizziness can be quite complex, especially when they manifest in a specific sequence and are accompanied by other sensations. Based on your description, it appears that your symptoms are multifaceted and may involve both physiological and psychological components.

1. Symptom Sequence: You mentioned that the symptoms typically start with a sensation of pressure or tingling in the scalp, followed by palpitations, facial flushing, and localized pressure in specific areas of the face. This progression suggests a possible autonomic nervous system response, which can be triggered by stress or fatigue. The autonomic nervous system regulates involuntary bodily functions, including heart rate and blood pressure, and can react strongly to emotional or physical stressors.

2. Elevated Blood Pressure: The increase in blood pressure you experience may indeed be linked to anxiety or stress, particularly if you are aware of your symptoms and are concerned about them. It is not uncommon for individuals to experience elevated blood pressure in response to anxiety, which can create a feedback loop where the anxiety exacerbates the physical symptoms, leading to further anxiety.

3. Nausea and Vomiting: The nausea you experience can be a result of several factors. It could be related to the autonomic nervous system's response to stress, or it could be a gastrointestinal reaction. Stress and anxiety can lead to gastrointestinal disturbances, including nausea, due to the gut-brain connection. The gut is sensitive to emotional states, and stress can lead to increased gastric motility or changes in gut flora, contributing to feelings of nausea.

4. Physical Tests: You mentioned that performing physical tests like raising your arms and moving your eyes does not exacerbate your symptoms. This is a positive sign, as it suggests that your symptoms may not be purely neurological or indicative of a serious underlying condition. However, it is essential to consider that symptoms can be multifactorial, and the absence of exacerbation during physical tests does not rule out other potential causes.

5. Potential Causes: Given the complexity of your symptoms, several potential causes could be considered:
- Anxiety Disorders: Generalized anxiety disorder or panic disorder could explain the sequence of symptoms you experience, particularly if they occur after a stressful day.

- Vestibular Disorders: Conditions affecting the inner ear can lead to dizziness and nausea, although your description does not suggest classic vertigo.

- Gastrointestinal Issues: Conditions such as gastritis or functional dyspepsia could contribute to nausea, especially if they are exacerbated by stress.

- Hormonal Changes: If you are experiencing any hormonal fluctuations, such as those related to menstrual cycles, these could also contribute to your symptoms.

6. Recommendations: It is advisable to consult with a healthcare provider who can conduct a thorough evaluation, including a physical examination and possibly further testing. Keeping a symptom diary may also help identify triggers or patterns in your symptoms. Additionally, stress management techniques such as mindfulness, yoga, or cognitive behavioral therapy may be beneficial in managing anxiety and its physical manifestations.

In conclusion, while your symptoms are concerning, they may be manageable with the right approach. A comprehensive evaluation by a healthcare professional can help clarify the underlying causes and guide you toward effective treatment options.

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