Discussions By Condition: I cannot get a diagnosis.

Headaches, nausea and dizziness

Posted In: I cannot get a diagnosis. 1 Replies
  • Posted By: txgirl
  • November 8, 2006
  • 03:24 PM

For the last six months I have been unable to get a diagnosis. It started out with extreme fatigue, nausea, dizziness and headaches. The fatigue pretty much went away and the nausea got somewhat better for a few months, and I only had the headaches/dizziness. I went to an internest and he did complete bloodwork, CT scan of abdomin, everything was fine.
The nausea came back so I went to a gastro. doc and he did a endoscopy, MRI of my abdomin and said everything was normal.
I also had an MRI of my brain, to rule out problems there.

I am at a total loss where to go. I still have nausea that comes and goes everyday and headaches/dizziness. I have tried to exercise to see if that helps, and it makes me feel very lightheaded and worse. The Gastro. doc said the headaches should not relate to the stomach problems!!

Could this be some type of gland problem or allergy? I would think that the blood work would have found some of this? Should I go see an endocrine doc. or allergist? I am really tired of feeling lousy. I have always been really healthy and slim, and have never had any medical problems. I am 45 and feel like I am 80!

Please help!

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  • Two things to consider: Positional Orthostatic Tachycardia Syndrome (POTS) or--somewhat related--orthostatic hypotension. In both cases, the body has difficulty regulating autonomic nervous systems functions--primarily blood pressure. With POTS, a change in body position (such as getting out of bed) causes blood pressure to drop--which can lead to nausea, dizziness, etc. With POTS, the heart beats faster to try to maintain blood pressure. With orthostatic hypotension, there's the same blood pressure drop, but the heart doesn't speed up. The gastro symptoms are also pretty typical concurrent symptoms with POTS or orthostatic hypotension. The reason: Those two are both problems with your autonomic nervous system. Your digestive function is another autonomic nervous system function. Bluntly put, your body isn't able to digest food the way it's supposed to. All the tests you had (MRI, CT scan, blood tests, etc.) would come back normal. (Have the docs suggested that it might be all in your head? When they can't find the cause, that's usually the next step.) And the gastro doc is incorrect. The headaches/dizziness and the gastro problems are just different manifestations of the same problem. The initial test for POTS or orthostatic hypotension is actually fairly easy. It involves taking your sitting blood pressure and then, immediately after standing, your standing blood pressure. Your pulse rate is also important. The "gold standard" test is the tilt table test. You're strapped horizontally to a platform or table. Then the platform rotates to an upright position. Your blood pressure and other signs are constantly monitored. Some cardiologists know about POTS and orthostatic hypotension. It's believed it might be linked to the adrenal gland but that's uncertain. And, no, endocrinologists don't really understand it and aren't good at diagnosing it. Another possibility (though I'd pursue the POTS/orthostatic hypotension possibility first) is a type of migrane headaches. Your symptoms also are a pretty good match there. And again, your gastro doc would be absolutely wrong about no connection between your headaches and your GI problems. Hope that helps.
    wordsmth 3 Replies Flag this Response
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