Question: Hello, I've been experiencing symptoms such as fatigue, lightheaded, headaches, and shortness of breath for sometime now. It seems to come and randomly and usually doesn't last very long, often only a few seconds to a few minutes.Although I have noticed it seems to be brought on by exercise or physical activity. I recently had a medical exam. The doctor found no signs the caused a concern. Heart and lungs sound normal, and blood pressure is in an acceptable range. The doctor then suggested blood test to check glucose, thyroid and kidney function. I just got my results back today and everything came back normal. However, I still feel like something is wrong.

Hello, I've been experiencing symptoms such as fatigue, lightheaded, headaches, and shortness of breath for sometime now. It seems to come and randomly and usually doesn't last very long, often only a few seconds to a few minutes.Although I have noticed it seems to be brought on by exercise or physical activity. I recently had a medical exam. The doctor found no signs the caused a concern. Heart and lungs sound normal, and blood pressure is in an acceptable range. The doctor then suggested blood test to check glucose, thyroid and kidney function. I just got my results back today and everything came back normal. However, I still feel like something is wrong.

Hello Dr. XXXXXXX thank you for reviewing my question and getting back to me so quickly. To answer your questions:

I'm not so sure if I would describe the lightheadedness as vertigo. Its not significant enough to cause a loss of balance or become disorientated. However, I would say it does seem to be brought on by changing potions quickly (going from laying down to standing suddenly or looking up or down for an extended time).

I would say my heart rate seems to be within the normal ranges most of the time. I've checked it several times along with my blood pressure and its usually somewhere between 75 and 85 beats per minute while at rest. However, it may be worth mentioning at times I've felt what could be heart palpitations, or what feels like fluttering for a few breaths. Especially right after exercises such as push ups, where i become exerted and quickly stand. This is also when I have noticed the shortness of breath to be worse. Almost like I'm holding my breath for a few seconds immediately after and then I slowly start to catch my breath. Could this be from simply being out of shape?

And lastly, no, no history of allergies, migraines or asthma.

Interesting that you mention anemia. After further research of symptoms, this became one of my primary concerns. Also, it came to mind that in the past I have noticed some slight gum bleeding while brushing. Over time, would bleeding gums be enough to cause anemia or iron deficiency?

Thank you for the suggestion on medication for the headaches. Although the headaches are not particular bothersome, only mild, and don't last very long.

Additionally, I am overweight, 6'2" 265, but have always been a bigger guy and have usually stayed into some type training (cardio weightlifting) not the case for the last 3 years though. That, along with a poor diet has certainly cause me to gain weight and become out of shape. However, I have drastically changed my diet over the last few weeks and started light exercises (20 minute brisk walks, push up mostly) as I originally thought my symptoms were due to elevated bloop pressure, and simply being overweight and out of shape. However, it now has me more concerned now that I see my blood pressure generally stays in an "acceptable" range (126/84 or so on average) I have however seen it as high as 130s/92.

With that in mind it is more concerning now that i have decided to make a life style change, lose weight and start exercising again. These symptoms make it almost scary to exercise or push myself too hard. My primary reasoning for seeking a doctors advise before continuing.

Thank you again, and I hope this is enough information to give you a better understanding of my symptoms and condition.

Hello Dr. XXXXXXX thank you for reviewing my question and getting back to me so quickly. To answer your questions:

I'm not so sure if I would describe the lightheadedness as vertigo. Its not significant enough to cause a loss of balance or become disorientated. However, I would say it does seem to be brought on by changing potions quickly (going from laying down to standing suddenly or looking up or down for an extended time).

I would say my heart rate seems to be within the normal ranges most of the time. I've checked it several times along with my blood pressure and its usually somewhere between 75 and 85 beats per minute while at rest. However, it may be worth mentioning at times I've felt what could be heart palpitations, or what feels like fluttering for a few breaths. Especially right after exercises such as push ups, where i become exerted and quickly stand. This is also when I have noticed the shortness of breath to be worse. Almost like I'm holding my breath for a few seconds immediately after and then I slowly start to catch my breath. Could this be from simply being out of shape?

And lastly, no, no history of allergies, migraines or asthma.

Interesting that you mention anemia. After further research of symptoms, this became one of my primary concerns. Also, it came to mind that in the past I have noticed some slight gum bleeding while brushing. Over time, would bleeding gums be enough to cause anemia or iron deficiency?

Thank you for the suggestion on medication for the headaches. Although the headaches are not particular bothersome, only mild, and don't last very long.

Additionally, I am overweight, 6'2" 265, but have always been a bigger guy and have usually stayed into some type training (cardio weightlifting) not the case for the last 3 years though. That, along with a poor diet has certainly cause me to gain weight and become out of shape. However, I have drastically changed my diet over the last few weeks and started light exercises (20 minute brisk walks, push up mostly) as I originally thought my symptoms were due to elevated bloop pressure, and simply being overweight and out of shape. However, it now has me more concerned now that I see my blood pressure generally stays in an "acceptable" range (126/84 or so on average) I have however seen it as high as 130s/92.

With that in mind it is more concerning now that i have decided to make a life style change, lose weight and start exercising again. These symptoms make it almost scary to exercise or push myself too hard. My primary reasoning for seeking a doctors advise before continuing.

Thank you again, and I hope this is enough information to give you a better understanding of my symptoms and condition.

Thank you so much for your advise. I will try to schedule a complete blood count in the near future.

Just to be sure I understand, bleeding gums is not significant enough to cause anemia over time, but a poor diet can? I've looked into anemia and iron deficiency and several of the symptoms do sound like what I have been experiencing. If this is a possibility, in the meantime would it be okay to take iron supplements to see if the condition improves?

Also I looked into (BPPV) as you suggested. A couple of the symptoms sound familiar, but could the explain the other symptoms such as the shortness of breath?

Some important notes I don't believe I mentioned before: Most of the time I feel completely fine, which is likely why I fell into a period where i just accepted it as "normal". These episodes just seem to happen randomly at times or be brought on by physical excretion. Also that the symptoms do not occur every time. Most of the time I can change position quickly and no lightheadedness or vertigo. This is also true for the shortness of breath, only happens for brief amounts of time and seems quite random. Also may be worth mentioning that it does seem to be triggered when first lying down along with the heart palpitation, or "fluttering" feeling. But again, this is only for a second or two.

One last thing that may help you get a better understanding. I've been doing research on how to better explain my symptoms. On that note, I came across on "Dyspnea". A better way to describe what I've been experiencing is a feeling of being smothered or suffocating. This got my attention because of several "triggers" that were mentioned. For example: pollen, being around smoke, steamy showers or being inside a hot car with the windows up. All of these at times have seemed to trigger it and make it feel as if I'm suffocating or not getting enough oxygen from the air around me.

Any final thoughts on this? I do apologize if I'm not being clear enough or adding too much. I'm having a hard time explaining exactly what I have been experiencing as this is the first time I've really spoken in depth about it and don't want to leave anything out. Once again, thank you for your advise and consideration and I hope this helps.

Thank you so much for your advise. I will try to schedule a complete blood count in the near future.

Just to be sure I understand, bleeding gums is not significant enough to cause anemia over time, but a poor diet can? I've looked into anemia and iron deficiency and several of the symptoms do sound like what I have been experiencing. If this is a possibility, in the meantime would it be okay to take iron supplements to see if the condition improves?

Also I looked into (BPPV) as you suggested. A couple of the symptoms sound familiar, but could the explain the other symptoms such as the shortness of breath?

Some important notes I don't believe I mentioned before: Most of the time I feel completely fine, which is likely why I fell into a period where i just accepted it as "normal". These episodes just seem to happen randomly at times or be brought on by physical excretion. Also that the symptoms do not occur every time. Most of the time I can change position quickly and no lightheadedness or vertigo. This is also true for the shortness of breath, only happens for brief amounts of time and seems quite random. Also may be worth mentioning that it does seem to be triggered when first lying down along with the heart palpitation, or "fluttering" feeling. But again, this is only for a second or two.

One last thing that may help you get a better understanding. I've been doing research on how to better explain my symptoms. On that note, I came across on "Dyspnea". A better way to describe what I've been experiencing is a feeling of being smothered or suffocating. This got my attention because of several "triggers" that were mentioned. For example: pollen, being around smoke, steamy showers or being inside a hot car with the windows up. All of these at times have seemed to trigger it and make it feel as if I'm suffocating or not getting enough oxygen from the air around me.

Any final thoughts on this? I do apologize if I'm not being clear enough or adding too much. I'm having a hard time explaining exactly what I have been experiencing as this is the first time I've really spoken in depth about it and don't want to leave anything out. Once again, thank you for your advise and consideration and I hope this helps.

Thank you for the help, I'm going to see if I can have a complete blood count done this week. Although, after speaking with you I'm not sure why the doctor just didn't order that along with the other blood test after my emanation... I just have a couple more last questions for you: I altered my diet a little and took out the brown rice, now mainly consisting of grilled chicken and leafy greens and I've noticed I feel better. Continued with some light cardio and light weight training with no problems. Could this be an indicator of any kind, could food like brown rice aggravate symptoms such as the ones I've been experiencing? Also, I have started taking an iron supplement, is there a suggested amount I should take and day and for a certain amount of time?

Thank you for the help, I'm going to see if I can have a complete blood count done this week. Although, after speaking with you I'm not sure why the doctor just didn't order that along with the other blood test after my emanation... I just have a couple more last questions for you: I altered my diet a little and took out the brown rice, now mainly consisting of grilled chicken and leafy greens and I've noticed I feel better. Continued with some light cardio and light weight training with no problems. Could this be an indicator of any kind, could food like brown rice aggravate symptoms such as the ones I've been experiencing? Also, I have started taking an iron supplement, is there a suggested amount I should take and day and for a certain amount of time?

Hello, Thank you again for you advice.

After doing further research I would like to run more information by you regarding my condition.

I have been looking into possible causes of anemia/ iron deficiency, as we discussed before I have several symptoms associated with iron deficiency anemia ( headache, shortness of breath, lightheadedness and fatigue).

I know we discussed poor diet could be a possible cause of iron deficiency, which brings me to what I wanted to bring to your attention. I came across the "Bristol stool chart" and realized I am a type 5 or 6 on this scale and have been for at least several months. However, bowl movement frequency has seemed to be normal, so I never thought much of it and just associated it with poor diet.

My question to you is this be an indication of anything, or a possible cause due to food passing through the digestive track to quickly and not allowing enough time to properly absorb nutrients? And if so, is there anything I should try to see if it improves, such as Pepto-Bismol or fiber supplements?

Thank you again.

Hello, Thank you again for you advice.

After doing further research I would like to run more information by you regarding my condition.

I have been looking into possible causes of anemia/ iron deficiency, as we discussed before I have several symptoms associated with iron deficiency anemia ( headache, shortness of breath, lightheadedness and fatigue).

I know we discussed poor diet could be a possible cause of iron deficiency, which brings me to what I wanted to bring to your attention. I came across the "Bristol stool chart" and realized I am a type 5 or 6 on this scale and have been for at least several months. However, bowl movement frequency has seemed to be normal, so I never thought much of it and just associated it with poor diet.

My question to you is this be an indication of anything, or a possible cause due to food passing through the digestive track to quickly and not allowing enough time to properly absorb nutrients? And if so, is there anything I should try to see if it improves, such as Pepto-Bismol or fiber supplements?

Thank you again.