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Started Vomiting, Feeling Lightheadedness And Fatigue. What Am I Suffering From?

Posted on Sat, 30 Mar 2013

Question: I've had ongoing symptoms for nearly a year. Started with a virus in April and I started getting lots of stomach issues (including morning vomiting) and constant lightheadedness. The stomach issues gradually tapered off but I started getting symptoms of needing to eat constantly, still having lots of lightheadedness, gas and bloating, off and on fatigue (mostly trouble waking up in the morning), etc. The symptoms were getting better for a long time but are now getting worse again. I've been sleeping a lot, getting lightheaded all of the time, and having symptoms exactly like hypoglycemia but my blood sugar is normal. This is getting very debilitating and I have not been able to get a diagnosis after seeing almost 10 doctors.

Answered by Dr. Payman Hajiazim (1 hour later)

Hi there, thanks for asking. Many viruses can cause chronic fatigue syndrome after improvement from the acute stage. Some viruses like infectious mono, cytomegalo virus are the examples. They can cause chronic sleep problems and fatigue during the day. In the second step, people who have lack of sleep, will have more than normal appetite and they eat more than usual.
You can ask your doctor to send a blood sample to assess if your situation is related to mononucleosis or some other viruses.
Your doctor will also do a full examination to see if your liver, spleen or any other organ has been involved by the virus since it is a possibility.
When they know more about it, its management is much easier.
In may occasions, sleep management will help a lot in controlling the appetite and also fatigue in these patients.
Feel free to ask me any question. I wish you a good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Payman Hajiazim (7 minutes later)

Well I tested positive for a past mono infection but I never had any illness similar to mono... it started with a virus but that was nearly a year ago. My doctors thought it was complications from the virus and they said I'd get better and better, and I was getting better for a while but now I'm getting worse and worse again. It's terrifying. I feel so faint and sick and even my eyes are having trouble focusing today. And some of my symptoms are exactly like hypoglycemia but my blood sugar is normal... what could cause this? I have to eat really frequently or I feel even worse.

Answered by Dr. Payman Hajiazim (2 hours later)

Hi there, thanks for asking. The symptoms of mono is not always typical. You can send me the lab data to see about your tests in that time if you have. Then i can tell you more probably. I am waiting.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Payman Hajiazim (16 minutes later)

Well I didn't get those results, they just told me I had EBV antibodies that showed a past infection. I have also had thyroid testing, I was borderline hyperthyroid for a while but now my free T4 is more toward hypo (1.14). My TSH is still on the lower end at 0.71. It's just a little odd because I seemed to be feeling gradually better but now I am a lot worse.

Answered by Dr. Payman Hajiazim (1 hour later)

Hi there, Thanks. We have two issues to assess:
First if your free T4 and TSH are low, you should be checked for the possible low thyroid function. If your have coarse hair, your lateral side of eyebrow is lacking the normal growth, if you are more sensitive to cold, you may have it. You have already fatigue and sleep problem which are the other signs of it.
It is good to know that sometimes viruses can affect the thyroid and cause low functioning which may last for several months to years.
Second, you may tell me if your test in that time showed that your mono antibody is IgM or IgG.
Let me know about the issues.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Payman Hajiazim (4 hours later)

Well I kind of have symptoms of both hyper and hypothyroidism. I was leaning toward hyper, and my total T4 was a little high, but now I'm more normal/hypo with a low-normal TSH. My hair was falling out a lot over the summer but it seems to have stopped, I don't think I've had any hair loss in my eyebrows. I'm more sensitive to heat than cold. I have a really fast heart rate and have to eat frequently. I think I have idiopathic reactive hypoglycemia, I have to eat almost constantly or I will feel much worse.
I'm not sure which antibody it was, I'll try to find out next time I go to the doctor.

Answered by Dr. Payman Hajiazim (6 hours later)

Hi there, thanks for the explanation. The symptoms you described are compatible with thyroid problem following the gland affected by virus. It causes hyper function at first and then it becomes hypo function. You can ask your doctor to see if it is true for you.
Regarding hypoglycemia I should say you might have it, although many cases are managed with regular exercise since it causes secretion of the adrenaline and it prevents the blood sugar to drop.
Please let me know if your question has been answered thoroughly.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Payman Hajiazim (6 hours later)

Could I still have normal thyroid levels even with this condition? And could I have hyper and hypo symptoms simultaneously?

Answered by Dr. Payman Hajiazim (2 hours later)

Hi XXXXXXX thanks for the question. In these cases, first their thyroid becomes hyperactive (following releasing of hormone from the gland) and then it become hypoactive (following depletion of the gland from hormones). These two things do not occur at the same time.
In the first stage T4 rises while TSH is low or even normal and this not a rule and it can vary case to case. First they should see if your thyroid has been involved during that illness.
Take care and have a good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Payman Hajiazim (5 hours later)

Thank you. Could adrenal insufficiency be another possibility?
I also am wondering how drinking alcohol affects reactive hypoglycemia or other hormonal issues. Tonight I had one glass of wine which was not strong at all, I had it with a meal and it made me really lightheaded and tired almost instantly. I never had reactions to alcohol like this in the past, but I hadn't drank any in about a year.

Answered by Dr. Payman Hajiazim (10 hours later)

Hi XXXXXXX thanks for asking. Adrenal insufficiency could, but it is accompanied with change in your skin color, sodium and potassium change in your blood test and also change in the immune system, etc. It is easily diagnosed with a blood test so you can ask your doctor to send a blood sample after examination if he is suspicious.
Alcohol surely cause hypoglycemia and people who are vulnerable should not drink or drink very little.
Have a good health!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Payman Hajiazim (11 hours later)

Okay, thank you. I haven't had changes in skin color, but I have had very dry skin and it appears thinner in some places, for example I am seeing more veins in my face than I used to, and the skin on my hands is extremely dry, more so than it has ever been.
Could alcohol make reactive hypoglycemia worse for the entire day after? I have felt awful all day. I feel very tired, weak, sick to my stomach, and am having to eat more frequently than usual.
Are there any other conditions I could have that you can think of?

Answered by Dr. Payman Hajiazim (31 minutes later)

Hi XXXXXXX thanks for your question. Your skin seems to be normal, since in the winter skin gets dry.
Hypoglycemia following drinking alcohol lasts for several hours and the person should eat something to treat it. Some people have a headache which is sensitive to alcohol. Then it might take longer. Fortunately, it seems you do not have it.
Have you ever checked for H. Pylori infection of the stomach? It can cause hunger feeling as you mention.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Payman Hajiazim (1 minute later)

I have been checked for h pylori, which was negative. If I don't have hypoglycemia what else could be causing it? I don't even feel hungry a lot of the time, I just get really lightheaded when I need to eat, which is usually every 2 hours or less depending on what I eat.

Answered by Dr. Payman Hajiazim (8 hours later)

hi XXXXXXX, thanks for sharing the informtio
n. we usually experience a transient lightheadedness four hours after eating. it could happen sooner if we eat just a snack. many people feel better after about half an hour. i guess it maay be just pphisiological reaction of the body to low blood sugar level.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Payman Hajiazim (10 hours later)

Well it's not like anything I experienced before I got this illness. It's exactly like reactive hypoglycemia without the low blood sugar readings. Some days are worse than others, I get lightheaded and shaky if I don't eat at least every two hours or less and sometimes I get really lightheaded right after a meal, more so than I ever did before.

Answered by Dr. Payman Hajiazim (5 hours later)

If you do not have low blood sugar reading, it is a good sign. It shows that the hormones which acts to defeat the effect of insulin work well in your body.
If blood sugar is normal, i may be late dumping syndrome which is a rare disorder. In this condition one feel lightheadedness and other symptoms after eating. Change in diet and life style can help and if they do not work, some medications which puts delay in absorption of sugar can work. I wish you the best health.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar