Brief Answer: Nausea occurs due to several reasons. Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 62 year old female • History of anxiety and panic attacks for 1 week after stressor 3 months back • Complaints of: Nausea on and off. Nausea is a very common symptoms. It can occur more than 50% medical illnesses. Before suspecting nausea due to psychological issues, it is important to rule out medical reasons for nausea first specially in older individual. I would like to have following routine investigation in your case: fasting blood sugar, liver function test, kidney function test, serum electrolytes, serum TSH and Urine routine/microscopic examination. I would also like to consider following possibilities in your case, which need to rule out in your case: • Acidity: Anxiety problem leads to increase acidity. • Side effect of substance use: Hope you are not using it. • Vitamins deficiency: Take balance and healthy diet. • Ear problem or infection. • Postural hypotension. Anxiety and panic causes several symptoms apart from psychological symptoms. Common symptoms of anxiety are: nervousness, restlessness, mild irritability, excessive worry regarding own health, tremor, muscle spasm, pain in multiple parts of body, easy fatigability, headache, nausea, acidity, dyspepsia, sleep disturbance, palpitation and dry mouth. If you are having some of the above symptoms then nausea is more likely due to anxiety. Many your nausea occur after seeing something leading to disgust or at some places (closed spaces/height), then it is more likely psychological in origin. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups. Wish you good health. Regards, http://bit.ly/Dr-Ashish-Mittal

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