Brief Answer: Review by an internist is my suggestion Detailed Answer: Hi and thanks for the query, I think a keen clinical review might be very important. The weakness you are experiencing could be of various origins. The commonest causes like anemia (low hemoglobin should be checked for). A complete blood count can easily give an indication of this parameter. GERD when uncontrolled or severe could associated with some gastrointestinal bleeding, which in some very silent forms could lead to large quantities of blood lost but clinically unnoticed. A fibroscopy to check for the state of the lesions could be very helpful. Weight loss, especially when acute could result from a multitude of causes. It is very important to exclude a cancer at this stage. An abdominal ultrasound and CT scan could help exclude any clinical silent abdominal mass. A chest X ray might be very useful to check for any possible infectious markers or masses. It is important to know if you have been coughing chronically lately or not. Diseases like pulmonary Tuberculosis and lung abscesses could present as such. Conditions like Aspergillosis, a parasitic infection, usually presenting itself as asthmatic attacks could have similar symptoms, manifesting itself as allergies, tiredness and dizziness. A hurting stomach deserves a careful evaluation for gastric ulcers, especially with a past history of GERD. A fibroscopy and biopsies of any ulcers, if present, to exclude any stomach tumor would be of great importance. The headaches you are experiencing could be primary (like migraine, tension headaches or cluster headaches) or secondary (infections, tumors, brain abcesses, stress, hypertension etc). It is imperative to get a good measurement of your blood pressure. It is not rare to have young people at your age with such symptoms due to hypertension. Heart racing deserves a proper review. Low hemoglobin levels (anemia) and fevers are common causes of rapid heart rate. A proper clinical exam to exclude any possibility of a heart condition might be useful. Based on the case history and medical and family history, in case of a notion of heart disease, an EKG and cardiac ultrasound, added to a simple chest X ray might aid clear any doubts. My suggestion is booking an appointment with an internist for a proper review. Thanks and kind regards as I wish you the best of health. Please, do feel free asking any follow up questions. I am predisposed to make my humble suggestions for your well being. Kind regards DR Bain

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