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What Do Nausea, Dizziness, Headache And Fatigue Indicate Despite Normal Test Results?
Question: Since February 4, I've had moderate nausea, mild dizziness, mild headache, and more than normal fatigue. My family practice doctor ran a blood test for anemia, etc. and the results were normal. My cardiologist had me wear a 24-hour heart monitor which showed nothing extraordinary. I reviewed 157 possible causes of nausea, dizziness, headache, and fatigue and nothing resonated in terms of other symptoms associated with each of the 157 conditions and diseases. WHAT SHOULD I DO NEXT?.
Brief Answer:
Neurologist review and CT may be needed
Detailed Answer:
Hi,
Based on the history you have shared, first of all, rather than focussing on all 157 causes, a clinician always picks the commonest ones first and slowly rule out the common ones.
In 99 percent this gets picked up. Broadly classifying it into cardiac causes, neurological causes, endocrine causes, autoimmune causes and infections so starting from first as 24 hour Holter was normal, an EKG can be done to rule out any valve abnormalities and if normal most of the cardiac causes gets ruled out.
Baseline blood work-up like serum electrolytes, including calcium, sodium, and potassium as well as bicarbonate can be helpful.
Along with these, sugar levels, thyroid functions and serum cortisol levels which can help to rule out common endocrine causes but the symptoms that you have shared promptly the need to be evaluated by a neurologist in detail with the detailed neurological examination as well brain imaging if needed.
CT scan of the brain may also be done to rule out causes of raised intracranial pressures etc (as well as fundoscopy may be needed).
Autoimmune disorders are less likely to present like this still baseline ANA can be done. Keep good hydration and start supplements for calcium, B12, B6 and folic acid as these may help with the symptoms.
Gastric problems may present with such symptoms at the start can be complicated by malabsorption syndrome in later stages but baselines may help to rule out that too.
Rest of baseline tests like complete blood counts and ESR or CRP may rule out any underlying infections or abnormal blood products which can prompt the need for workup of any hematological condition.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Saddiq Ulabidin, General & Family Physician
Neurologist review and CT may be needed
Detailed Answer:
Hi,
Based on the history you have shared, first of all, rather than focussing on all 157 causes, a clinician always picks the commonest ones first and slowly rule out the common ones.
In 99 percent this gets picked up. Broadly classifying it into cardiac causes, neurological causes, endocrine causes, autoimmune causes and infections so starting from first as 24 hour Holter was normal, an EKG can be done to rule out any valve abnormalities and if normal most of the cardiac causes gets ruled out.
Baseline blood work-up like serum electrolytes, including calcium, sodium, and potassium as well as bicarbonate can be helpful.
Along with these, sugar levels, thyroid functions and serum cortisol levels which can help to rule out common endocrine causes but the symptoms that you have shared promptly the need to be evaluated by a neurologist in detail with the detailed neurological examination as well brain imaging if needed.
CT scan of the brain may also be done to rule out causes of raised intracranial pressures etc (as well as fundoscopy may be needed).
Autoimmune disorders are less likely to present like this still baseline ANA can be done. Keep good hydration and start supplements for calcium, B12, B6 and folic acid as these may help with the symptoms.
Gastric problems may present with such symptoms at the start can be complicated by malabsorption syndrome in later stages but baselines may help to rule out that too.
Rest of baseline tests like complete blood counts and ESR or CRP may rule out any underlying infections or abnormal blood products which can prompt the need for workup of any hematological condition.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Saddiq Ulabidin, General & Family Physician
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
No questions, just a "thank you" for your informative response that I will use in consultation with my primary care doctor.
Brief Answer:
Closing remarks
Detailed Answer:
Hello,
Just forgot to mention Echocardiogram with EKG during cardiac evaluation. Rest of the possibilities have been as discussed earlier.
Hope I have answered your query.
Take care
Regards,
Dr Saddiq Ulabidin, General & Family Physician
Closing remarks
Detailed Answer:
Hello,
Just forgot to mention Echocardiogram with EKG during cardiac evaluation. Rest of the possibilities have been as discussed earlier.
Hope I have answered your query.
Take care
Regards,
Dr Saddiq Ulabidin, General & Family Physician
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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