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Feeling queasy and hungry, weak stomach, smokes. Have anxiety, breathless and heart pounds. On cymbalta and xanax. Suggest?

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General & Family Physician
Practicing since : 2009
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am 22 yrs old and not pregnant. for the past year and a half or longer, I have been waking up queasy and extremely hungry. somedays are worse than others. While eating fixes the problem, many mornings even though I feel hungry I have no appetite. I'm about 5'5 and 115 pounds, with a very high metabolisn which seens to be slowing a little as I grow. in the past year, I have grown quite a bit. I have a weak stomach anyways, but its beyond that. I also have anxiety and sometimes my heart pounds and I get breathless. my grandma toldme she has a thyroid problem so I was wondering if that might be the case. for the medications I take, for the past 4 months I've been taking cymbalta which works great, the nuvaring for the past 6 months, and occasionally a xanax if I really need it. my diet varies, but almost every day it is balanced out between greas y convenient food and fruits and whole grains and fish and stuff at home. I am a regular pot smoker. can you help me at all?
Posted Tue, 28 May 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Luchuo Engelbert Bain 2 hours later
Hi and thanks for the query,

What you describe with respect to hunger and anxiety fluctuations deserve a formal exclusion of thyroid disease as you rightly put it. Hyperthyroidism could have digestive classical manifestations, and could actually lead to diarrhea in some cases. Hyperthyroidism could affect the heart and leads to a clinical syndrome called cardio-thyrotoxicosis. This can lead to heart failure in the course of the disease. A clinical evaluation should therefore involve active search of heart disease and lung disease, considering the fact that you present with breathlessness.

It might be very helpful quitting smoking completely. I would love to know if you have been consulted by a psychiatrist before. It would be very necessary to get this specialist consultation, diagnosis and proper follow up.

My suggestion is you book an appointment with an internist/endocrinologist for a proper clinical evaluation and management. Meeting a psychiatrist might be very useful too.

Thanks and hope this helps as I wish you the best of health.
Best regards,
Dr Luchuo, MD.
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