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Dr. Andrew Rynne

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Suggest remedy for dizziness and fatigue

Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 6462 Questions

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Posted on Mon, 26 Oct 2015 in General Health
Question: Hello Doctor
And sometimes I feel after I drive a car and then make sense of such blood flow from the thighs and legs up with dizziness and the feeling that I will fall for two seconds and then come back with a natural sense of tired.
I also sometimes feel very sleepy and lack of advancement.
What are the reasons and how is it treated .
doctor
Answered by Dr. Ilir Sharka 42 minutes later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Thank you for asking on HCM!

I understand your concern and would explain that your symptoms could be related to an orthostatic hypontesion or sleep apnea.

I would like to know your age and your body weight (if you are overweight). Do you feel sleepy many times during the day?

A sleep apnea could be related to similar episodes during the day and increased sleepiness. It is more common in overweight persons.

I recommend to closely monitor your blood pressure in sitting and standing up position. A decrease more than 20mm Hg in standing up position compared to sitting position, would be indicative of orthostatic hypotension.

A head up tilt test is necessary to rule in/out this possible disorder.

I also recommend performing some blood lab tests :

- complete blood count (for chronic anemia)
- kidney and liver function tests
- fasting glucose
- blood electrolytes
- cortisol plasma levels (adrenal gland fucntion)
- blood gas analysis (for possible sleep apnea)
- thyroid hormone levels (thyroid gland function)

A polysomnography is needed to exclude possible sleep apnea.

Hope to have been helpful!

I am at your disposal for any other questions, whenever you need!

Best wishes,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 14 minutes later
Hello Doctor
174 cm longitudinally and I weigh almost 79.5
I have high blood pressure as well as high in cholesterol and eat regular treatment
Naberl 10 mg and 20 mg Zekor.
As I had a cooler in the parties do not know the reasons.
I attached analyzes requested by noting that the analysis of blood cortisol 10.
Any advice Dr
doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
I recommend to discuss with your doctor on the other tests I recommended

Detailed Answer:
Hello again!

Thank you for the information provided.

I reviewed all your uploaded tests and it results just a complete blood count (uploaded six times). It seems to be quite normal.

Your cortisol plasma levels are within the normal reference ranges. So an adrenal gland dysfunction can be excluded.

Your body wait and Body Mass index are within the normal ranges, but this fact doesn't exclude a possible sleep apnea.

Do you snore at night?

Regarding the medication you are taking, could you spell again the first drug?

Zocor could cause muscular pain and cramps as adverse effects, but would not be related to the episodes you refer.

So I recommend you to discuss with your doctor on the other tests, I recommended to your (head up tilt test, polysomnography,other lab blood tests).

If all the above tests result normal, you should consider anxiety as a possible cause related to this symptomatology.

Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Greetings!

Dr. Iliri




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 25 minutes later
Hello Dr
1- I am not snoozing during night sleep(But I have a blocked noise because of sensitivit ).
2- Second medcine Narapril(Enalapril maleate 10mg).
Requesting Dr
1-Test other than polysomnography test (please re type it please ) change mind in to anxity causes.
2- since my Cholestrol high especially triglyceride .
Note that I have a pain muscles.
doctor
Answered by Dr. Ilir Sharka 7 minutes later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again,

Enalapril in this dose, could not related to any adverse effects that may mimic your symptoms.

Regarding your high cholesterol levels, they could be related to different causes :
- an unhealthy diet (rich in fatty acids and rapidly absorbed sugar food and low omega 3 intake)
- low physical activity (office work)
- thyroid dysfunction
- sleep apnea could also raise cholesterol levels.

Besides polysomnography (for sleep apnea), head up tilt test (for orthostatic hypotension), I would recommend performing these lab tests:

- kidney and liver function tests
- fasting glucose
- blood electrolytes
- blood gas analysis (for possible sleep apnea)
- thyroid hormone levels (thyroid gland function).

Hope to have been helpful!

Best regards,

Dr. Iliri




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 15 hours later
Hi, I have provided some attachments. Please review them.
doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
Your blood gas test seems normal.

Detailed Answer:

Hello!

I reviewed you blood gas analysis. It seems to be from a venous blood sample instead of an arterial.

Nevertheless, your uploaded test doesn't seem to be problematic (judging it is venous blood), it is normal.

If possible I would advise you to check again an arterial blood test (the blood should be drawn from an artery, such as radial, femoral artery).

Other recommended tests (from the above discussion) should be performed as well, for an optimal differential diagnosis.

Kind regards,

Dr. Iliri




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