I have had this complaint of extreme fatigue and tiredness after having lunch. I have a history of lightheadedness, spinning sensations, ringing in the right ear (sometimes), extreme fatigue, and tired legs. It is like a sudden drop in energy levels. I was told this could be postprandial. I was diagnosed with BPPV a few years back, which got better in a few weeks, but now, I feel a bit lightheaded with my head or even physical movement on a very consistent basis. It is like a bit of a spinning feeling that I get. Mostly at work. It is not bad while sitting, and feeling much better, but my leg and foot fatigue are my problems. At work, the eyes feel very tired and lead to a heavy head by late afternoon. My CBC was conducted recently, and the report is enclosed. The spinning sensation does not happen while sleeping or sitting but is more prominent with a movement. I have nerve deafness in my left ear, and sometimes I hear ringing in my right ear. Request your feedback. I take vitamin D 50,000 weekly and Prucalopride 2 mg (when constipated).
I have gone through your history and assure you that you will be alright in a short time. Can you tell me whether you have undergone any other blood tests as you are 40?
The probable cause could be type 2 diabetes mellitus, vitamin deficiency, and hyperglycemia. The differential diagnosis is electrolyte deficiency. I suggest you take the following test.
1. Fasting Blood Sugar Test (FBS).
2. Postprandial Blood Sugar test (PPBS).
3. Hemoglobin A1c (HbA1c).
4. Vitamin B12.
5. Vitamin D3.
6. Serum electrolytes.
I also suggest you take multivitamins per day at night. Avoid sugary food, and take food at regular intervals.
Revert with all the test reports.
I have attached all my results, fasting blood sugar, Vitamin B12, and others. My question is regarding constant head spinning, especially during head motion. Please go through my detailed submission before you provide your answer.
I have seen your reports; (the attachments are removed to protect the patient's identities) your CBC (complete blood count), cholesterol level, and electrolyte levels are in the normal range. However, your estimated glomerular filtration rate (eGFR) has been higher in the last two years.
A high eGFR level indicates early renal damage, as your symptoms indicate increased glucose level. In your report, you had not done this report. So again, I suggest getting FBS, PPBS, CT (computed tomography), abdomen, and HbA1c as early as possible. The probable diagnosis is high glucose level and hypertension. As you had been diagnosed with BPPV (benign paroxysmal positional vertigo), it may be related to your glucose level.
And as compared to your blood, urea and serum creatinine levels are also increased. So please get these tests done if they are negative or normal. Only in that case will we go for further evaluation. Measure your urine output in 24 hours. For example, if your urine output is 1200 mL per day, you can consume 1200+600= 1800 mL of fluid. Please get the reports done earliest.
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