long-lasting severe nausea
Long-lasting, severe nausea without vomiting
Hello,
I am a 40-year-old male, weighing 74 kg at 178 cm in height.
For about 1.5 years, I have been suffering from unexplained nausea. A year ago, I underwent a gastroscopy and colonoscopy, which showed only 'subtle signs of antrum gastritis' without any further results. During this time, I also experienced unexplained and painful cracks in both corners of my mouth. (Angular cheilitis) The symptoms lasted for several months, then almost completely disappeared in the summer/fall of 2013.
I have heart arrhythmias (confirmed by EKG) and three years ago, I visited a cardiologist after experiencing a nocturnal circulatory attack, but he did not find anything life-threatening. In a 24-hour EKG, my sinus rhythm ranged from 43 bpm to 114 bpm (even though I avoided any exertion!), with high 'R-waves in the chest leads'.
I experienced these nocturnal attacks with sweating, severe nausea, chills, trembling, and a shallow, flying pulse only once more. Due to my professional experience as an emergency medical technician, they remind me of shock symptoms (due to various causes).
For the past four months, I have been suffering from severe nausea again (the symptoms tend to be more severe), which in my opinion does not originate from the stomach.
The nausea is often so severe upon waking up in bed that I can hardly get out of bed. It takes me about two hours with coffee to feel somewhat awake. However, I have a lot of gas in my stomach, even after waking up when I haven't eaten anything, and I have to burp a lot (not acidic reflux), which has not yet been clarified. Sometimes, I feel a specific relief of the nausea when I burp, so it may be related.
For about six months, I have also had these (related) symptoms:
I often wake up startled, my right arm twitches, and the right side of my right hand is numb or tingling (when lying on my back!). In addition, I experience severe nausea, palpitations, and my blood pressure is around 140/95 during this nausea, whereas my normal pressure is currently on average rather low (110/70-120/85). The experience is so distressing and frightening that I have been on the verge of calling emergency services several times. I also experience mild dizziness, sometimes an immense pressure in my head (as if it were about to explode), and occasionally headaches.
Some symptoms suggest a form of intoxication. Cardiac function? Liver? Metabolic imbalance?
A blood test six weeks ago revealed a TSH value of 4.06 and an ultrasound showed a very small thyroid gland. My primary care physician mentioned a tendency towards hypothyroidism, saying 'my power plant is exhausted'. However, just four weeks later, the TSH value was 2.26 and all thyroid hormones were within normal range, and he reassured me. My cholesterol was surprisingly elevated at 224, which has never been the case for me. As mentioned earlier, I suspect a metabolic disorder.
I feel exhausted, sometimes almost debilitating fatigue, I am definitely not as mentally stable, and I also have depressive phases (which are certainly the psychological consequences of problems that cannot be categorized). I often feel as if I have 'cotton wool' in my head, a certain dizziness, and a feeling of not being able to think clearly.
However, the nausea is the 'leading symptom', so severe that I often struggle to do anything reasonable during the day, and I have to force myself to do so, as I have a responsible profession as a teacher. When I am symptom-free (usually in the early evening), I could rejoice, it is like a nightmare that is lifted from me.
Moving generally makes me feel better, so for years I have been walking an average of one hour a day (!) plus 10 minutes of jogging recently, even though I sometimes experience a stabbing pain in my left shoulder/neck area after about 5 minutes.
Could the improved condition with movement indicate circulatory disorders (for whatever reason) that cause an imbalance in my acid/base balance (and thus the nausea)?
From an orthopedic perspective, I have hip osteoarthritis due to a poorly treated hip misalignment as a child, and my back is not the most stable. I also have flat feet. Could the symptoms also come from this direction?
Due to these rather unclear symptoms, I have been referred to a cardiologist and a neurologist, but I would be very grateful for a preliminary opinion and an assessment of the most likely direction the symptoms point to. They are so debilitating to my quality of life that I am currently only 'fighting for survival', feeling lost and desperate.
In my past, I worked in
