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fainting

Brain & Nervous System | Last Active: Aug 21, 2012 | Replies (15)

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@justkrs

I'm a 32 year old female. I had my first fainting episode almost 3 years ago. The first few months I was in the ER having blacked out at work almost once a week.
In time we learned that I had a combination of problems, and now 3 years later I'm still not ok, but many of my symptoms occur less often at least.

We found that my B-12 was so low it was non-existent because I have pernicious anemia. I now take weekly B-12 shots as my body can no longer absorb B-12 from food.

We also found my iron was crazy low, I was not only anemia but my body had no iron in storage (ferritin) either. Twice now I've been treated with IV iron protocols. My iron continues to drop for unknown reasons (we have run every test out there) so we check my blood counts monthly to monitor when I need more IV iron.

They started me 2 medications: Midodrine and Fludrocortisone. These both help alot with preventing me from actually blacking out all the way when I feel like I might.

In addition I transitioned to a high salt diet and increased my fluid intake to roughly 4 liters of water and juice a day.

With all of that in play things are managed to the point where I only fully black out maybe once ever other month or so and I've always had enough warning to sit or lay down first.
My continued problem is that after I black out, or almost black out, my heart rate drops to somewhere in the 32-45 range and stays there for hours or days on end. It is so low at that point that I can hardly get out of bed or function.

My team of docs (Primary Care, Cardiology, Neurology, Hematology, GI, Rheumatology, Gynecology) at this point are all scratching their heads. They cannot find any cause for the consistent low pulse. I was even hospitalized for a few days after my last blackout until my pulse was back above 50 and they were not able to determine the root of the problem, nor a way to treat it. We just had to "Wait it out".

Next week I go to talk to my cardiologist again. We are considering putting in a pacemaker to see if can at the very least help my body to bounce back AFTER an episode, if not prevent the syncope in the first place.

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Replies to "I'm a 32 year old female. I had my first fainting episode almost 3 years ago...."

Do you exercise frequently or vigorously? How are your eating habits? Based on information from my last cardiologist visit, I think I was exercising too intensely, too long, and too often. I also was not eating enough. I looked normal but for the amount and intensity of exercise I was doing my food intake was too low, especially protein. I now make sure to eat enough protein and don't exercise at such a high intensity.

my cardio has me wear a heart monitor and keep my pulse below 165 while working out. And I only work out a few times a week.
Keeping my pulse below 165 and not doing things that cause my pulse to quickly jump from slow to fast or fast to slow during workouts - these have helped alot in me not blacking out while working out.

Also I eat alot of protein every day because I need to watch my iron levels, and try to be less tired.

Try adding an endocrinologist to that mix of doctors. Syncope can be from an endocrine problem. Check adrenals, thyroid, pituitary function. Do the blood work in the A.M. It sounds like an endocrine or dysautonomia problem.... like POTS or NCS or adrenal insufficiency both primary and secondary..