QuestionHello,
I had a bay girl 4 months ago. Since then I have been very lightheaded/dizzy. At first it would come and go however now it is daily. I have gone to a cardiologist and wore a heart monitor and had an echocardiogram done. The Dr. told me I was a bit dehydrated so I have been drinking more fluids and added a bit more salt to my diet--still not working. My family doctor did some lab work and she stated that my liver function panel was elevated (not sure of the #'s) so we did more lab work and a CT scan and everything came out fine but the liver panel is still elevated. Could the two be related? I almost feel like I have vertigo b/c I am dizzy on a regular basis and I hate it. I work 2 days a week and spend the rest at home taking care of my young kids (both under 2). I am scared that I am going to faint while I am home by myself with them. Should I have an MRI done of my head or my heart or any other tests done? I just need to get something resolved fast. Can you test for vertigo? Is there medication? I looked it up on line and have been doing one of the exercises for it hoping it will help. But I am not even sure that is what it is? I was just wondering if you recommend any other tests or blood work? Thanks for you help.
Kara
AnswerHi Kara,
Certainly there is a normal amount of fatigue associated with recent delivery. But it sounds to me like you have a post partum anemia. Anemia is often overlooked in these settings because the normal female "range" for hemoglobin is substantially lower than is the male range, thus it can be overlooked. For example, if your ante partum Hemoglobin levels were 14 and now they are 9, you would have the symptoms that you are describing, but still be in the normal range. A CBC (complete blood count) will answer this. Even better would be to compare a recent hemoglobin (or CBC) to an earlier test, when you felt well.
If this is vertigo, imaging your brain further will not elucidate the problem, but, having said that, if your medical group will provide you a head MRI, there is certainly no harm in it (and may offer an answer).
Vertigo, in general is divided into two groups: BPV and all others. BPV is benign positional vertigo, and as the name suggests, it is positional. It can be initiated by head movement, and can e resolved by keeping your head still.
The medication, meclizine (antivert) can be diagnostic and curative in the setting of BPV. Accordingly, if you respond to antivert, you likely have BPV.
The post partum course is always challenging, especially with a pair of little ones. But 4 months is a little long to continue with the symptoms. Another thought is that of PPD (post partum depression) as you know, depression can cause weakness and fatigue.
I'm not sure of the association between your liver labs and imaging findings and your symptoms. However, whenever LFT's are elevated beyond what might be expected, viral serology should be considered. This would be to check for various viral hepatitis viruses. If positive, that should be followed up with specific viral load labs.
Best of luck, let me know how else I might help.
Dr. Tim
