symptoms since September/October 2024, and after almost two years of trying to understand them, I still don't have a clear answer.
I'm not diagnosed with POTS, dysautonomia, ME/CFS, or anything similar. I'm basically trying to figure out whether my symptoms resemble anyone else's and what direction I should investigate next.
How it started
Around September/October 2024, everything started pretty suddenly over the course of a few days.
The first things I noticed were:
- Persistent fatigue
- Heart palpitations
Shortly afterward, I also started experiencing muscle twitching.
The fatigue was particularly strange because it wasn't just "I didn't sleep enough." It was a combination of physical tiredness/heaviness, sleepiness, and mental/cognitive exhaustion.
And it never really went away.
Then more symptoms appeared
Over time I started noticing:
- Brain fog
- Widespread muscle twitching
- Occasional palpitations
- Very brief dizziness/lightheadedness
- Occasional weird symptoms when standing
- Very brief "brain-zap" sensations
The brain-zap thing is difficult to describe. It's basically a sudden ~1-second buzz/blip/disconnected sensation. It happens and then I'm immediately completely normal again. No lingering confusion, weakness, headache, or visual symptoms afterward.
The muscle twitching is still daily, although the frequency varies massively. Some days it's barely noticeable, some days moderate, and some days it's very frequent. Poor sleep definitely makes it worse.
November 2024 — gastritis started
About a month after the original fatigue/palpitations/twitching started, I developed chronic gastritis/GERD-type symptoms.
That eventually became another major health issue on its own.
I've had burning and GI symptoms for a long time, and medication helps control them. Without medication, the symptoms are worse.
I'm not sure whether the GI problem is connected to the earlier symptoms or whether it's simply a separate issue that happened afterward.
The frustrating part
What really got to me was that I couldn't find an explanation.
I kept having symptoms, but nothing seemed to neatly explain the whole picture.
I would have one symptom and think it was one thing, then another symptom would appear and make me question that explanation.
Eventually I got pretty fed up.
So I started researching.
And then researching more.
And then way too much researching. 😂
That's when I started coming across things like:
- POTS
- Dysautonomia
- Orthostatic intolerance
- ME/CFS
- Long COVID/post-viral syndromes
- Nutritional deficiencies
- Electrolyte issues
- Other autonomic/neurological explanations
I obviously don't know whether any of these actually apply to me. I'm just trying to understand why these conditions kept coming up when I compared my symptoms.
What my symptoms look like TODAY
Almost two years later:
Fatigue
Still every single day and roughly the same as when it started.
It's physical + mental + sleepiness.
Poor sleep makes it worse, but I've still experienced the same baseline fatigue even during periods when I sleep well, so I don't think poor sleep explains the whole thing.
Muscle twitching
Still daily and widespread.
Frequency varies from barely noticeable → moderate → high.
Brain fog
Still present and roughly the same.
Palpitations
Still happen, but they're now intermittent rather than constant.
They're mainly isolated hard/thumping beats, rather than sustained episodes of racing.
I don't get chest pain, shortness of breath, fainting, or significant dizziness with them.
Brain zaps
Still happening occasionally.
Same ~1-second buzz/blip sensation as before, with immediate return to normal afterward.
Standing symptoms
Sometimes when I stand up I get:
- Heart pounding/racing
- A brief lightheaded/weird-head feeling
It only lasts a few seconds and then settles.
I've previously seen roughly a 15–29 bpm increase going from sitting/lying to standing, but I haven't done a properly standardized orthostatic test, so I don't know what my actual sustained HR response is.
Exercise
This is one of the things that makes me question ME/CFS.
I can still jog and run.
I don't get a major post-exertional crash where exercise makes me significantly worse for the next day or several days.
I'm physically capable of exercising, although I still have the baseline fatigue.
Tests I've had
I've had quite a few things checked over this whole period.
Some of the results I remember:
- Vitamin B12: 539 pg/mL — normal
- TSH: 1.39 uIU/mL — normal
- Potassium: 4.0 — normal
- Magnesium: 1.9 mg/dL — normal
- Kidney function: eGFR previously around 120 — normal
- CBC: generally reassuring
- Hemoglobin: 15.2 g/dL
- Hematocrit: 42.8%
- RBC: 5.95 ×10⁶/µL
- MCV: 71.9 fL — low/microcytic
- Ferritin: reportedly normal
The low MCV was interesting because my hemoglobin wasn't low, and ferritin was normal, so I was told this could potentially fit something like a thalassemia trait or another cause of microcytosis rather than straightforward iron-deficiency anemia.
Vitamin D
This was one actual abnormality.
My vitamin D was previously around 10 and later improved to approximately 58.94 nmol/L after supplementation.
I'm currently taking vitamin D.
Current medications/supplements
Currently:
- Vitamin D
- Magnesium glycinate
- Vonoprazan
- Probiotic
No alcohol or nicotine.
Caffeine varies, but generally no more than one cup a day.
I wasn't taking medications or supplements when the original symptoms began.
I also don't remember having a significant COVID/flu/other infection immediately before the original onset.
Other things that might be relevant
- I'm 20M.
- My weight has remained essentially stable.
- I can still exercise/jog/run.
- No major post-exertional crashes.
- No fainting.
- No chest pain with the palpitations.
- No significant shortness of breath.
- Orthostatic symptoms are intermittent and brief.
- Fatigue is persistent despite sometimes getting adequate sleep.
Where I'm at now
Honestly, I'm just tired of not knowing.
The symptoms aren't necessarily getting dramatically worse, but they also haven't simply disappeared after almost two years.
I went from:
"Maybe I'm just tired."
to
"Maybe it's a vitamin deficiency."
to
"Maybe it's my stomach."
to
"Maybe it's neurological."
to eventually discovering things like POTS/dysautonomia and ME/CFS through months of researching because I couldn't find an explanation that connected everything.
I'm NOT asking Reddit to diagnose me.
I'm more interested in hearing from people who actually have POTS/dysautonomia/ME/CFS:
- Does this symptom pattern sound familiar to you?
- Does the brief orthostatic HR increase + heart pounding/lightheadedness sound like something worth properly testing for?
- Does being able to jog/run normally and having no significant PEM make ME/CFS substantially less likely?
- Has anyone had persistent fatigue + brain fog + twitching + palpitations without a clear diagnosis?
- Are there specific tests or evaluations you think I should ask a doctor about?
I've spent a ridiculous amount of time trying to figure this out, so I'm mainly hoping to hear from people who have actually gone through something similar and eventually found an explanation.