28 F with chronic brain fog and fatigue
Hi! I'm a 28 year old female, active and live a healthy lifestyle, but for the past 5 years, I've dealt with bouts of fatigue and brain fog that are slowly getting worse until just the past year I'm realizing this is starting to affect my job and social life. It's like most of the time I'm fine, but some days I will wake up feeling horrible like my body has been sucked dry of any energy. I work remote and even sitting at my desk on those days feels impossible, and then I will get almost immediate relief if I lay down.
I also feel a lot of chest discomfort and intense brain fog. The brain fog is like I'm looking through a foggy window and don't feel aware at all of what's going on. I also often black out when I stand up where I don't pass out but my vision goes black and have a ringing in my ears and heart feels to me like it's beating rapidly. I have passed out twice when I was a teenager and another time when I got my blood drawn, but I haven't passed out in the past probably ten years.
Because of that, I thought that maybe this is POTS, so I went down that rabbit hole and met with a cardiologist. He ordered an EKG, heart monitor, and stress test, and they all apparently came back normal with no indications of POTS and they also did a quick testing of my heart rate and blood pressure in office laying down and then sitting and standing, and that didn't reach the criteria for POTS. However, while all of that was happening, he told me to increase my liquids, electrolytes, and use compression socks, and those have really taken the edge off most of the symptoms, but not really enough to make a huge difference. When I mentioned the brain fog again with the cardio follow up, he said I may need to see a neurologist so I guess that might be my next step.
Also last thing, I will say that I first really noticed these symptoms about five years ago, but the more I thought about it, I realized I used to have spells as a kid where I felt like I was dreaming or didn't quite know what was going on, which I would now say was the brain fog feeling, but you don't really have the vocab to explain that as a kid.
I'm tired of not getting any answers and all my tests coming back normal, so if anyone has any insight or suggestion of a type of doctor I should see next or supplements to try, I would greatly appreciate it.
Current diagnoses for other issues are PCOS, mildly low blood sugar (not enough to be dangerous, but I've used a dexcom to learn the signs and adjust my diet), seasonal allergies, acid reflux. So my only medications currently are zyrtec for the allergies and pantroprazole for the reflux. The cardiologist did give me a prescription for Midodrine, so I will be starting that soon.
TL;DR: I'm suffering from chronic brain fog and fatigue and all my doctors say my tests are coming back normal, so curious if anyone has suggestions??
Edit: for missing info, I'm in the US, caucasion, 5'9, 160 lbs, diagnosed already with PCOS and reflux, taking pantoprazole 40mg and zyrtec for allergies, no drug use, don't smoke.