I am having an issue that's basically put my life on hold and I'm working with my doctor to figure it out. But I am always open to more ideas with respect to what this could be. I've provided a list of recent symptoms and also symptoms chronologically.
Symptoms over the past two weeks:
Persistent fatigue, brainfog, vertigo, and pressure and heat/"burning" in the back of my neck and head, all of which gradually increase in intensity until I lay down. Rather than the world spinning, the vertigo is more like I notice myself moving when I feel like I'm staying still, and I have trouble staying balanced. I spend most of the day in bed to keep these symptoms minimized (I'm no longer working as a result of this). I have no fever during the day or night--body temperature is always normal (~98.3F). Occasionally I have air hunger. On one occasion the lymph nodes in my neck swelled up significantly for several days.
Night time symptoms: the pressure and heat in the back of my neck often becomes worse and spreads into the back of my head. The pressure can be all around my head but is always most significant in the upper sides (above ears and then back a bit) and just above my nose bridge. The pressure is substantial but I've yet to experience a headache (I should note that I completely stopped getting headaches after severe migraines around the age of 12-14. I used to get "general headaches" from food/allergies/colds/etc. etc. prior to that, but never afterwards). Sometimes in addition to heat in my neck / back of head I experience a rather extreme tingling that is similar to when a limb falls asleep. A few times I've had the feeling of having the flu with a high fever (as in disorientation, feeling like I'm in a bubble, feeling like I'm "in the Twilight Zone"), but even during these episodes my temperature is normal. I also often feel these strange "fluid flows" throughout my head. All of these things can keep me awake late into the night (e.g. 3am).
Other various night time symptoms: Chills. Momentary extreme night sweats. Pin pricks in my spine (not very painful but enough to wake me out of my sleep). My left eye has felt "ice cold" for a few seconds in two different instances. I've yet to experience any debilitating pain--I'm mostly left uncomfortable, sleep-deprived, and terrified by these things.
Chronologically:
~Mid Sept - One night I noticed a bug bite on my torso that looked similar to a tick bite (no tick found, no idea when the bite occurred). I work outside in the rural upstate NY area where there's an increasing prevalence of ticks carrying lyme disease + coinfections. It faded after several days and never turned into a lyme bullseye. Picture of bite: https://i.imgur.com/1o5GC6G.jpg
(Subsequent blood test for Lyme was negative. But I also understand false negatives are common)
Shortly afterwards I started feeling general fatigue, brainfog and a slight sore throat throughout the day, with intermittent more extreme forms accompanied by vertigo. Rather than the world spinning, the vertigo is more like I notice myself moving when I feel like I'm still and I feel like I'm swaying/have trouble staying balanced. Laying down for 20 minutes or so would relieve the extreme forms of fatigue/brainfog and vertigo, but the "general fatigue/brainfog" would still persist. I also started sleeping 10 to 12 hours per night.
Sept 28 - My doctor put me on 200mg (100mg 2x per day) of doxycycline in case what I was experiencing was lyme. Over the next few weeks I thought I was improving--my sore throat went away and the fatigue, brainfog, and intermittent vertigo (+ more extreme forms of fatigue/brainfog) diminished but never completely went away.
Oct 13 - A few days prior to this I noticed my symptoms fatigue/brainfog getting worse and the vertigo becoming permanent (although not extreme) rather than intermittent and I was only able to work a few hours per day. But on this day (a friday) the lymph nodes in my neck swelled up significantly. This persisted until Monday when my doctor evaluated me and confirmed the swollen lymph nodes. By the end of Monday the swelling subsided. My doctor ordered blood tests.
Oct 16th - During the night I started feeling this burning/heat sensation in the back of my neck. This also persisted into the following night.
Oct 18th - During the day the fatigue/brainfog/vertigo became even worse and I had to spend all day laying down (except for going in to get labs done). It was at this point that I completely stopped working because I was only getting worse and the aforementioned symptoms became so bad that I was unable to function. I also started feeling occasional air hunger. At night I started feeling many of the night time symptoms outlined earlier: the burning/heat sensation moved into my head, feelings of pressure around head, sensation of fluid flows in head, flu-like "high fever" symptoms (but temperature was normal), pin pricks in spine. Milder forms of this persisted for the next few days but at the very least I experienced significant head pressure.
Oct 22nd - The flu-like symptoms subsided considerably. Fatigue/brainfog/vertigo improved but was still present. I tried going for a walk but I could only do 15 minutes before feeling completely wiped out and needing to return home.
Oct 23rd - At night, the burning, pressure, and fluid-flow sensations were accompanied by the aforementioned tingling sensations. Night sweats. Left eye felt ice cold briefly.
Oct 24th and onward - Still feeling general fatigue/brainfog/vertigo but I'm able to stay on my feet longer before having to lay down. My doctor took me off doxycycline on the 25th. Blood tests indicate that nothing is wrong except for low D3. At night, I'm just experiencing pressure sensations in my head but they seem to be less than usual since going off of the doxy.
So I'm a bit overwhelmed by all of these weird symptoms. One thing I'm wondering is if I'm experiencing the "increased intracranial pressure" side-effect of the doxycycline (could this cause some of the other weird things I'm experiencing?) but I guess I should know as the doxy leaves my system over the next few days. Of course that doesn't explain the gradually worsening fatigue, brainfog, and vertigo I was originally experiencing (and still am).
Blood test results:
Lyme Disease Serology, S - negative
CBC/Automated Differential
White blood cell count - 5.6 [3.7,10.6]
Red blood cell count - 4.65 [3.7,5.9]
Hemoglobin - 15 [11.5,18]
Hematocrit - 45.7 [35,50]
MCV - 98.3 [81,99]
MCH - 32.3 [27,33.5]
MCHC - 32.8 [31.5,35.5]
RDW - 43.5 [37.3,49]
Platelet Count - 231 [140,425]
Mean Platelet Volume - 10 [8,12]
Neutrophils Relative - 62 [40,70]
Neutrophils Absolute - 3450 [1500,7400]
Lymphocytes Relative - 26.3 [12,50]
Lymphocytes Absolute - 1460 [950,3500]
Monocytes Relative - 10.4 [2,14]
Monocytes Absolute - 580 [150,940]
Eosinophils Relative - 1.1 [0,6]
Eosinophils Absolute - 60 [0,550]
Basophils Relative - 0.2 [0,3]
Basophils Absolute - 10 [0,175]
Comprehensive Metabolic Panel
Sodium - 143 [135,145]
Potassium - 4.4 [3.4,5]
Chloride - 103 [98,110]
Carbon Dioxide - 30 [22,34]
Anion Gap - 10 [6,14]
Glucose, Random - 67 [70,139] (low)
BUN - 11 [9,20]
Creatinine - 0.9 [0.7,1.3]
eGFR - >60
Protein, Total - 7.6 [6.3,8.2]
Albumin - 4.5 [3.5,5]
Albumin/Globulin Ratio - 1.5 [1.1,2.1]
Bilirubin, Total - 0.6 [0.0,1.0]
AST - 28 [17,59]
ALT - 27 [21,72]
Alkaline Phosphatase - 57 [38,125]
Calcium - 9.4 [8.4,10.2]
Calcium, Ionized - 5.4 [4.2,5.4]
PTH, Intact - 36 [14,72]
T3, Total - 70.5 [80,180] (low)
T4, Free - 0.8 [0.6,1.6]
T4 (thyroxine), total only, S - 5.6 [4.5,11.7]
Thyroxine Binding Globulin, S - 15 [12,26]
Thyroid Stimulating Hormone (TSH) - 1.87 [0.34,3.00]
Vitamin B12 - 823 [228,1100]
Vitamin D - 29 [31,100] (low)
Testosterone, Total, S - 425 [240,950]
Testosterone, Free, S - 8.93 [4.85,19]