<s>[INST] Hi. My name is Wendy. I m in my early 20s and for months now I ve been suffering with presyncope - lightheaded, feeling heavy , unsteady; I ve been nauseous (feeling like there is a lump in my throat but there isn t... I know because I ve had an endoscopy done and a barium swallow - both negative) and I dry heave very often from this sensation, and I feel like my eyes are out of focus. I don t know how to explain it. I guess it s kind of like it s hard for my eyes to concentrate on something, like they re straining. Also, I ve been diagnosed with migraines years ago and have been on numerous medications for it. I ve also been diagnosed with chronic tension headaches. I feel shaky, and I do have hypothyroidism. I m on levothyroxine for it. I usually feel very hot at night and cold in the morning. Sometimes I feel hot during the day but my skin won t necessarily feel warm. I have difficulty concentrating. I m tired almost all the time, even when I get enough sleep. I usually sleep between 4-7 hours a night, typically. I ve realized that when I wake up, I have so little energy but at night when I should be tired, is when I have the most amount. I ll be alert and energetic. And a problem I ve suffered with every day that has caused a lot of problems is that I have a really heightened sense of smell. Even things that most people think smell fine makes me nauseous and make my head hurt. I don t know where else to turn to find answers. I hope you can help me. Any insight would be greatly appreciated. I thank you in advance. [/INST] Hello, I would like to know the names of the drugs that you have taken before. I would recommend discussing with your doctor on the possibility of taking gabapentin or valproate for the migraine prevention. Another option would be an antidepressant-like sertraline for a tension-type headache. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist </s>