Hey everyone,

I am hoping to get some insight from those of you who have been dealing with Vestibular Migraines or PPPD, as I am completely new to this diagnosis and just trying to make sense of it all.

For context, I am a 31y/o male, 6'5". My health started going downhill suddenly about six months ago around mid-October, right at the tail end of a very stressful period, some medication changes, and a specific physical project.

The Timeline & Onset

For some background, I took Cymbalta for sciatica from April 2024 to June 2025. After that, I did a short stint on Gabapentin from late September 2025 to mid-October 2025. Right around this same time, my dog ran away. We thankfully got her back, but it was an incredibly stressful event. I was also spending time doing a bunch of bondo and sanding on my project car. That exact window (mid-October, coming off Gabapentin, dealing with the extreme stress, and doing all that bodywork) is right when everything started to get worse and my symptoms really kicked into high gear.

The Thyroid Misdirection

Initially, we went straight down the thyroid rabbit hole. I had gained 35lbs in a year (200 to 235lbs), which my GP originally attributed to my time on Cymbalta, but I also had severe brain fog, poor cold tolerance, and crazy fatigue where I would often need to lie down midday. Over multiple tests, my TSH fluctuated (2.76, up to 5.18, then 3.47 and 4.59). My GP looped in an Endo and started me on a trial of 25mcg of Levothyroxine, alongside 5000iu D3, 100mcg K2, and 1000mcg B12.

However, after further testing, my TSH is now 1.32. With my levels sitting right in the optimal range and my ultrasounds and antibodies coming back totally clear, my thyroid is officially not the root cause of this.

The Shift to VM / PPPD

I have been dealing with a bunch of symptoms that neurology originally labeled "peripheral neuropathy" with no clear cause, but now my doctor and an ENT has brought up Vestibular Migraines and PPPD. Here is what I am dealing with on a daily basis:

• Constant head pressure and daily flares: This is the big one. It is a persistent, baseline pressure that is almost always there. I work from home on the computer from 6am to 3pm daily, and I flare up almost every single day around 11am or 12pm, which lasts for a few hours. Even outside of those flares, the pressure never leaves. Vision gets slightly blurry at time...
• Dizziness and environmental triggers: The dizziness is a persistent challenge. I never actually feel like I am going to faint, but it is just always there. It gets significantly worse when I am driving or going into big stores (Costco is an absolute killer). I also attend industry work conferences, and those environments completely kill me.
• Autonomic weirdness: Episodes of feeling overheated or flushed with sweating. When I feel a flare, I feel my heartbeat very strongly during a flare, though a recent Holter monitor came back totally clear. My Apple Watch will also actually alert me to low HRV shortly before I get an episode. (Note: Stopping all magnesium supplements at least helped with the heart racing).
• Neuropathy symptoms: Numbness and tingling in my hands, legs, or feet.
• Physical changes: Dark circles and puffiness around my eyes, subtle facial changes, muscle soreness, and weakness.

Current Status & Next Steps

My doctor has referred me to a local provider for VRT. We are also exploring potential medication paths, including SSRIs, to see if that helps reset whatever is misfiring. To be thorough, I also have an MRI scheduled for May 18 to make sure we are not missing anything else.

It is still a rollercoaster. My cognition feels closer to normal speed at times, and thankfully alcohol tolerance (and honestly a drink or two clears my head) has not sent me into an immediate flare-up, but I am still dizzy and dealing with this head pressure much of the time. I feel like I can barely drive, which is my singular hobby. It's horrible.

I know I am early in this new direction, but I have two main questions for this group:

1. Does having a constant headache and baseline head pressure, rather than distinct episodic attacks, fit with VM, or does that point more towards PPPD?
2. Did anyone else get misdirected by thyroid issues, weird neuropathy, or autonomic symptoms before landing on a VM/PPPD diagnosis?

I just cannot wait to feel better. Any advice, insights, or shared experiences would be incredibly appreciated!