Hello, For Months Now I Have Been Having Strong Fatigue,

Posted on Tue, 28 Jan 2020

Question: Hello, for months now I have been having strong fatigue, twitching both awake (st rest) and asleep and just completely exhausted also random pains here and there throughout the body that come and go. I've had a variety of tests run and am looking for an opinion. I am wondering if my results point to anything specific or if you were my doctor what would you be thinking and hm look for next. As of my last blood test my T4 is high, TSI is normal, TSH is normal and Thyroid Peroxidase Antibodies are also normal. I am ANA positive with a titer of 1:80 and nuclear, dense, fine speckled pattern. My birthcontrol is currently SPRINTEC and in 2018 my Sex Horomone Binding Globulin was high at 195. If you were my doctor what would you be thinking? All other bloodwork is coming up normal other than triglycerides in cholesterol levels high as well. The fatigue is by far the most concerning symptom. 5 out of 7 days I feel lousy (I can tell shortly after I wake up). It’s not dependent on sleep amount or activity from what I can tell.

Answered by Dr. Divya Agarwal (8 hours later)

Brief Answer:
chronic fatigue syndrome/fibromyalgia

Detailed Answer:
hi
I have gone through all your reports.
the reports are broadly ok.
the ana titers are positive, however they are in the range of being low positive, and thus dont explain your symptoms.
the chances of this being due to chronic fatigue/fibromyalgia are greater.
I think we might need to think on these lines to get a solution to this issue.
let me know what you think.
regards

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Divya Agarwal (4 hours later)

Brief Answer:
exercise programs

Detailed Answer:
hi
what is recommended is graded exercise, to help you overcome the fatigue.
the exercise program should gradually escalate and probably group exercise programmes under expert guidance are better.
medications are those that act on the central nervous system like pregabalin, duloxetine and gabapentin.
this will have to be done under the guidance of a doctor.
A balanced diet should help you overcome this problem.
hope that helps.
regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Divya Agarwal (4 minutes later)

Thank you for your response! It’s good to know the levels are more or less not to concerning. Is there a particular “diet/way of eating” you recommend for patients experiencing issues like mine?

Also, would anything make you think this could be neurologically related?

Follow up: Dr. Divya Agarwal (9 minutes later)

Finally, what medications should I discuss with my doctor? I’m at my breaking point as far as physical fatigue. It’s impacting life and mentally just now starting to get to me as I’ve been trying to deal with this since before October (initially I thought it was something I would just “get over”)

Thank you again,
Jini