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How Can Weakness In The Legs And Thighs, Extreme Fatigue Leading To Excessive Sleep Be Diagnosed And Treated?
Question: I have several questions on bloodwork taken. It does not appear that I am absorbing iron, B12, or Vit. D. However, I believe you will my bloodwork is fine and within range. But not my usual levels. Iron Sat 25%, I crave meat (hamburgers and tacos and Spinach is my primary vegetable. B12 is 656; my B12 has never been under 1,200 and I've taken the same B12 complex supplement for 10 years. Vit D 65; it use to be 85. I take 10,000 IU per day since December 1. Creatine Kinase 5. This is the first time on this test. Its very low considering range is 22-198. My blood related aunt had myasthenia gravis and has had IV therapy 3 times per week. Erthrocyte Sedimentation rate seems low also at 5 with range 0-30. All other tests are completely normal total 16 blood tests (thyroid, electrolytes, cholesterol, glucose, kidneys, liver, CBC, etc)
My symptoms are extreme fatigue I force myself to get up after 12 hours only with alarm.. I sometimes take naps. Any activity at all my leg/thigh weekness, throbbing, unsteady and within an hour or two, I'm exhausted again. Symptoms began in December. I am 64 year old female.
My symptoms are extreme fatigue I force myself to get up after 12 hours only with alarm.. I sometimes take naps. Any activity at all my leg/thigh weekness, throbbing, unsteady and within an hour or two, I'm exhausted again. Symptoms began in December. I am 64 year old female.
Brief Answer:
Follow up with your appointment as scheduled
Detailed Answer:
Hello,
Your blood tests are well within the normal range. Even though there is a decrease in blood levels of vitamin D and B12 from the last test, it is nothing to be worried about. It is common to see variations in blood levels of Iron and vitamins within the normal range, especially if the testing has been done further apart in time.
Low level of creatine kinase in people above 60 due to a decrease in muscle mass. It is not suggestive of any illness like myasthenia. Please be advised to exercise regularly to maintain healthy muscles.
Erythrocyte sedimentation rate (ESR) of 5 is completely normal and very reassuring. High ESR occurs in infection, inflammation etc.
The leg/thigh pain and weakness you are experiencing can occur due to hip and spinal problems. Physical examination and Xray of hip, spine is recommended.
Since your blood workup is mostly normal, the tiredness can be age-related or a possibility of other conditions like sleep apnea should be explored.
There is nothing to be worried about currently. Please be advised to follow up with the appointment as scheduled. You can also repeat the Iron saturation, Vitamin D, and B12 levels after 3 months to see if there is a further drop.
Hope this answers your question. Please let me know if you need further clarification.
Regards,
Dr. Lekshmi
Follow up with your appointment as scheduled
Detailed Answer:
Hello,
Your blood tests are well within the normal range. Even though there is a decrease in blood levels of vitamin D and B12 from the last test, it is nothing to be worried about. It is common to see variations in blood levels of Iron and vitamins within the normal range, especially if the testing has been done further apart in time.
Low level of creatine kinase in people above 60 due to a decrease in muscle mass. It is not suggestive of any illness like myasthenia. Please be advised to exercise regularly to maintain healthy muscles.
Erythrocyte sedimentation rate (ESR) of 5 is completely normal and very reassuring. High ESR occurs in infection, inflammation etc.
The leg/thigh pain and weakness you are experiencing can occur due to hip and spinal problems. Physical examination and Xray of hip, spine is recommended.
Since your blood workup is mostly normal, the tiredness can be age-related or a possibility of other conditions like sleep apnea should be explored.
There is nothing to be worried about currently. Please be advised to follow up with the appointment as scheduled. You can also repeat the Iron saturation, Vitamin D, and B12 levels after 3 months to see if there is a further drop.
Hope this answers your question. Please let me know if you need further clarification.
Regards,
Dr. Lekshmi
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you for your response. Well, I know for sure I do not have sleep apnea. Any other explanation for the extreme fatigue?
Brief Answer:
Evaluation of fatigue
Detailed Answer:
Hi,
Since your hormonal , metabolic profile and other blood investigations are within normal limit, further evaluation to rule out underlying cause for fatigue us required.
An undiagnosed cardiac issue lie coronary artery disease can cause fatigue. So it is important to undergo EKG and stress test.
Also, screening test including colonoscopy and mammography to be done.
A detailed neurological evaluation is also recommended. Sometimes early stages of neurological conditions like Parkinson's, dementia etc., can present as fatigue.
Regards,
Dr. Lekshmi
Evaluation of fatigue
Detailed Answer:
Hi,
Since your hormonal , metabolic profile and other blood investigations are within normal limit, further evaluation to rule out underlying cause for fatigue us required.
An undiagnosed cardiac issue lie coronary artery disease can cause fatigue. So it is important to undergo EKG and stress test.
Also, screening test including colonoscopy and mammography to be done.
A detailed neurological evaluation is also recommended. Sometimes early stages of neurological conditions like Parkinson's, dementia etc., can present as fatigue.
Regards,
Dr. Lekshmi
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Above answer was peer-reviewed by :
Dr. Remy Koshy
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