
So Over The Last Year I Have Started Feeling Tired

You need detailed evaluation.
Detailed Answer:
Hi,
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.
I have noted your clinical details. You require a detailed neurological examination, followed by investigations.
Possibilities include-
1. Thyroid hormone dysfunction, which can cause forgetfulness and tiredness.
2. Vitamin B12 deficiency can also cause several of these symptoms.
3. A brain scan should be done to exclude secondary causes related to various brain diseases.
4. Muscle twitching are most likely due to benign fasciculations. However, if doubt persists, an EMG may be done to rule out other causes.
I sincerely hope my reply has helped you.
I would be pleased to answer, if you have any follow up queries or if you require any further information.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/


Proceed for rest of the work up.
Detailed Answer:
Thank you for getting back.
Blood tests for B12 and thyroxine are first level tests, which are normal.
However, since your symptoms are persiting, you should proceed for the second level work up. These would include:
1. Neurological clinical examination
2. Brain scan, preferably MRI,
3. EMG study
Best wishes,
Dr Sudhir Kumar MD DM

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