Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Fatigue And Recurrent Skin Infection
Question: Hello,
I am a 27 year old male, height 5'10 and weigh 145lbs,happily married. For the last two years I have extreme fatigue and chronic hairloss. My skin also is turning thin and
i have recurring skin infections. I have extensive blood work done and everything came
back normal, except slightly high chlestrol . Two of my maternal uncles committed suicide when they were 25 and 27. I don't know why because I wasn't born at that time. I think its some sort of hormonal imbalance and I want to get extensive hormonal testing. Please guide me to some private clinic here in US or anywhere in the world and what sort hormonal tests should i get, I don't care of the cost.
Thank You!
sincerely
I am a 27 year old male, height 5'10 and weigh 145lbs,happily married. For the last two years I have extreme fatigue and chronic hairloss. My skin also is turning thin and
i have recurring skin infections. I have extensive blood work done and everything came
back normal, except slightly high chlestrol . Two of my maternal uncles committed suicide when they were 25 and 27. I don't know why because I wasn't born at that time. I think its some sort of hormonal imbalance and I want to get extensive hormonal testing. Please guide me to some private clinic here in US or anywhere in the world and what sort hormonal tests should i get, I don't care of the cost.
Thank You!
sincerely
Brief Answer:
Fatigue and recurrent skin infection.
Detailed Answer:
Hello XXXX .
You are having :
Fatigue ,
Hairs loss,
Skin thinning ,
Recurrent skin infection .
These symptoms are for 2 years , happily married life , age 27 yrs ( young ,in spite of this these symptoms present) weight and height perfect ( 5'10" and 145 lbs).
Two maternal uncle committed suicide before your birth.
These symptoms may be due to two possibilities , these include :
1 Asthenia , is often accompanied by a tendency to AVOID physical activities , complaints of day time sleepiness , necessity for frequent naps, and difficulty in concentrating on activities such as reading .
2 Pathological fatigability .
In contrast asthenia .pathological fatigability occurs in disorders of neuromuscular transmission and in disorders ALTERING energy production, including defects in glycolysis , lipid metabolism ( as high levels of cholesterol present in your case in just 27 yrs of age) or mitochondrial energy production.
PLEASE read above mentioned very carefully and you will find out , which type of disease you are suffering .
If 1 then consult PSYCHIATRIST because in ASTHENIA there is feelings of overwhelming STRESS & DEPRESSION.
If 2 get in serum creatine kinase ( C K level ).
ELECTROMYOGRAPHY ( E M G )
Certain muscle disorders can be definitely diagnosed by DNA analysis .
These tests available anywhere in USA .
As far as concerned about hairs loss , this may be due to 1 & 2 , beside scalp infection may be the another reason , so use ketoconazole shampoo for hairs wash 2-3 times in week .
Also take ketoconazole tablet , only one in a week for 2 weeks .
Hope this will help you.
Further any question I will reply in follow up.
Good luck.
Fatigue and recurrent skin infection.
Detailed Answer:
Hello XXXX .
You are having :
Fatigue ,
Hairs loss,
Skin thinning ,
Recurrent skin infection .
These symptoms are for 2 years , happily married life , age 27 yrs ( young ,in spite of this these symptoms present) weight and height perfect ( 5'10" and 145 lbs).
Two maternal uncle committed suicide before your birth.
These symptoms may be due to two possibilities , these include :
1 Asthenia , is often accompanied by a tendency to AVOID physical activities , complaints of day time sleepiness , necessity for frequent naps, and difficulty in concentrating on activities such as reading .
2 Pathological fatigability .
In contrast asthenia .pathological fatigability occurs in disorders of neuromuscular transmission and in disorders ALTERING energy production, including defects in glycolysis , lipid metabolism ( as high levels of cholesterol present in your case in just 27 yrs of age) or mitochondrial energy production.
PLEASE read above mentioned very carefully and you will find out , which type of disease you are suffering .
If 1 then consult PSYCHIATRIST because in ASTHENIA there is feelings of overwhelming STRESS & DEPRESSION.
If 2 get in serum creatine kinase ( C K level ).
ELECTROMYOGRAPHY ( E M G )
Certain muscle disorders can be definitely diagnosed by DNA analysis .
These tests available anywhere in USA .
As far as concerned about hairs loss , this may be due to 1 & 2 , beside scalp infection may be the another reason , so use ketoconazole shampoo for hairs wash 2-3 times in week .
Also take ketoconazole tablet , only one in a week for 2 weeks .
Hope this will help you.
Further any question I will reply in follow up.
Good luck.
Above answer was peer-reviewed by :
Dr. Yogesh D
thank you sir?
I had my ck levels checked it came back 810 and AST at 80 the doctor ordered
another test for the same and it came back at CK180 AST 66
Hematology
WBC 6.9
RBC 4.43
Hemoglobin143
Hematocrit 0.42
MCV 94
MCH 33.2
MCHC 354
Platelet Count 240
Differential
Neutrophils 4.0
Lymphocytes 1.7
Monocytes 0.6
Eosinophils 0.0
Basophils 0.0
Granulocytes Immature 0.0
Biochemical Investigation of Anemias and Iron Overload
Vitamin B12 393 156 - 698 pmol/L
(Roche - Electrochemiluminescence)
Interpretation:
Serum B12 [Probability of symptomatic deficiency]
<75 pmol/L high
75-150 pmol/L moderate
150-220 pmol/L low
>220 pmol/L rare
Clinically significant B12 deficiency may occur
with B12 levels in the normal range, particularly
in elderly patients.
Ferritin 61 > 14 ug/L
Interpretation:
<15 ug/L-diagnostic of iron deficiency
15-49 ug/L-probable iron deficiency
50-100 ug/L-possible iron deficiency
>100 ug/L-iron deficiency unlikely. If result
is persistently >1000 ug/L, consider
test for iron overload (transferrin
saturation).
General Chemistry
Glucose Fasting 4.7 3.6 - 5.5 mmol/L
- Hours After Meal 16.5 h pc
- Specimen Drawn 1535 h
Hemoglobin A1C 4.9
Sodium 141
Potassium 4.5
Creatinine 85
Estimated GFR 92
Calcium 2.43
Total Protein 68
Albumin 48
Total Bilirubin 16
Alkaline Phosphatase 69
Gamma GT 13
ALT 19
AST 80
Muscle Enzymes
CK H 810
Please have look thanks
I had my ck levels checked it came back 810 and AST at 80 the doctor ordered
another test for the same and it came back at CK180 AST 66
Hematology
WBC 6.9
RBC 4.43
Hemoglobin143
Hematocrit 0.42
MCV 94
MCH 33.2
MCHC 354
Platelet Count 240
Differential
Neutrophils 4.0
Lymphocytes 1.7
Monocytes 0.6
Eosinophils 0.0
Basophils 0.0
Granulocytes Immature 0.0
Biochemical Investigation of Anemias and Iron Overload
Vitamin B12 393 156 - 698 pmol/L
(Roche - Electrochemiluminescence)
Interpretation:
Serum B12 [Probability of symptomatic deficiency]
<75 pmol/L high
75-150 pmol/L moderate
150-220 pmol/L low
>220 pmol/L rare
Clinically significant B12 deficiency may occur
with B12 levels in the normal range, particularly
in elderly patients.
Ferritin 61 > 14 ug/L
Interpretation:
<15 ug/L-diagnostic of iron deficiency
15-49 ug/L-probable iron deficiency
50-100 ug/L-possible iron deficiency
>100 ug/L-iron deficiency unlikely. If result
is persistently >1000 ug/L, consider
test for iron overload (transferrin
saturation).
General Chemistry
Glucose Fasting 4.7 3.6 - 5.5 mmol/L
- Hours After Meal 16.5 h pc
- Specimen Drawn 1535 h
Hemoglobin A1C 4.9
Sodium 141
Potassium 4.5
Creatinine 85
Estimated GFR 92
Calcium 2.43
Total Protein 68
Albumin 48
Total Bilirubin 16
Alkaline Phosphatase 69
Gamma GT 13
ALT 19
AST 80
Muscle Enzymes
CK H 810
Please have look thanks
Brief Answer:
Pathological fatigability
Detailed Answer:
Hello XXXX
After reading these reports , such type of symptoms may be due to these reasons , these include:
1 Muscle weakness and myalgias. C K level is increased 810 in your case ( 60-400U/L ) AST 80 ( normal 5-45 IU) .
Serum CK can be elevated in normal individuals without provocation , presumably on a genetic basis (not in your case ) or after strenuous activity , minor trauma (including E M G needle ) a prolonged muscle cramps.
But in your case aspartate aminotransferase is also raised ,this is enzyme sharing origin both in liver as well muscle .
Because in reading, most of liver function tests are normal , so we should establish that elevated level of C K and AST may be due to muscle involvement . So consult a muscle specialist ( physician ) and get his opinion.
2 Anemias B 12 interpretation shows that B 12 DEFICIENCY present ,including Ferritin ( iron deficiency ) .
This is another reason may be responsible for these ( above mentioned ) symptoms , because decrease of immunity produces many symptoms like tiredness, thinning of skin , skin infection ( recurrent ) and hairs loss.
Any of above mentioned reason may be responsible for your symptoms .
So consult your treating doctor and get his opinion as physical examination as well as clinical examination will play an important role in establishment of diagnosis.
However , we can rule out stress and depression in your case i.e. asthenia don't present.
Hope this will help you .
Good luck.
Pathological fatigability
Detailed Answer:
Hello XXXX
After reading these reports , such type of symptoms may be due to these reasons , these include:
1 Muscle weakness and myalgias. C K level is increased 810 in your case ( 60-400U/L ) AST 80 ( normal 5-45 IU) .
Serum CK can be elevated in normal individuals without provocation , presumably on a genetic basis (not in your case ) or after strenuous activity , minor trauma (including E M G needle ) a prolonged muscle cramps.
But in your case aspartate aminotransferase is also raised ,this is enzyme sharing origin both in liver as well muscle .
Because in reading, most of liver function tests are normal , so we should establish that elevated level of C K and AST may be due to muscle involvement . So consult a muscle specialist ( physician ) and get his opinion.
2 Anemias B 12 interpretation shows that B 12 DEFICIENCY present ,including Ferritin ( iron deficiency ) .
This is another reason may be responsible for these ( above mentioned ) symptoms , because decrease of immunity produces many symptoms like tiredness, thinning of skin , skin infection ( recurrent ) and hairs loss.
Any of above mentioned reason may be responsible for your symptoms .
So consult your treating doctor and get his opinion as physical examination as well as clinical examination will play an important role in establishment of diagnosis.
However , we can rule out stress and depression in your case i.e. asthenia don't present.
Hope this will help you .
Good luck.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
