
Suggest Treatment For Severe Fatigue, Sore Throat And Cough

Previously He also had a high level of fatigue from Nov thru mid March. His doctor saw him at annual check and suggested he start taking Vit D in a tiered dosage - high level for 2 weeks, then bring it down for 2 weeks then bring it down again 2 weeks after that. Because there wasn't a big change in his energy level I calle dthe doctor - they ran a mono test and the results showed the antibodies were in line with being towards the end of mono and the Dr. said he could have had it for the last 6 mos.
What do you think?
Some thoughts
Detailed Answer:
Hello and welcome,
I am not sure at what point he was diagnosed with Mono (Epstein Barr virus). Mono can definitely give prolonged symptoms of fatigue, headaches, and just feeling poorly. And the immune system can be mildly compromised from it and so a person may be more likely to get other viral infections concurrently.
I do not think Vitamin D level has much to do with any of his symptoms.
But I would suggest a TSH (thyroid stimulating hormone) and thyroxine level as sometimes after a viral infection a teen can get a transient thyroiditis which can cause fatigue too.
He should also have an Epstein Barr antibody panel which should include IgG and IgM levels. Elevated levels of IgM means that he still has an acute in infection to EBV; IgG on the other hand shows immunity from a past infection.
And his liver and spleen sizes should be checked with a physical exam to make sure they are not enlarged from the EBV. If there is any question about that, a liver function panel would be important to do too.
I hope this helps. This must be very frustrating.


I will check with the doctor's office re: thyroid test (transient). But I thought his thyroid was checked at the same time as the mono test.
Over the last two weeks there has been a lot of pollen in the air. We put him on Claritin (possible allergies) over the weekend and on Monday he complained about feeling dizzy while at school. His eyes looked very different.
Should he go thru a comprehensive allergy testing?
About EBV
Detailed Answer:
Regarding the duration of EBV infection symptoms, it definitely varies. The majority of the adult population has had EBV infection. Most people have had EBV by the time they are in their mid twenties, and never knew they had it. Just a bad cold that lasts for a week to 1 month. However, there is a smaller subset that gets full blown Mono, and the fatigue from that can go on for months. In mono, the liver and spleen can also become enlarged in some people (which can be felt during physical exam of the abdomen) too, but this resolves in a shorter amount of time compared with the fatigue some get.
About the possible allergies: In much of the country right now (June), the seasonal allergen is grass pollen. It goes on for most of XXXXXXX The stuff you actually see blowing around, such as from Cottonwood trees, is for the most part too large to cause respiratory allergies. The pollen that causes itchy eyes, nose, throat, and sneezing is too small to see. If your son thinks the dizziness correlates with starting Claritin, you might want to switch to Zyrtec. If the eyes are very troublesome, there are antihistamine eye drops (by prescription).
Regarding getting comprehensive allergy skin testing, if the problem has been one that you have seen over time, rather than one that just started this year, then yes, it might be helpful. However, if it is just a recent problem, it may be more related to his being run down after EBV infection. Still, it wouldn't hurt to consult with an allergist. Specialty Board Certified allergists are also trained in immunology, and so it might not be a bad idea to see one about the whole picture.

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