Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully passed through your question and would explain that chronic fatigue could be related to high altitude.

But the increased frequency of urination is not related to this cause.

From the other hand the dose of lipitor that you are taking is the maximal dose. I would like to review your blood lipid profile. You should know that chronic fatigue and muscular pain could also be related to adverse effects of lipitor.

Coming to this point, I would recommend consulting with your attending physician for a careful physical exam and some tests:

- a resting ECG and cardiac ultrasound to examine your heart structure and function (especially when considering your past medical history for BYPASS surgery)
- a chest X ray and respiratory function tests to examine your lung function
- a blood gas analysis
- some other blood lab tests (complete blood count for anemia, PCR, sedimentation rate, blood electrolytes, kidney and liver function tests)
- an urinary tract ultrasound
- an urine analysis

You should discuss with your doctor on the above issues.

Meanwhile, I recommend you to closely monitor your blood pressure frequently during the day (usually sitting position after 10 minutes of total relax) and refer those values to your doctor. Low blood pressure could also cause chronic fatigue.

Hope to have been helpful!

Kind regards,

Dr. Iliri

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