Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Fatigue With Nausea?
Question: i am constantly tired and sleeping for hours at a time during the day, feel nauseous often to the point that i cant bear to drink my favourite food coffee and i have diarrhoea on and off and a very bloated stomach...I have been suffering from stomach aches and wearing loose clothing as a result...what could this be from and how can i get back to normal life?
i am 60, overweight at 85k and 5 2 but exceptionally active on the whole apart from periods in bed with long term back issues.
i am 60, overweight at 85k and 5 2 but exceptionally active on the whole apart from periods in bed with long term back issues.
Brief Answer:
Liver disease...
Detailed Answer:
Hi, thank you for posting!
I have gone through your query and I understand your concerns.
There are different diseases and conditions that can cause your symptoms.
But I think that your symptoms are caused by a liver disease. In this case it might be caused by an infection or by Metformin(Metformin can cause liver injury).
To treat your condition an exact diagnosis is necessary. To determine the diagnosis you need an abdominal ultrasound, liver function test, complete blood count and an urine test. A stool culture is also necessary.
If the above tests can't find the diagnosis then an abdominal Ct-scan will be necessary.
Contact your gastroenterologist to discuss about the diagnosis and the proper treatment.
Ask me for anything unclear.
Wish you good health.
Dr. Behar.
Liver disease...
Detailed Answer:
Hi, thank you for posting!
I have gone through your query and I understand your concerns.
There are different diseases and conditions that can cause your symptoms.
But I think that your symptoms are caused by a liver disease. In this case it might be caused by an infection or by Metformin(Metformin can cause liver injury).
To treat your condition an exact diagnosis is necessary. To determine the diagnosis you need an abdominal ultrasound, liver function test, complete blood count and an urine test. A stool culture is also necessary.
If the above tests can't find the diagnosis then an abdominal Ct-scan will be necessary.
Contact your gastroenterologist to discuss about the diagnosis and the proper treatment.
Ask me for anything unclear.
Wish you good health.
Dr. Behar.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you for your speedy reply but it has made me wonder about two aspects of my diabetes diagnosis that I am concerned about:
a) if metformin is causing the liver problem what could i substitute to control my sugar levels to reduce the problem, I am a little reluctant to start testing if such a simple change could resolve the issue.
b) if my sugar actually goes down after having something with sugar (that I have actually eliminated since learning I have "diabetes" why is it that when someone gave me something with sugar that it is actually the only time it returned to 100 or lower (so I have repeated the experiment with having something with sugar and each time it has actually brought my sugar down to normal (once even from 300 to 100) is it possible i do not have diabetes but some other problem?
Since it looks like the solution has been making me worse (and somehow I have felt that metformin has been poisoning me when I take it) I am really concerned to resolve the problem in another way. I also take amaryl that has actually brought down my sugar levels but only when i have also taken metformin and eaten carbs.
is there anything else I could take that does not have the effect on my liver...
a) if metformin is causing the liver problem what could i substitute to control my sugar levels to reduce the problem, I am a little reluctant to start testing if such a simple change could resolve the issue.
b) if my sugar actually goes down after having something with sugar (that I have actually eliminated since learning I have "diabetes" why is it that when someone gave me something with sugar that it is actually the only time it returned to 100 or lower (so I have repeated the experiment with having something with sugar and each time it has actually brought my sugar down to normal (once even from 300 to 100) is it possible i do not have diabetes but some other problem?
Since it looks like the solution has been making me worse (and somehow I have felt that metformin has been poisoning me when I take it) I am really concerned to resolve the problem in another way. I also take amaryl that has actually brought down my sugar levels but only when i have also taken metformin and eaten carbs.
is there anything else I could take that does not have the effect on my liver...
Brief Answer:
Above tests are necessary...
Detailed Answer:
Thank you for writing back.
As I said to you above liver injury is caused by different diseases and another factor that can cause liver injury is Metformin.
For that reason the above tests are necessary in order to rule out a possible stomach, pancreas or gallbladder pathology.
If the above tests are negative it means that Metformin is causing you the symptoms.
You can't substitute this medicine because it is the best medicine of its kind in treating Diabetes.
In this case, the only thing that you can do is lowering the dosage.
To confirm if you are Diabetic or no you need an HbA1c test.
If you don't need any further clarifications you can close the discussion and rate the answer.
All the best.
Dr. Behar.
Above tests are necessary...
Detailed Answer:
Thank you for writing back.
As I said to you above liver injury is caused by different diseases and another factor that can cause liver injury is Metformin.
For that reason the above tests are necessary in order to rule out a possible stomach, pancreas or gallbladder pathology.
If the above tests are negative it means that Metformin is causing you the symptoms.
You can't substitute this medicine because it is the best medicine of its kind in treating Diabetes.
In this case, the only thing that you can do is lowering the dosage.
To confirm if you are Diabetic or no you need an HbA1c test.
If you don't need any further clarifications you can close the discussion and rate the answer.
All the best.
Dr. Behar.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you so much. I appreciate your original reply but basically I am reluctant to do unnecessary testing which is why i asked my second question .... so is there any way around the testing to eliminate metformin as the cause... also is it normal for sugar levels to go down when ingesting sugar, and to stay high without carbohydrates?
I really appreciate the fullness of your first reply but am disappointed with the second...
If you have any advice on the above I would really appreciate it as if I really found it helpful to visit my doctor I would not be looking online.
I really appreciate the fullness of your first reply but am disappointed with the second...
If you have any advice on the above I would really appreciate it as if I really found it helpful to visit my doctor I would not be looking online.
Brief Answer:
Try lowering Metformin dosage...
Detailed Answer:
If you don't want to get the tests I mentioned above, there is another way to rule out Metformin as the cause. Try halving the dosage of Metformin and continue taking it for two weeks. If the symptoms subside after lowering the dosage, it means that Metformin was the cause.
As for Diabetes I don't think you are Diabetic, because what you referred above is not normal. I think it might be Reactive Hypoglycemia, because in patients that suffer from this condition, sugar level decreases after eating.
In these cases it is recommended to avoid sugar, eat several small meals and snacks.
You must contact your endocrinologist in order to confirm the diagnosis for Reactive Hypoglycemia and to discuss about the dosage of Metformin.
I hope I answered all your questions.
All the best.
Dr. Behar.
Try lowering Metformin dosage...
Detailed Answer:
If you don't want to get the tests I mentioned above, there is another way to rule out Metformin as the cause. Try halving the dosage of Metformin and continue taking it for two weeks. If the symptoms subside after lowering the dosage, it means that Metformin was the cause.
As for Diabetes I don't think you are Diabetic, because what you referred above is not normal. I think it might be Reactive Hypoglycemia, because in patients that suffer from this condition, sugar level decreases after eating.
In these cases it is recommended to avoid sugar, eat several small meals and snacks.
You must contact your endocrinologist in order to confirm the diagnosis for Reactive Hypoglycemia and to discuss about the dosage of Metformin.
I hope I answered all your questions.
All the best.
Dr. Behar.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
