Brief Answer: Anemia;Atopy Detailed Answer: Hello and welcome to healthcaremagic I am Dr. Kakkar. I have gone through your query and I have understood it. Your medical history of Anemia is significant, because anemia could be the cause of Tiredness/ lack of Energy as well as itching Pruritus is the initial symptom in number of a systemic disease commonly Thyroid, Diabetes and Iron deficiency anemia. I would suggest that you start with an Iron supplement (if not already) and also get a few lab tests for thyroid (TSH levels) and blood sugar. Another possible reason for itchy legs could be that, may be you are Atopic(prone to dry skin and allergies). Atopics have dry skin and dry skin is itchy People who are atopic/allergic have a low water retentive capacity of the skin, which leads to trans-epidermal water loss from the skin into the atmosphere specially when the weather is cold and dry thereby resulting in a dry itchy skin. Soaps exacerbates the condition further. In such a situation it is advisable to apply a good moisturizer as frequently as possible. Moisturizers hydrate as well as form an occlusive film thereby preventing further loss of moisture from the skin. Moisturizers specially those which contain hygroscopic (attract water from the atmosphere and lock it into the skin) and keratoloytic agents like Ammonium lactate, Urea, Lactic acid and Glycerin and Hyaluronic acid are specially useful in such cases. Moisturizers should be applied as frequently as possible I usually ask my patients to mix a potent topical steroid like mometasone furoate and moisturizer (in equal proportions, 1:1) and apply at least twice daily. Try to avoid using soaps OR use a gentle cleansing body wash. An OTC antihistamine once daily e.g cetrizine or loratadine would help you symptomatically. Once the condition improves with this combination, usually within 2-4 weeks, only moisturizers alone would suffice. I hope you will find this useful Regards take care

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Brief Answer: Pruritus of unknown origin Detailed Answer: I would label it as Pruritus of unknown origin. For 'Pruritus of unknown origin', As a treating doctor my First line of treatment would be: -Non-sedating antihistamines e.g Fexofenadine 180mg once daily; Loratadine 10mg once daily. The dose can be safely titrated upwards upto 4 times the recommended dose i.e Fexofenadine XXXXXXX upto 720mg in a day in divided doses and loratadine XXXXXXX upto 40mg in a day in divided doses. If this proves ineffective or insufficient then i would like to add a First generation sedating antihistamines once or twice daily preferably at night e.g Hydroxyzine or Pheniramine or doxepin. This much is usually sufficient in most of the patients but if needed gabapentin can be given in addition to these Or may be Pregabalin can be given in place of gabapentin as it has a better tolerability profile as compared to gabapentin in terms of sedation. I hope this information helps you. regards

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