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What Causes Weakness, Trembling, Severe Fatigue, Labored Breathing, Chest Pain And Discomfort?

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Posted on Thu, 23 Jul 2015
Question: I am a 59 year old male. For over two years I have had episodes of weakness, trembling, severe fatigue, chest pain and discomfort and labored breathing. These episodes usually follow some activity mild to moderate. I have even fainted on one occasion. I have had blood sugar studies, and a heart XXXXXXX The symptoms most often mimic those of extremely low blood sugar but blood sugar levels always seem to be fine. I do take metformin for type two diabetes. My doctor is at a loss of what avenue to explore next.
doctor
Answered by Dr. Muhammad Hanif (3 hours later)
Brief Answer:
You need a second opinion from a pulmonologist and a cardiologist.

Detailed Answer:
Dr. Hanif warmly Welcomes you!

Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can realize your health worries. Being your physician, I will take care all of your medical concerns.

Differential diagnosis on the basis of the symptoms, and their brief detail for your help may be:
Anemia.
Lung disease.
Cardiac problems.
kidney problems.

What we need to know first and you physician must have done that is complete blood count with differentials. your Problem may be due to anemia. Decreased hemoglobin causes all the symptoms which you face.

Diabetes Mellitus you yourself ruled out as your blood sugar level is in the limits. Say your physician that you still need to know what is your HBA1c (glycated hemoglobin- a blood test). It will tell us 4months control of sugar levels in blood.

Next is heart problems. Your echo perhaps came back normal. So it isn't your heart. But usually it is highly likely that heart problems do all that. EKG, cardiac angiography and exercise stress tests along with echo tell us the story. I suggest you to consult a cardiologist for the same.

Kidneys also may cause problems and symptoms like your's are due to that sometimes. What is your kidney function tests? Your physician must have done that and I think its normal, that's why you didn't mention that too.

Last but not the least is the Lung disease. Due to low levels of lung functions symptoms appear like this. I refer you to a Pulmonologist for complete evaluation and treatment of the same. There may be a gaseous exchange defect in alveoli of the lungs and there isn't enough oxygen going to tissues instead of having normal hemoglobin levels. There may be some problem with the airways that sometimes get narrowed and cause the issues like weakness, trembling, severe fatigue, chest pains and discomfort and difficulty breathing. Some autoimmune diseases of the lungs damage the lungs and are the reason too.

Have a wonderful time ahead. Hope I answered all of your questions. Let me know if you have any further clinical concerns. If satisfied, please give a five star rating and don't forget to close the discussion.

Regards!
DR. XXXXXXX HANIF
USA
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
Dr.
Dr. Muhammad Hanif

General & Family Physician

Practicing since :2009

Answered : 2369 Questions

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What Causes Weakness, Trembling, Severe Fatigue, Labored Breathing, Chest Pain And Discomfort?

Brief Answer: You need a second opinion from a pulmonologist and a cardiologist. Detailed Answer: Dr. Hanif warmly Welcomes you! Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can realize your health worries. Being your physician, I will take care all of your medical concerns. Differential diagnosis on the basis of the symptoms, and their brief detail for your help may be: Anemia. Lung disease. Cardiac problems. kidney problems. What we need to know first and you physician must have done that is complete blood count with differentials. your Problem may be due to anemia. Decreased hemoglobin causes all the symptoms which you face. Diabetes Mellitus you yourself ruled out as your blood sugar level is in the limits. Say your physician that you still need to know what is your HBA1c (glycated hemoglobin- a blood test). It will tell us 4months control of sugar levels in blood. Next is heart problems. Your echo perhaps came back normal. So it isn't your heart. But usually it is highly likely that heart problems do all that. EKG, cardiac angiography and exercise stress tests along with echo tell us the story. I suggest you to consult a cardiologist for the same. Kidneys also may cause problems and symptoms like your's are due to that sometimes. What is your kidney function tests? Your physician must have done that and I think its normal, that's why you didn't mention that too. Last but not the least is the Lung disease. Due to low levels of lung functions symptoms appear like this. I refer you to a Pulmonologist for complete evaluation and treatment of the same. There may be a gaseous exchange defect in alveoli of the lungs and there isn't enough oxygen going to tissues instead of having normal hemoglobin levels. There may be some problem with the airways that sometimes get narrowed and cause the issues like weakness, trembling, severe fatigue, chest pains and discomfort and difficulty breathing. Some autoimmune diseases of the lungs damage the lungs and are the reason too. Have a wonderful time ahead. Hope I answered all of your questions. Let me know if you have any further clinical concerns. If satisfied, please give a five star rating and don't forget to close the discussion. Regards! DR. XXXXXXX HANIF USA