# Fatigue issues



## Kathleen M.

Here is the problem I have long term low level fatigue punctuated by occasional periods of extreme fatigue (I call it malignant fatigue because it just won't go away when it hits and resting more doesn't make it better). I have had this my entire adult life.The biggest problem is I do not have the other clinical features of CFS or FMS.Usually when I go to the doctor everything the test for is normal. Sometimes we find something wrong, but that doesn't seem to fix the fatigue issues. I think the physical stress of the wrong thing may set it off.Things that have been fixed along the way.1) Upper Airway Resistance Syndrome (surgery fixed the nose and I have REM cycles so we connsider this in remission)I had a very unusual presentation as I was not in anyway the typical patient.2) Allergies/Asthma. Mostly in remission with allergy shots but I think the physical stress of the reactions I get to the shots may set it off.3) Anemia. Well sort of. I had a fibroid removed because of heavy periods. My Ferritin was low, but usually my blood counts were normal or near normal. People I know who are seriously anemic don't seem as tired as me (people who need B-12 shots or iron infusions) I have the exhaustion when I am not anemic at all.Ongoing /long term issues.I have always had to have a full night's sleep and eat three meals a day on time. I never could stay up to 3 am with friends or miss a meal or all the things other teens/twenty somethings seem to get away with.I cannot build cardiovascular fitness. Even when I do regular exercise. I work at the same level and still get the same heart rate (I can get chest pain if my heart rate goes up too high so when I was doing a walking program last year i monitored it closely. I can build muscle strength easily.I pee 3-6 times in the first couple of hours of sleep, fairly good amounts not just a dribble.Like I said I have to eat meals on time and have to get my sleep at night.I did have mononucleosis a couple of years before I noticed the first really bad exhaustion time.New things.I've been feeling cold more than usual, and maybe a bit more constipated than ever, but TSH was normal last fall.I see the allergy doctor tomarrow, any test to ask for besides redoing the thyroid ones?Like I said it isn't likely to be DFS or fibro, but maybe y'all would have some ideas.K.


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## Cherrie

Hi, Kathleen ~ I can totally empathize! I mean, I don't have allergies/asthma/resportory problems and I know I don't have CFS, but I just get soooooo tired around 2pm almost daily that I have to lay down for a while otherwise I just plain can't function (can't even keep my eyes open even when I've had 8 hours of sleep)... And it's been happening more and more often since I got IBS... Can't believe this is happening to me







... and I'd love some ideas and suggestions, too!


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## M&M

I am going to ponder this a bit more today, and see if an idea will congeal. Have you had other thyroid tests besides the TSH? The free T3 and free T4 tests are the best way to check thyroid function. Assuming you've had that, and they all came back normal, I am stumped at the moment.That's one of the worst things about having fatigue as a symptom. It's so darn vague, and can be caused by just about any darn thing...Any chance you're still fighting a low-grade infection of the mono, or that it's reactivated in your system?Allergies can also cause severe fatigue. Do you take anything besides the shots? Like prescription antihistamines, or nasal sprays?Do you take any prescription or OTC meds on a regular basis? Some drugs can either cause fatigue, or worsen fatigue.Narrowing down when you feel the fatigue can make a difference too - is it from the moment you wake up in the morning, or just in the afternoons? Generally, if someone wakes up in the morning feeling fairly rested, but develops fatigue rapidly during their activity for the day - that is generally a sign of some underlying, ongoing physical condition (like under active thyroid, for example). But if you wake up with zero energy and fatigue, and have it all day - that usually points in a different direction.These are just a few ideas off the top of my head. But I'm going to continue thinking about this, and hope to come up with some new ideas by this evening. I can understand your frustration, and hope to be able to come up with something helpful!


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## Feisty

If you've got some serious allergies, that, in itself, can make you tired. I get tired easily, especially during the worst of the allergy season; although, I have year 'round allergies, spring, summer and fall are the absolute worst for me. I also noticed as I get older







........I can't seem to take the heat like I once could and that makes me feel more exhausted, too.Being colder than you use to be.......Hmmmmmmm.......wondering if your circulation isn't real good? Where do you feel cold? Arms, legs, feet? Or all over? Do you feel like you are chilled? If you feel like you are chilled, you could have a low grade temp. Have you checked your temp to see if it fluctuates at all? A low grade temp could mean a low grade infection? Just some thoughts.


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## Kathleen M.

Temperature is the same really low it usually is, although it might be a bit lower than normal for me.Just like the room temp is too low, I'm not getting cold hands and feet or anything just 75 feels like 65.I'll see if they'll do the full thyroid panel.K.


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## M&M

I swear, all your symptoms are screaming out "hypothyroid" to me. It all fits, fatigue, intolerance of cold, constipation, all of it. Of course, I don't know where the peeing so much would fall, or the need for the regular meals. Not sure if that would fit with hypothyroid. I wish I could be of more help! Other than the full thyroid panel, maybe just pick the doc's brain again. Man, it's frustrating trying to pinpoint something - you are reminding me of one of my favorite shows on TLC: "Mystery Diagnosis".If you don't mind, please let us know how you get on tomorrow at the allergist's. I am looking forward to following your fatigue issues, and finding out what is going on inside your body. Even more than my own personal interest, I hope you can find a way to feel better!


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## Feisty

Kathleen.....how did your Doc appointment go today?


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## Kathleen M.

Well the good thing is my allergist is a good guy and I was able to talk about it without just breaking down in tears.If it ends up just being the allergy shots I may be SOL, but he at least was sympathetic with the whole sometimes you have no good choice because A messes up B but not A is worse. He didn't really have any good ideas about what to about it, but at least he didn't make me feel like I was just a nut case, and that counts for a lot.I seem him back again in November after the fall allergy season to check on how the shots are doing, he says he'll call me if he sees anything. I see my regular doctor in July so I'll be able to check with him about the results, and if something is up I'd probably need to see him anyway.Anywho we drew blood for Complete blood count with differentialTSHFree T3Free T4FerritinCortisol (I'm not really sick enough for adrenal gland problems but it is a shot in the dark and it is the fashionable thing to test so why not and prednisone usually makes me feel good).At least we rule out the clear easy to treat things.What I'm going to do if nothing is wrong I don't know.K.


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## M&M

Oh I am soooooo glad your allergist is a nice man! Isn't it a shame how surprised we are when a doctor turns out to be nice!? I am really glad he listened, and took your symptoms seriously.And I'm really glad you'll be going to your regular doctor soon. You'll more than likely have your lab results back by the time you see him, so hopefully you can sort something out.I'm anxious to hear your lab results, and I sure hope they'll find SOMETHING! Anything that can be treated, just something.I don't know if your symptoms are such that you can log them daily in a journal. But, if they are, that would be a good thing to do too, while you wait for your next appointment - that might help your regular doctor to try to see patterns, and anything along those lines.I sure hope you find something wrong!! That's a weird thing to wish, but I sure hope it comes true!


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## Kathleen M.

Yep, even if the "wrong" isn't treatable at least I'm not just crazy. Hopefully they find something they can actually do something about.I'm usually so relieved when they find a something, I had hoped the anemia thing was going to be it, but that should be under control now.It can be so frustrating when you just feel bad too much of the time.K.


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## M&M

Hi Kathleen!Just checking in to see how you're getting on. Have you gotten any results back yet from your blood work? Are you still feeling about the same?Sure hope you're hanging in there, and will find something in your lab work!


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## Kathleen M.

The worst of the episode seems to be over.I haven't seen the results yet. I see my regular doctor later this month so I can get them then.I've been monitoring my basal temp and it is up a bit, but I don't know if it is just normal cycling or not, yet.I've also been airing the house out a bit more since sometimes I feel better when I'm outside more, but I have to avoid too much sun, so that makes outside less appealing.K.


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## Kathleen M.

Emailed the doc I see later this month to let him know blood tests were run.According to them I am disgustingly heathy.Ferritin stores are a little low, but not anything that should be doing this.What drives me nuts is it was after the build which should be the worst of the allergy shots.I really do not know what else to do.


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## M&M

Wow! So nothing on all the thyroid tests?Boy, this is really puzzling. I am really sorry that nothing has turned up again on all your labwork. It's maddening!I'm going to keep researching and thinking, and see if I can come up with any idea for you. This is just plain terrible!


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## Kathleen M.

Pretty much smack dab in the middle of the range for Free T3, free T4 and TSH. I did send the exact numbers to K9Mom to look at.The cortisol was a bit low, but in range for that time of day, so I don't think I can go for the new "fashionable" adrenal fatigue thing. Besides most of the herb combos for that have licorice to bring up the blood pressure and I run too high so I can't take them anyway.I did try some DHEA, but quite that after a couple of days because all I felt was nauseated and did not get the rush of energy most peple seem to say they get on it.*sigh*K.


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## M&M

Oh I'm glad you sent the numbers to K-9Mom! She might be able to pick up on something subtle in your lab values, and give you a good idea.It's just so weird that no doctor has been able to figure this out yet. I just have no idea what would be going on.My Ferritin levels were low also, and my doctor did put me on an Rx Iron for it. In fact, I am still on the Iron, though now I only take it every other day instead of every day. Low Ferritin levels aren't supposed to cause much of a problem though, from the reading I've done, unless you're an Olympic athlete, or something. But he put me on the Iron anyway, to get the level up. My level has gone up considerably, and is nearly in the "normal" range now. I'm not sure if it has made much of a difference in the way I feel, but I figure getting the level into "normal" can't hurt. Would you be able to take an Iron supplement for a little while, to see if that helps at all? Or, I may have missed it, and you may have already done that. I think there are lots of Iron supps. you can get that aren't Rx only.I don't know, I'm kind of grasping at straws here, but if it wouldn't hurt you, or interfere with any other meds you're on, it might be worth a shot. Even if it didn't make a huge difference, it might be worth a shot.Do you take any meds on a regular basis that could be making you feel more exhausted as a side effect?What about taking a really potent vitamin, with B complex in it, or just a B complex vitamin? (Like the NOW Brand Multi, or B vitamins)I was also wondering, do you wake up in the morning feeling exhausted? Or wake up feeling more or less ok, and get the exhausted feeling once you're up and about?Still grasping at straws, and I imagine these are probably all things you've already discussed, tried, or thought about - as you've been dealing with this problem for so long. I really just wish there was a good answer for you!


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## M&M

Just had another brain storm - how's your blood pressure? Does it tend to run low?Do you ever have trouble when you're standing up? Vision going black, black splotches in your vision, dizziness, weakness, grabbing onto the wall to keep from falling, anything like that?


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## Kathleen M.

My Ferritin is a tad lower than it was, but not where it should cause problems. I may go bck on the iron, I sometimes take a Bvitamin/Selenium/Vit D combo. Haven't been as I wondered if that was masking something.I so hoped when the bleeding excessively thin was fixed with a fibroidectomy I'd be OK, but then I've had this most of my life.I'm always tired, I'm not always sleepy, if anything I may feel better in the early evening than during the day, but not always.Meds shouldn't be doing this.Blood presure is high. I sometimes have dizzy issues but that seems to be my inner ear rather than standing up blood pressure things.The only thing that in anyway started about the time the tired started was I pee a lot at night. There is a med that can l that, with the high blood pressure might not be a good idea. Although maye I need a diuretic in the moring and antidiuretic at night.I don't think it is messing up my sleep that much (it stops between 1-2 am, I can go 6 times from bedtime to 1 am) as when I turn off my alarm on weekends I get up at the same time and I'm not that sleepy like I was with the sleep problem.K.


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## M&M

Well, I had the bright idea that maybe you have some kind of orthostatic intolerance! But that's a bust too. lolI sure wish I had a good idea for you. I'm hoping maybe K-9Mom will have some constructive ideas.I'm really sorry you are still dealing with this, and still with no answers. The only thing I can think for you to do is just keep trying to look for answers. I do believe that eventually, the issue, problem, or illness WILL be uncovered. It might take a long time, but eventually something will come to light.Even though I don't have any answers, I know everyone in this forum understands what you're dealing with, and the frustration you feel at not getting any answers for years and years. Please keep us posted, and know that you can come here and vent whenever you need!!((((((((((((((((((((( Kathleen )))))))))))))))))))))))))


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## Kathleen M.

well back from the internist.Unfortunately three really aren't any more tests he can think of to run that would make any sense to run.So it is just watch and wait and see if anyhing ever breaks bad enough to mean anything.I hate being "perfectly healthy" and feeling like ####.I know the allergy think "might" explain it but it doesn't seem to do this to everyone else.Just really frustrated and upset.There are a couple of holistic types around here, but I don't know that I want to pay out that kinda money that I don't have right now for a brunch of treatments that in all the clinical studies tend to show are placebos, or I know the "tests" used to "diagnose" the problems are not really able to see what the makes of the equipment claim they can. Some seem set up to find something so they can sell you prodcuts to fix the problems the test can' diagnose to start with.I do think the medical Qi Gong I am learning seems to help as well as airing out the house regularly even though that should make the allergies much worse. I also need to take the vitamin set that I know has clinical evidence for it more regularly.While I am a bit moody and irritable it doesn't even seem time to just throw me on antidepressants, not that hulped much for this in the past and they tend to have side effects I can't risk for a just see.So I'm pretty much screwed.I might email that one doctor in Cary with the I find what is wrong wiyh everyone ad, but I really don't think that I'd end up being what she cures as I think my blood tests already rule out everything in her ads she says she can find and fix.K.


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## M&M

Well, that just plain stinks!! I sure was hoping they'd be able to pinpoint at least SOMETHING that was off a little in your labs.There has got to be _something_ going on in your body. And no wonder you're a bit moody and irritable! You feel like #### all the time and don't know why! I think you've earned the right to be a bit moody and irritable!Any other specialists you can think of that might be able to help at all? Neurologist? Cardiologist (for the lack of cardio building ability)? Endocrinologist? In the back of my mind, I just hope that maybe if you keep pushing, and pushing someone might eventually find _something_. But, you just never know.I hope we can keep this thread alive, in case you have any new insights, or updates, and in case anyone comes along with a new idea or suggestion. Sure wish they would have found something, and I wish even more your Internist would have been able to come up with something instead of just saying "That's all we can check you for". That's so frustrating!!! I just get aggravated when medical professionals throw up their hands so quickly, when something is so obviously going wrong in your body, somewhere. Phooey. And you're stuck feeling like #### in the meantime!!


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