Discussions By Condition: I cannot get a diagnosis.

Extreme Fatigue...

Posted In: I cannot get a diagnosis. 41 Replies
  • Posted By: Christopher74
  • January 21, 2010
  • 06:57 AM

I am a 35 year old male, 6'3", 175 lbs.

My symptoms (past 20 years) are extreme fatigue, social anxiety, frequent panic attacks, depression, some food sensitivities (whey, soy, fatty foods), slightly elevated blood glucose (fasting 105), clammy hands, and occasional numbness in lips (past 2 years).

I have a family history of bipolar and diabetes (not sure which type).

I appreciate any ideas/insights.

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41 Replies:

  • Fatigue is worse. My lips are still numb, and today I have some numbness in my hands as well. My blood pressure is normal. I am going to see my primary care doctor soon, but I need to have some idea of what's wrong or else I'm afraid we will not make any progress. She recently put me on Provigil (200 mg/day) for fatigue, but it has not made a dent... maybe even made it worse.
    Christopher74 12 Replies
    • January 21, 2010
    • 06:37 PM
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  • Have you ever had your thyroid checked? It can cause fatigue, depression, anxiety, etc. Also, I deal with depression and never had problems with anxiety until my doc had me try Abilify. All of a sudden, I couldn't stand heights, hated driving over bridges, had extreme anxiety driving, etc. We attributed this to the new medication and it got much better after we changed. Also, have you had your blood tested for hormone or vitamin deficiencies? A deficiency in B12 can certainly cause fatigue. Hope you get some answers!
    Anonymous 42789 Replies
    • January 21, 2010
    • 07:52 PM
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  • Fatigue is worse. My lips are still numb, and today I have some numbness in my hands as well. My blood pressure is normal. I am going to see my primary care doctor soon, but I need to have some idea of what's wrong or else I'm afraid we will not make any progress. She recently put me on Provigil (200 mg/day) for fatigue, but it has not made a dent... maybe even made it worse.Ever though about taking a good sleep? or a nap?
    Anonymous 42789 Replies
    • January 22, 2010
    • 06:04 PM
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  • Thank you, Okiegirl43.I made an appt for Jan. 25 and will ask my doc about my thyroid... I don't think I've had it checked before, at least not in a long while. I think I get plenty of B-12, but I'll ask anyway.BTW- I also tried Abilify several years ago and had a terrible physical reaction, which really surprised my doctor. I guess it could have been something I ate, but I will definitely never try it again.
    Christopher74 12 Replies
    • January 22, 2010
    • 06:35 PM
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  • Wow... I somehow forgot to mention that I recently began eating a gluten-free diet (I thought it might help my fatigue). Could this be making my fatigue worse?If so, what does that mean?
    Christopher74 12 Replies
    • January 23, 2010
    • 09:09 PM
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  • 1. Definitely do have thyroid tests done - ask for T4 and TSH. Very important!!!2. Have your blood checked for erythrocytes, hemoglobin and iron. Anemia causes extreme fatigue.3. Do allergy tests. Lip numbness can be caused by food allergens. The spectrum of "your" allergen changes over time!4. You may want to see a neurologist if points 1-3 won't bring you a diagnosisin the meantime -quit drinking coffee and black tea for a while - too much caffeine, especially in combination with thyroid disease, can make you feel pretty worn out.Do you happen to use nose sprays (like Afrin and similar) often ? If so, stop. They cause very often those symptoms.
    Anonymous 42789 Replies
    • January 23, 2010
    • 09:56 PM
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  • I am a 35 year old male, 6'3", 175 lbs. My symptoms (past 20 years) are extreme fatigue, social anxiety, frequent panic attacks, depression, some food sensitivities (whey, soy, fatty foods), slightly elevated blood glucose (fasting 105), clammy hands, and occasional numbness in lips (past 2 years). I have a family history of bipolar and diabetes (not sure which type). I appreciate any ideas/insights. Your fasting gluocose is too high and blood sugar issues loww/high can cause many of your symptoms. See a dietitian to get that under control. You can make ziplock bags of nuts and dried fruit to equal 1 starch exchange and 1 fruit exchange for snacks instead of junk and that may help, for instance). There is an emerging link between low testosterone and diabetes. You can have your hormones checked. You can supplement with DHEA since DHEA levels peak at 30 and you are past that, but most studies were done with 50+ and the DHEA had a good effect. DHEA can also convert to estrogen, so you would need to look into aromatase inhibitors to prevent that (which could be your problem anyway). You might have your neurotransmitter levels checked - low serotonin can cause symtoms of depression and fatigue. Low serotonin can be caused by homocysteine (methyl cycle issues). If you are low in B6, or unable to break it down, for instance, you can have panic attacks/anxiety issues, as well as not be able to make serotonin. Good luck.
    madanthony 1087 Replies
    • January 25, 2010
    • 10:22 PM
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  • 1. Definitely do have thyroid tests done - ask for T4 and TSH. Very important!!!2. Have your blood checked for erythrocytes, hemoglobin and iron. Anemia causes extreme fatigue.3. Do allergy tests. Lip numbness can be caused by food allergens. The spectrum of "your" allergen changes over time!4. You may want to see a neurologist if points 1-3 won't bring you a diagnosisin the meantime -quit drinking coffee and black tea for a while - too much caffeine, especially in combination with thyroid disease, can make you feel pretty worn out.Do you happen to use nose sprays (like Afrin and similar) often ? If so, stop. They cause very often those symptoms.^I must have missed this post.Saw my doctor yesterday. She is comfortable with a fasting blood glucose of 101-105. She suggested we check my Vit. D and iron levels... I should get the results tomorrow. And she started me on Cymbalta (30mg for a week, then up to 60), and gave me Ativan for panic.I had already been wondering about my thyroid anyway... I can't remember why I didn't ask her about it. I guess I thought she had good reason to check for other things first, and I didn't want to seem rude.
    Christopher74 12 Replies
    • January 26, 2010
    • 04:53 PM
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  • Your fasting gluocose is too high and blood sugar issues loww/high can cause many of your symptoms. See a dietitian to get that under control. You can make ziplock bags of nuts and dried fruit to equal 1 starch exchange and 1 fruit exchange for snacks instead of junk and that may help, for instance). There is an emerging link between low testosterone and diabetes. You can have your hormones checked. You can supplement with DHEA since DHEA levels peak at 30 and you are past that, but most studies were done with 50+ and the DHEA had a good effect. DHEA can also convert to estrogen, so you would need to look into aromatase inhibitors to prevent that (which could be your problem anyway). You might have your neurotransmitter levels checked - low serotonin can cause symtoms of depression and fatigue. Low serotonin can be caused by homocysteine (methyl cycle issues). If you are low in B6, or unable to break it down, for instance, you can have panic attacks/anxiety issues, as well as not be able to make serotonin. Good luck.Thank you, madanthony.I have taken DHEA with some positive results, but I have seen so much negative information about it that I decided to stop taking it. Is it safe? Do you know where I can find some good information?
    Christopher74 12 Replies
    • January 27, 2010
    • 05:37 PM
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  • ^I must have missed this post. Saw my doctor yesterday. She is comfortable with a fasting blood glucose of 101-105. She suggested we check my Vit. D and iron levels... I should get the results tomorrow. And she started me on Cymbalta (30mg for a week, then up to 60), and gave me Ativan for panic.I had already been wondering about my thyroid anyway... I can't remember why I didn't ask her about it. I guess I thought she had good reason to check for other things first, and I didn't want to seem rude. Christopher - there is no good reason for your fasting blood suagr to be anything other than 80. It may be common because pre-diabetes is common, but it is not good. anxiety/panic are symptoms of low blood sugar, as are clammy hands, shaking, fatigue, (sorry I can't scroll back to see your original list of symptoms but most of them can be caused by unstable blood sugar). I would not take a drug for panic instead of finding out and fixing the cause. Are you taking and breaking down B6? A homocysteine test is a simple blood test to find out if you have low B6/P5P, low B12, or low folate/6-MTHFR. The time to resort to drugs is after you've exhausted the common sense checks that you should do!
    madanthony 1087 Replies
    • January 27, 2010
    • 10:30 PM
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  • Christopher - there is no good reason for your fasting blood suagr to be anything other than 80. It may be common because pre-diabetes is common, but it is not good. anxiety/panic are symptoms of low blood sugar, as are clammy hands, shaking, fatigue, (sorry I can't scroll back to see your original list of symptoms but most of them can be caused by unstable blood sugar). I would not take a drug for panic instead of finding out and fixing the cause. Are you taking and breaking down B6? A homocysteine test is a simple blood test to find out if you have low B6/P5P, low B12, or low folate/6-MTHFR. The time to resort to drugs is after you've exhausted the common sense checks that you should do!Much thanks, again, madanthony.But what about DHEA? I posted a question to you before about it (for some reason it doesn't seem to have shown up here yet... oh well). I had been taking 25-50 mg/day with good results, but I got off of it because I couldn't find enough reassurance that it is safe. What do you think? Do you know any resources I could check out?
    Christopher74 12 Replies
    • January 28, 2010
    • 00:07 AM
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  • Christopher, this site has a timeout so I can hardly check for references for you. About DHEA...there are hundreds or even thousands of studies done on people 50+ years old with a dose of 50mg. You can find many of them using Google Scholar. It is probably not safe if you have a pre-existing cancer and you should get a PSA test or whatever cancer tests doctors feel are appropriate for persons of your age. Peak DHEA is at 30 and the age of the tests supplementing at 50mg is 50, so you are a quarter of the way there and could maybe start at 10-15 mg. However, the way to do any hormone supplementation is (1) get a baseline hormone reading, (2) take the hormones indicated for 2-3 months, (3) retest to see what hormones you make. Meridian Valley has the best hormone testing I have seen but it runs about $600. The test will pick up things like whether or not you need aromatase inhibitors. As men age they DO need aromatase inhibitors, one of which is zinc. It will also pick up whether or not you need 5AR (5-aromatase-reductase) inhibitor to prevent DHT (hair loss). Hormone tests are the best thing you can do to make sure your supplement regime is safe. Do not trust any lab levels because they typically will list the "average hormone levels" for someone your age (you know - the average unhealthy American). Life extension Foundation feels it is best to restore youthful levels. I believe this. IMHO hormone related cancers typically appear AFTER hormone levels wane. I have to stop here for fear of being timed out.
    madanthony 1087 Replies
    • January 30, 2010
    • 07:44 PM
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  • Christopher, I also want to mention that I take pregnenolone, not DHEA alone, because you can't make progesterone from DHEA. It is sold in 15mg and 30 mg doses. Your brain uses pregnenolone so taking a small amount seems balanced and useful. But you aren't 50 yet and since you won't be taking 50mh DHEA, maybe not ready to worry about that. But keep it in mind for the future. I do think you should get a homocysteine test. It is very common for blood sugar issues and elevated homocysteine to occur together. Homocysteine is currently one of the hot topics of research and they do not presently know all the things it causes...there has been some speculation that the deleterious chemical might be what kills the pancreatic cells that eventually leads to insulin dependent diabetes. It remains for research to tell. at any rate homocysteine is worse than high cholesterol on your vascular system and kidnies and if you have it, you are deficient on one of the B vitamins, which can itself cause depression/anxiety/mood symptoms, among other serious things. Your homocysteine level should be 6. For every 3 points above 6 you have a 35% greater risk of vascular events (you know, heart attack, stroke, etc). A young healthy persons DHEA:cortisol level is 10:1 -- anything less limits the amount of stress you can take. Well, put that together with the fact that 2 cups of coffee raise cortisol levels 30% and you can see that coffee might not be a good idea if you can't tolerate stress. Coffee also raises homocysteine, whereas tea reduces it. You know after making sure your homocysteine level is good, the next step is to try 5-HTP. Then, after that if none of those are it, try drugs. But don't let drugs mask a deficiency that will cause you a heart attack! Take are. madanthony
    madanthony 1087 Replies
    • January 30, 2010
    • 08:01 PM
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  • Much thanks, madanthony!My doctor wants to see me on Tuesday. I will ask about a homocysteine test.Also, the reason I was taking DHEA is because I have testicular pain/sensitivity that is lessened when I take it. The first time I took it (several years ago) I must have been taking too much because it caused my prostate to swell. Since then I've had more respect for it. I think I was taking 50mg. Maybe I'll try 10mg... see how that goes.thanks, again.
    Christopher74 12 Replies
    • January 31, 2010
    • 06:42 AM
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  • Much thanks, madanthony! My doctor wants to see me on Tuesday. I will ask about a homocysteine test. Also, the reason I was taking DHEA is because I have testicular pain/sensitivity that is lessened when I take it. The first time I took it (several years ago) I must have been taking too much because it caused my prostate to swell. Since then I've had more respect for it. I think I was taking 50mg. Maybe I'll try 10mg... see how that goes. thanks, again. Christopher DHEA only stays in your system for 20 hours, so whatever dose is right for you, divide it and take it in 2 doses. You may find a lower dose works just fine for you if you remember to divide it in two so you never have none in your system. I read it is sort of a stimulant (I'm not sure that is the right word but it might keep you awake if you take it late in the day). So the second dose should maybe be at dinner or before, or maybe you'll need melatonin to sleep. But one of the things that can prevent an enlarged prostate is Saw Palmetto combined with nettle as these inhibit DHT. DHT is not only implicated in baldness and enlarged prostate, but there is some thought that it might be one thing that leads to prostate cancer. Considering that you've had these symptoms, I can't stress strongly enough getting your hormones measured (and also get checked for cancer). DHEA will cause you to make more testosterone, but your system may be converting the testosterone to DHT and/or estrogen and that's what you need to check and inhibit. Do a google search for "aromatase inhibitors" and "5-alpha-reductase inhibitors". It may be that all you need to do is make sure the testosteron eyou do make does not convert to something else. (This is actually step 1 before making more hormones). Hey, I have to quit before I get timed out. Good luck
    madanthony 1087 Replies
    • January 31, 2010
    • 07:40 PM
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  • Much thanks, madanthony! My doctor wants to see me on Tuesday. I will ask about a homocysteine test. Also, the reason I was taking DHEA is because I have testicular pain/sensitivity that is lessened when I take it. The first time I took it (several years ago) I must have been taking too much because it caused my prostate to swell. Since then I've had more respect for it. I think I was taking 50mg. Maybe I'll try 10mg... see how that goes. thanks, again. Christopher, Hormones add robustness to your system...they are like an alternate route around some health problems. Without hormones it is like having the freeway closed for road repairs and being forced to take side streets, any of which may be closed for repairs. A system is more robust if there are multiple ways to accomplish the same goal. So if/WHEN your hormones wane and you find you have health problems-- that means there are road blocks on the side streets and you should not ignore that and just take hormones. To take the analogy a little further, if you need a life-saving perscription, you have less chance of biting the dust if you have more than one route to take to get to the pharmacy, that in the event of a traffic accident you can still get there. So eat healthy and take your homocysteine test to repair the side streets. Keep all the roads open! Don't over-rely on hormones. At that same time it is powerful to have another route so don't ignore hormones. I just noticed that you list numbness as one of your problems and there is another thread in this blog by an RN who wrote the book "Could it be B12?" that lists numbness as one of the symptoms of B12 deficiency. Low B12 also causes high homocysteine. She says you need an MMA test and a homocysteine test to diagnoze B12 deficiency (serum B12 test is not sensitive enough). You might look into that as well. Low B12 causes neuropathy. Regards, madanthony
    madanthony 1087 Replies
    • January 31, 2010
    • 07:55 PM
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  • Christopher, I am uncomfortable suggesting you take any hormone since you tried it an it caused BPH (benign prostate hyperplasia). Please read what Life Extension has to say about BPH below. I am a member of LEF (I get their magazine and their compendium book on health issues and buy 5-MTHFR from them, which I can't get locally; www.lef.org) -- to me they are the cutting edge of alternative medicine taking the place of Prevention ever since Rodale died. Unlike Prevention, LEF is run by doctors who do reccommend pharmaceuticals if there is no good vitamin/herbal solution, so you get advice from actual doctors committed to health. I also go to a doctor from a list of local doctors they say follow their beliefs. Here is a web page to read, but they have a lot more to say about BPH and there is a whole article about it in their February magazine. They say that saw palmetto has the same effect as pharmaceuticals w/o the side effects and the effects are better with nettle amd pygeum. Anyway, you really should get a hormone test. Maybe there is a cheaper one you can get than Meridian Valley, but if you do make sure it shows estradiol, and DHT as well as testosterone. http://www.lef.org/protocols/male_reproductive/benign_prostatic_hyperplasia_01.htm
    madanthony 1087 Replies
    • February 1, 2010
    • 04:22 PM
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  • Back to blood sugar issues. You can find out info on balancingblood sugar anywhere so I did not talk about it, but I want to make sure you don't go off on a tangent so here are some things that might help you with thatr: (1) Adele Davis, an early nutritionist, cited a study -- sorry I can't take the time to track these down in a timed forum like this -- in which blood sugar could be kept stable (as opposed to low) throughout the day, even after lunch, if 20 g. of protein was ingested at breakfast. She is not saying to eat more protein, but only to move some of your protein intake forward in the day. Protein slows digestion of starches and tends to stabilize your blood sugar. So no skipping breakfast or doing a bagel and coffee. (2) There is research out of Australia, sorry I can't remember for sure, but I think the book might be called "The Gylcemic revolution". It is cutting edge on the glycemic index of food. One principle their study added to using protein to slow starch digestion is that acid accomplishes the same objective. So, for instance, sourdough bread (which has an acid in it) maintains your blood sugar more than regular bread. Vinegar on your salad, or any sour food, does the same. Another principle you can take away from those studies is that the less "instant" a food is, theslower it dihests and the less it messes with your blood sugar. That means the less pulverized, for instance. Slow cook oatmeal is better than instant. Fruits are better than fruit juice, etc. (3) People with blood sugar issues are typically low in chromium and vanadium. Chromium is one of the top ten nutrients proven to extend lif e(in tiny organisms with short life spans -- how else could that be tested w/o waiting a 100 years?). Anyway, chromium is a good supplement to take anyway. (4) I read a long time ago that diabetics are low in zinc but I can no longer remember where so can't check the reference, just watch for it. Anyway, may not be true of pre-diabetics. It takes zinc to make insulin and if you eat a lot of junk food requiring a lot of insulin to be made, it sounds reasonable it could be a problem. Also, I have a friend who slipped on the ice and it caused her to suddenly go from "fine" to being a "brittle" diabetic. I have wondered if it had anything to do with that it also takes zinc to make adrenaline...maybe the zinc got used up, or something else...? They say you can't supplement >30mg zinc w/o taking copper as well. You should do a search for zinc and copper relationship to decide for yourself what to do about that (don't cause a copper dficiency). Zinc is an aromatase inhibitor, probably why men feel "not right" on a vegetarian diet -- those who feel that way are not taking steps to make sure they get enough zinc (such as via chick peas). (5) There are a lot of supplements that lower blood sugar. Your fasting blood sugar is too high. You canlook into alpha-lipoic acid. The Germans use this in a diose of 600mg to lower blood sugar for diabetes. It is very strong. Do NOT take 600mg since you have symptoms of low blood sugar (despite your fasting blood sugar reading). However you could try maybe 100mg. Let me tell you what happens if I take 600mg -- I will have not one but THREE low blood sugar attacks in one day. I can tolerate 100mgmyself. Thereare many other supplements and teas that lower your blood sugar just a little, like fenugreek. Fenugreek tea takes kindof like chicken soup and - I can't remember if it lowers your blood sugar 15 points or 10% - but it is some modest amount - which may be more what you are looking for. You can do a search for "lower" "blood sugar" and maybe throw the word supplements or herbs in the search list. (6) Diet is most important - cut out the crud. I'd like to hope you know what the crud is, but if you don't or you need help figuring out how to integrate healthy diet into your lifestyle, that's what a dietitian is for. Make sure you find one that will work with you if eating at restaurants is something you refuse to give up. (7) If you do all those things and still have problems, it really could be homocysteine. Check it out. Best. madanthony
    madanthony 1087 Replies
    • February 1, 2010
    • 04:48 PM
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  • Two other things I can't believe I failed to mention about blood sugar (its this time limit thing). (1) Insulin resistance, which preceeds diabetes, MAY have something to do with the fats you eat. The cell membrane has ion channels which are supposed to be made from omega-3's but your body will use whatever fat you supply. If your body has to use a different fat, it will not as readily make ion exchanges and you have insulin resistance. Taking omega-3's is very important to warding off diabetes IMHO. It takes 5 years to replace every cell in your body, so it's not something you can turn around quickly if you've not been getting your omega-3's, so don't wait, start now! (2) I started having a lot of problems with low blood sugar -- someone would cut me off in traffic and I would not be able to stop shaking until I ate something, for instance. I looked into it and - well, not only do I refuse to take drugs, but I won't even take glandulars - so my research led me to believe I probably had something wrong with my adrenal gland -- possibly it was overworked from my high stress job at the least. And the thing that I found to help with that which didn't sound like something I would not want to take, is Rhodiola. It did the trick for me. It is a little plant from the Himalayahs that the people up there drink as a tea, and they are the longest lived people on the planet, which some attribute to the rhodiola. It is thought to be an adaptogen. I regarded it as "mother's little helper" for stress and found it worked very well. Hope this is of some help P.S. In order that you can take this in context, I have to admit that I am female. So please read what lef.org has to say about BPH. I can only tell you what I have read and have no direct experience on that. madanthony (after mad anthony wayne)
    madanthony 1087 Replies
    • February 1, 2010
    • 05:06 PM
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  • Thank you, madanthony. :) You've given me a lot to study and think about. Just returned from doc. She was excited and told me I am Vitamin D deficient (my level was 8, she said it should be at least 10). She gave me a Rx for some kind of "brain super-food" that she thinks will have me skipping into her office in three months. I'm cautiously hopeful. I failed miserably, however, to ask her if we could check my homocysteine level. I just didn't feel comfortable asking. (Of course, I'm kicking myself now!!)
    Christopher74 12 Replies
    • February 2, 2010
    • 04:56 PM
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