Discussions By Condition: I cannot get a diagnosis.

20 yo male experiencing fatigue for several years

Posted In: I cannot get a diagnosis. 8 Replies
  • Posted By: Anonymous
  • July 30, 2007
  • 00:40 AM

hello, this is kind of a long post and it's not very straight forward unfortunately, but read my observations below at least and see if you can think of anything. when i first went to see a gp i did a terrible job at explaining my symptoms and he was nearly pulling his hair out since the more i talked the more confusing things got (poor guy heh), but if you wanna give any kind of input at all go ahead (i'm not expecting anything but i figure it can't hurt to make a thread). you can put forward some condition that you think these symptoms might resemble, but keep in mind i've already been to a gp, a cardiologist + a lung specialist, and the heart itself is healthy, as are my lungs, so whatever is wrong is not easy to identify it would seem, unless i did a horrible job explaining my symptoms to them.

i'm a 20 yo male, kinda skinny, good diet, don't smoke or drink, and no family history of any notable diseases. i've been experiencing fatigue for several years that has gotten progressively worse. it is so bad that there is no way i could have a regular job, both because of physical tiredness and my inability to concentrate on things (i used to think i had ADD but that's not the case). infact all i do is sit on a computer chair all day (not out of choice mind u). i started getting shortness of breath during exercise last year (along with fatigue obviously which i've had for a while), so i figured it was time to get checked out. as i said i've been to a gp + cardiologist already, and i was
prescribed pills that contain a beta-blocker a few months ago to reduce blood pressure - the leaflet said it was to treat moderate to severe heart failure, but it was the second smallest mg tablet avalible from this brand. the pills pretty much just lessened the severity of the symptoms, but i still had a lot of trouble concentrating on things at times (especially during the times when i used to do fairly intense exercise) and fatigue was still quite strong at times, especially when i tried exercising in the first few weeks.

i forgot to take my pill one day, a few weeks in, and i had been doing boxing and stuff the days before and i experienced horrible fatigue later that evening (at one point it was like i've been 3 days without sleep and my body just cannot function), bad muscle weakness (when i attempted weight training), a feeling of anxiety and a fast resting heart rate. however, once i took the pill it improved things a lot, but i still was not near the point where i feel good... and from then on i stopped all intense exercise completely... all i do is walking for maybe 5 minutes at a time several times a day (too much walking has the same effect as intense exercise in that it will make my heart rate go up and i'll start sweating, getting fatigued, maybe shortness of breath - depending on whether i was doing intense exercise the days before or not).

now some observations i've made:
1) the fatigue is getting progressively worse
2) the only thing abnormal from a physical examination is that my blood pressure is a lil high, but not that high, and i got a high resting heart rate - usually 75 bpm when i get outta bed, then 85-90 bpm for the rest of the day... or even 100 bpm when i'm feeling really bad (it was 130 bpm when i was at the doctor becuz i had to walk for a bit, and i guess i was a lil nervous, but not that nervous, so it's more than just nerves) - also, during exercise my heart rate simply beats way faster then it should for the
intensity of the exercise, and it takes a very long time to calm down after exercise, this may just sound like poor physical fitness, but it's more then just that. and remember all i do is sit on a chair all day, and there is no stress or anything that could trigger it to beat faster.
3) during times when i felt good my resting heart rate was around 55-60 bpm - and i have not felt good for several months now. there was 4 days back in march when i felt great - i was getting less but better quality sleep, i woke up and jumped outta bed, i felt great, confident, energetic, very alert, etc, but then i did intense exercise and messed things up... i think the way exercise makes me feel bad is noteworthy (it's taken me years to realize this, and i'm not a quitter i don't give up easily, but this is the reality, it's only in the last year that i'm being honest with myself)
4) intense exercise makes me feel horrible in the following days... it leads to things like shortness of breath, a feeling of anxiety, bad muscle weakness (i cannot do one push up sometimes - over the years on days when i felt good i could do around 30 without killing myself)
5) i have incredibly low self-esteem, which shows in certain situations, and when i was talking to the cardiologists i suspect i did not really emphasize just how bad the fatigue is and how much it affects my quality of life and i did say i was under stress (i may have came across as someone who was seeking comfort), but the stress is mainly derived from this condition, so therefore stress is not a cause. i'll have to point this out at my next appointment
6) i'm fatigued all the time, it even affects my quality of sleep, i never wake up feeling truly refreshed, except during those days when i felt good (which are very rare and i have not had any good days for a few months now)
7) this may not be as important but sometimes my pulse feels pretty weak, especially when it's beating fast, and i apply the same pressure on my wrist to check it each time.

more about the fatigue:
it first started when i was 16 - i had trouble concentrating in school and stuff, and it got especially bad when i started doing weight training (i only realize this now). it has gotten much worse now, and how badly i'm fatigued throughout the day varies... usually it's not so bad in the morning... it tends to reach it's peak around midday to the evening where i have sometimes have a great deal of difficulty concentrating on things and i feel so drained physically. it's just a horrible feeling, and i usually just end up listening to muic or whatever since i cannot do anything else... it causes a lot of discomfort and it is really distracting... it tends to die down a bit near the end of the day (like right now - there is no way i could have typed this out in one go during midday) and i can usually concentrate on things more, but still nowhere near the point where i feel good. i also have to avoid exercising for a even a moderate amount of time, and i have to avoid doing anything physically demanding since my body cannot seem to tolerate it and as i stated above i get muscle weakness, shortness of breath and the fatigue worsens.

i'm positive that i am not depressed or have any kind of anxiety condition. i just feel down sometimes and or experience anxiety due to this condition creating stress and having to deal with difficult people who do not listen and there being no escape from a variety of things which cause me grief. i'm not a weak person, i'm a competitive one - i just gotta peservere through these difficult times and look forward to the days when i get healthier and can do more things. it was a relief finally seeing a doctor last year a doctor as they can at at least reduce symptoms, but it would of course be nice to identify the condition(s) i have and maybe even get a cured. i don't know much about
chronic fatigue syndrome but my fatigue is so bad, and there are other symptoms aswell like the heart rate and increased blood pressure that i figure i either have CFS + other things wrong, or that it's just simply not CFS and it is something else.if u managed to read all that... or at least the observations i made, feel free to make a suggestion

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8 Replies:

  • Oh wow! I feel like I am reading the story of my life! Your experiences are virtually identical...exercise triggering the problem, confusion explaining to the doctor, and then dealing with those same symptoms. The only difference with me is that I have very low blood pressure. It comes in cycles which could last for months. I would go from running on a treadmill every day to collapsing after 5 minutes. And then the nightmare began. Walking up a couple of steps would put me out of breath. Even during simple movements such as standing my HR would get significantly faster. My pulse always felt weak with a fast HR at rest. My muscles were good for nothing and I started wondering if I had ADD as concentration was near impossible. I suggested to my doctor (actually nurse practitioner) that it might be anemia. (By the way--many do not like knowlegable patients). She tested me for iron-deficiency anemia, which came back negative. She gave me anti-depressants and convinced me that the symptoms were in my head (she said I kept coming back with the same complaints--hmm, may indicate a problem). Because I was dealing with the symptoms I wasn't motivated to pursue the matter so I just learned coping strategies. .......NOW HERE IS WHERE IT GETS INTERESTING....... Since January 1, I have been hospitalized 3x for excruciating pain of my back and abdomen after taking either aspirin or ibuprofen for headache (note that I only take 1/2 dose of aspirin or recommended amt ibupr.) Doctors were telling me it was everything from heartburn to allergic reaction. For a week or so after, I would deal with severe fatigue, sudden bouts of profuse sweating, tachycardia, and yellowed eyes. Luckily, my cousin is a doctor in another state and she realized what was happening. I was having episodes of severe hemolytic anemia due to a G6PDH deficiency, which everyone has on my dad's side. Though it is x-linked inheritance the women have it equally as bad and one has even required a blood transfusion... So, what does this have to do with my previous symptoms? I have a history of frequent headaches, so I am guessing that I would take pain killers frequently enough during certain months that I would prolong the anemia. It was not until this year that my deficiency got bad enough to cause hemolytic crisis. At any rate, I would recommend you look into different types of anemia if you have not already. Or perhaps there is another disorder which influences oxygen-carrying capacity? Best Wishes! and feel free to contact me if I can be of any help. My email is danny7ls@aol.com.
    lsoroosh 51 Replies Flag this Response
  • man you have no idea how happy i was while reading your post lsoroosh - i quickly searched through the wikipedia on different kinds of anemia and and related conditions and for once all my symptoms seem to fit nicely into one condition, but i cannot jump to any conclusions, i just discussed it with my mom and she didn't seem too impressed, but what does she know hah.anyways, when i first went to the gp one of the first things that was mentioned when i rang them to check about my blood test results is that my bilirubin levels were pretty high, and he asked me on the phone did i have jaundice, but i don't. my mom also had high bilirubin levels when she got a blood test done so it was dismissed as Gilbert's syndrome, which is harmless, but high bilirubin levels are also a sign in some kinds of anemic-related conditions, but this isn't really solid enough.i'm just wondering if i can rule out anything... my father does not have any health problems, and my mom has 4 sisters, 1 brother, and her mom has 3 brothers, so i feel if there was some genetic condition it would of been identified by now. so while it is unlikely i have the exact condition you have, i'll consider everything, and of course i got blood tests taken by my gp + a cardiologist but it's really difficult to say what kind of anemic-related conditions could have been ruled out by thoses blood tests.thanks for the reply man. it's kinda reassuring to see someone else experience something very similiar to me (in a weird kinda way). i considered lots of things and last year i kinda convinced myself there was somethin serously wrong with my heart when i started gettin shortness of breath but that was not the case, but maybe now i'm getting a little bit closer to finding out the problem.if anyone has any more input i'd like to hear it. i'll just give things some more thought and look into those conditions like you suggested.
    Anonymous 42789 Replies Flag this Response
  • I experienced all the same problems as you for 30 years!! finally I got a diagnosis of Systemic mastocytosis at 46. You may have this or more probably a mast cell activation disorder. MCAD. Brain fog, depression and fatigue are hallmarks of these conditions. (caused by the mast cell mediators affecting the brain chemistry.) Anyway, whatever ails you, I strongly advise you to look into is yourself, coz I didn't and my life could have been a whole lot better if I had. I finally got diagnosed after an xray showed that I had "mottled bones". Doctors can be completely horrible if your symptoms baffle them - try to hang in there and stick up for yourself.Best wishesJan
    Anonymous 42789 Replies Flag this Response
  • I am glad I can be of some help--at least in broadening your awareness of other possibilities. Keep in mind that hemolytic anemia is not always caused by g6pdh deficiency and there are multiple types of anemia. Also, my family has an unusually severe variant of the enzyme deficiency, which make the symptoms so obvious (this type is most common to the mediterranean). Even though I inherited it thru my dad, he does not recall ever having problems with anemia and he takes lo dose aspirin every day. Once again, good luck! P.S.: If you do come up with a diagnosis for your symptoms, can you keep me posted? I am very curious, especially since I am working on getting into medical school
    lsoroosh 51 Replies Flag this Response
  • hello i'm the thread starter and i've done some more searching and still cannot come up with anythingthx for the reply jan, i read a little about that condition but i still think my condition is something else. i've also also ruled out anemia since i'm sure that's somethin that would have been considered and ruled out early on.i tried doing some mild exercise yesterday and here i am today... feeling a little bit more fatigued then usual... which is no surprise down to the exercise..... i woke up this morning and my knees were kinda red and warm.... is this if significance?? prolly notthe cardiologist is taking his time sending out the next appointment... i guess he's giving me plenty of time to try and identify the problem myself since i'm not in any pain, and based on the blood tests and whatever else i guess they concluded it is not seriousi really have no idea what i'm gonna say when i go back up to the cardiologist... i can only really try emphasise how bad the fatigue is and mention that my symptoms could be similar to those of someone suffering from quite bad anemia, especially because of the fatigue, shortnesss of breath, increased heart rate, and exercise intolerance in particular, to give him a better indication of what i'm going through.it's not possible that i contracted something from a needle or unprotected sex and it's not something that a doctor would have identified in a blood test (only thing abnormal is high bilirubin levels)if anyone has any ideas put em forward please, i'll consider anything
    Anonymous 42789 Replies Flag this Response
  • your total bilirubin,conjugated, unconjugated bilirubin is high ?which one?Did you have your urine test ?whats the results?
    Anonymous 42789 Replies Flag this Response
  • To the thread starter:Hi! I'm sorry to hear of your fatigue, but you described it very well. I can relate to the part you put about not being able to type out your question on this forum midday. My fatigue is very much like that.One day, I woke up with my resting heartrate at 115-120. I couldn't stand it!! It was hard for me to relax to go to sleep, etc. It felt like I was running even though I would be laying down watching tv. And, completely forget about exercising. Any time I exercise too intensely, I will become sick and require an antibiotic. So, I went to my GP who did an EKG, and had we wear one of those heart monitoring things, and the result was that I had the normal sinus rhythm of someone jogging. But, I told him, I'm glad it's normal, but I'm NOT JOGGING. I'm just sitting down. Finally, after intense research on the Internet I found the diagnosis of "Inapproriate Sinus Tachycardia" I finally found a cardiologist who agreed with my assesment, and placed me on the correct type and amount of beta-blocker to lower my pulse rate. This might not be your problem, but I thought I might throw it out there as an idea for you.Hope you find a solution soon!
    Anonymous 42789 Replies Flag this Response
  • hey thx for the repliesxjia - it must have been increased unconjugated bilirubin levels since my gp dismissed it as gilberts. i did not have a urine test, my gp just sent me off to a medical team due to my rapid heart rate + the unxplained fatigue, etc, but maybe a urine test will be something considered next.Unregistered - that's interesting, i think my cardiologist might actually think i have that condition as i just got done with a 3 month supply of beta-blockers, and he named out some condition the day he gave me the perscription and it sounds similar to what you said... i wasn't really listening cuz i was excited since a couple of days before i felt the best i had felt in years so i was under the illusion that everything was caused by stress and these pills he's about to give me will just speed up the recovery process, but that's not the case... anyways, it's possible that's the condition he thinks i have... i also had a heart monitor fitted for 24 hours, although it was never discussed... but i check my pulse all the time so i have an idea myself, it's 70-75 for 30 mins in the morning, it gradually rises for the next two hours and usually peaks at 90 bpm, stays around 90 for a few hours, then maybe lowers to 85 or 80 a few hours later (while i'm sitting on a chair all day) - these heart rates may not even seem all that high, but keep in mind my heart rate has been as low as 55 during times when i felt good. also, it gets as high as 130 when i go to see a doctor for some reason, dunno why.... i sometimes have a feeling of anxiety around midday, and combined with some walkin around the hospital (exercise), and the fact that i'm a lil nervous about goin up there anyways, all contribute to make my heart rate go up from 90-100 bpm to 120-130 bpm.well whatever, the pills did make me feel great for a few hours on the very first day, long story short - i did exercise nearly every day, i gradually felt worse and worse and then i stopped doing exercise completely since i'm a human being and there are limitations to what i can endure, but even without doing exercise for six weeks, i was never 100%, my resting heart rate never dropped down to 55 or 60 like it had been on the very first day, it was 70 at lowest, and i still experienced fatigue + difficulty concentrating. my supply of pills ran out 3 weeks ago and i'm doin ok i guess, i just gotta avoid any kind of physical activity and just sit out the daily midday run of fatigue and things aren't so bad in the evening.this diagnosis thing is prolly best left up to the experts, but if anyone still wants to make suggestions go ahead. creating this thread has at least helped me get a better idea of the problems i've been having, and of course ruling out conditions which are similar helps me understand what's wrong with me that little bit more, so maybe i can do a better job explaining things at my next appointment. i know this is all a bit of a nightmare, even for doctors hah, so i appreciate the replies.
    Anonymous 42789 Replies Flag this Response
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