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Is my tiredness related to carotid disease? Have type 2 diabetes, high BP, angina and depression.

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General & Family Physician
Practicing since : 1992
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I am 68 years old male and have type 2 diabetes, high bp, angina, depression, and sole carer re my wife who has had schizophrenia for over 40 years. I am self employed with some stress in my work. For best part of 2 years or so I have had extreme fatigue and feelings of exhaustion but no specific answers given as to why. Need additional sleep during day. Recent health screening has evidenced substantial plaque in right carotid artery and am seeing surgeon this week. Is it likely that my tiredness situation is directly related to carotid disease discovery?
Posted Fri, 20 Apr 2012 in Hypertension and Heart Disease
Answered by Dr. James M. Schwartz 12 minutes later

Thanks for the query. I am happy to help you with your question.

It sounds like you have a lot on your plate and I commend you for your devotion to your wife.

Plaque in the carotid artery would not cause fatigue. Your surgeon will confirm this when you see him/her.

If, as you suggest, you have had a general medical evaluation and no specific cause of fatigue is found (including normal thyroid function), then I would entertain the following possibilities, all of which can cause fatigue:

1. Poorly controlled blood pressure.
2. Side effect of blood pressure medication.
3. Poorly controlled diabetes.
4. Stress/depression.

If 1-3 are ruled out (though it is difficult to rule out medication side effect, other than stopping or changing medication), then I would strongly consider #4, which is a very common cause of fatigue. Indeed I see it every day in my Family Medicine practice.

I hope I have answered your query. I will be available to answer any follow up regarding this query. Once you are satisfied with all my answer, please accept it.

Best regards,
Dr. Schwartz
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