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Suggest Treatment For Sore Throat And Fatigue
Question: My 18 year old son has been feeling very lethargic, sore throat, achey and just overall crappy for the last four months. The first doctor thought it was a virus, a second doctor tested for mono, but said it was inconclusive and then did an ultrasound of his liver, which came back fine, but he is not getting any better. I think I need to to take him to a secialist, but I dont know what kind
Brief Answer:
Infectious disease/immunologist
Detailed Answer:
Hello and welcome,
This sounds like a difficult situation.
I imagine your son's doctor did a mono spot for Mono. But did he or she test him for antibody tests for mono? Mono IgG shows past infection and recovery, but IgM shows current infection. This may provide more information than the mono spot, if the doctor hasn't done so already.
While testing for this, also test for cytomegalo virus (CMV) which can present like mono.
I would also suggest a CBC with complete, manual, peripheral smear.
I think it would be good to do an initial work up for autoimmune disorders, including a sedimentation rate (shows if there is inflammation), ANA and rheumatoid factor to start with.
Also test his thyroid function: TSH and free T3 and T 4.
I was surprised to see that he was on steroid. If they were oral and for more than a week or two, this will knock down the immune system afterwards and can cause people to have the symptoms you described.
If you feel you have come to the end of what his own doctor can look into, I'd suggest and infectious disease/immunologist. Best place would be your nearest university hospital or major medical center.
I hope this information helps.
Infectious disease/immunologist
Detailed Answer:
Hello and welcome,
This sounds like a difficult situation.
I imagine your son's doctor did a mono spot for Mono. But did he or she test him for antibody tests for mono? Mono IgG shows past infection and recovery, but IgM shows current infection. This may provide more information than the mono spot, if the doctor hasn't done so already.
While testing for this, also test for cytomegalo virus (CMV) which can present like mono.
I would also suggest a CBC with complete, manual, peripheral smear.
I think it would be good to do an initial work up for autoimmune disorders, including a sedimentation rate (shows if there is inflammation), ANA and rheumatoid factor to start with.
Also test his thyroid function: TSH and free T3 and T 4.
I was surprised to see that he was on steroid. If they were oral and for more than a week or two, this will knock down the immune system afterwards and can cause people to have the symptoms you described.
If you feel you have come to the end of what his own doctor can look into, I'd suggest and infectious disease/immunologist. Best place would be your nearest university hospital or major medical center.
I hope this information helps.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you so much for the information. Is it possible this could be a thyroid issue? His mom has Hashimotos
Brief Answer:
Yes, a thyroid problem is possible
Detailed Answer:
In teens, it's possible to get a viral thyroiditis which can create a state of hypothyroidism and fatigue and can resolve slowly. That's why I listed the thyroid function tests (above). Antithyroid antibody test could be included in that thyroid panel too.
Yes, a thyroid problem is possible
Detailed Answer:
In teens, it's possible to get a viral thyroiditis which can create a state of hypothyroidism and fatigue and can resolve slowly. That's why I listed the thyroid function tests (above). Antithyroid antibody test could be included in that thyroid panel too.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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