Brief Answer:
Proper clinical review, lab tests

Detailed Answer:
Hi and thanks for the query,

I do understand this could be disturbing. However, it might be necessary to consider a few things before making an in depth evaluation of your current health status. When did you start experiencing this? Do you have any enlarged lymph nodes some where? Any notion of recent weight loss? Any feeling of malaise or state of feeling generally not well? When was your last fasting blood sugar screen for diabetes? For how long have you been on Fluoxetine? Any recent change in your drugs?

It might be necessary to note that sweating and feeling tired are common side effects seen with fluoxetine.

These questions are all important to be carefully addressed in addressing your problem, especially if this has been going on for quite some time.

Do you experience any palpitations, tremor, or recent weight loss, increased appetite? It is imperative to check for hyperthyroidism. This is a common clinical presentation seen in raised circulating thyroid hormone disease.

Any joint or muscle pain, weakness at the pelvic girdle or shoulders would be suggestive of polymyalgia rheumatica. It would be needed for an Erythrocyte Sedimentation Rate, ESR, to be done. If raised, this could be indicative of a chronic inflammatory disease, generally easy to treat and response well to steroid therapy.

Systemic diseases like sarcoidosis also do present as such. A chest X ray could be very informative. It is not rare to find classical signs even in patients presenting no clinical manifestations.

I strongly suggest you test for diabetes and doing a fasting blood sugar, and also get an HIV test run.

Blood tests to rule out a possible infection, either viral or bacterial would be useful. A complete blood count with raised lymphocytes would be indicative if a viral condition. In case neutrophils are raised relatively, a bacterial infection would be more likely to be the underlying cause. Simple tests like the Erythrocyte Sedimentation rate and C reactive Protein , CrP, would be most useful. Based on clinical findings, it might warrant that blood cultures be done in case deemed necessary by your physician.

Thanks and kind regards as I wish you the best of health. Please, do feel free asking any further questions in case you have any specific concerns. Kind regards.

Dr Bain

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