Brief Answer:
Hi Can you please upload your reports.

Detailed Answer:
Dear Sir,
Thank you for your query to HCM.

I did review your concern . Low grade fever accompanied with muscle aches and body fatigue can be seen in systemic viral infection most commonly with influenza viral infection commonly called as flu. Sometimes it does not have a cold or a sorethroat component with it.

Morever, it can be caused by other viruses like EBV or CMV infection. However, since they are not positive as of now they are unlikely causes.

Many other non infectious causes of such complaints for now about a week can be liver illness, blood problems, thyroid problems, kidney problems or electrolyte problems.

Chronic fatigue syndrome is a diagnosis of exclusion made only after excluding all these illness and the fatigue and other problems are still present. Hence, I would be in a much better position to advise you regarding the next steps to be taken and curing this problem if I know what investigations have been done and what was their report (most as you said were normal except slightly low platelet count).

Also, I've noted you have been taking Sertraline and Xanax.

How long have you been taking that and why did the doctor put you on those medications?

You can simply upload your report files here or can can send them to YYYY@YYYY with Sub: ATTN 'Dr Parth XXXXXXX Desai.

Awaiting your reply.

Let me know if you have any more questions or concerns sir.

Wish you all the best.
Sincerely,
Dr Parth Desai.

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Brief Answer:
Hi I would recommend the following.

Detailed Answer:
Dear Sir,

Thank you for your reply query. I did a detailed review of your reports which have been recently done and they are essentially within normal limits.

Your problem appears to be due to excessive anxiety or stress. I would also like to know for how long have you been taking sertraline and xanax. However I would like to rule out any thyroid related probems and would recommend atleast a TSH level assay as well as serum electrolytes (sodium, potassium , calcium magnesium and chloride levels) as electrolyte imbalances can cause fatigue with muscle aches. Sometimes thyroid illness can also cause just fatigue, muscle aches and low fever. It can also be due to postviral illness.

Regardless of the cause my best advice would be to
1) Stay calm and not worry too much about your problem since there is no major organic cause and all your organs seem to be functioning fine.

2) I would recommend some relaxation exercises like Yoga or Tai chi along with graded exercise schedule everyday in the morning at least for 45 min-1 hour. You can also join a laughter club if it is functioning nearby a place you live.

Such activities do help a lot in people with fatigue due to unknown causes.

3) Also, please let your family doctor know if you are loosing a lot of weight and are having high grade fever or notice any swelling on your body for more than 3 weeks. Maintain a temperature chart and body weight chart if necessary and measure with same thermometer 2 times a day once in morning and another in evening. Weight should be measured in morning immediately after waking up.

4) I would recommend at TSH (thyroid stimulating hormone) assay and serum electrolytes.

I hope this helps.
Please Let me know about followup regarding your health.

Let me know if you have any more questions or concerns sir.

Wish you all the very best.
Sincerely,
Dr Parth Desai.

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Brief Answer:
Yes cold can cause such symptoms and TSH aberrations are not serious.

Detailed Answer:
Dear Sir,
Thank you for your reply query.

Panic disorder is a very common clinical problem. If you have not had panic episodes in last year I would recommend that you talk to your doctor regarding this and the idea of slowly tapering these medications. Sertraline can cause fatigue and tiredness in some patients.

Regarding your question about whether cold can do that. Yes cold if you mean influenza flu it can cause these symptoms exactly even without sorethroat and nasal discharge problems. However, patients generally recover by 1-2 weeks or maximum 3 weeks.

TSH is a thyroid stimulating hormone which can go up or down in thyroid problems and it is not a very serious condition and can be cured with medications but first of all we are not sure so we need to know whether there is any problem or not by doing the test. Similiarly for persistent fatigue and muscle pain serum electrolytes including sodium, potassium and chloride are done to see for any problems.

Another thing I would recommend is in case you also have experienced excessive daytime sleepiness along with fatigue and tiredness to also check if you are snoring at night while sleeping if someone has noticed.

So all in all, nothing is serious and major serious illness are ruled out by normal lab reports till now and there is nothing much to worry. But it is essential for us to get you back to your previous energy levels and hence these tests are recommended. Also do think about the exercise, yoga or taichi as I recommended previously.
I must infact admit that you are a very brave person. I could certainly not drive to work for 200kms daily. That is certainly a thing to be proud off sir.

I hope this helps.
Please Let me know about followup regarding your health.

Let me know if you have any more questions or concerns sir.

Wish you all the very best.
Sincerely,
Dr Parth Desai.

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Brief Answer:
Hi, It most likely seems like a recovery from a viral illness.

Detailed Answer:
Dear Sir,

Thank you for your reply query. It seems that you may be recovering from a viral illness most likely influenza infection (flu) and it can cause some loose stools and low abdominal pain in later part of the infection.
I would recommend you to drink lot of water and keep yourself hydrated and take paracetamol (500mg) SOS when fever rises higher than 37.8 degree C.

Let me know if the fever and body aches as well as fatigues persist even after a week's time and then you can go ahead with the recommendations I previously advised. They may not be necessary as of now.

I hope this helps.
Let me know if you have any more questions or concerns sir.
Wish you all the very best.
Sincerely,
Dr Parth Desai.
Replied by Dr. Parth , 9 hours ago

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