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Why do I have fatigue and weakness?

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Practicing since : 1995
Answered : 6 Questions
Requested an Endocrinologist but below says Orthopaedic Surgeon- Age 44, 5'2, 122lbs. I have low testosterone- <0.5 rr is <2.0, elevated lymphocytes 3.78 rr- 1.0-3.2, elevated MCH 33 rr 27-32, TSH 3.52 , T4free- 14 (lower end of normal reference range) rr 12-22, fatigue, degenerative disc disease, osteoarthritis, inflammation, memory loss, leg and foot cramps, hip pain, joint pain, low tolerance for excercise, low sex drive, weak muscle strength, shortness of breath with little exertion, big toe pain (minimal), swollen eyelids, insomnia, irritability, overall weakness... I get so tired and have no will for anything especially at time of ovulation. I'm not sure if all of this is related but I would like to find the root cause so that I can deal with it. Also was on ortho 777 for 18 years symptoms showed after I got off of the ortho. Been off for 2 years. Anything you can do to help me get a proper diagnosis would be appreciated. I realize that I am complicated... :-)
Posted Sun, 15 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Manuj Sharma 13 hours later

Thanks for the query.

I have gone through your description, which shows that you are having involvement of joint and connective tissue.

Disease of connective tissue and hormones usually have such a vast spectrum of problems like yours. So, I felt an Orthopedic opinion too would be helpful for us which would help us in coming to a conclusion and suggesting you better.

I have asked my coordinator to forward your query to an experienced Orthopedician too for his suggestions. And would advise you on his reference.

Hopefully we can find out some root cause.

Awaiting Orthopedician's suggestions for you.

Wish you good health.

Above answer was peer-reviewed by
Answered by Dr. Manuj Sharma 18 hours later

We got the answer from an Orthopedic Surgeon, Dr. XXXXXXX here. Please go through his opinion as under. You may also want to view his profile here.


Thanks for the query and referral.

As Dr Manuj Sharma has already mentioned, it may seem like a connective
tissue disorder but a differential diagnosis might suggest this as a
complex of few things.

Firstly if I am not mistaken ortho777 is a birth control pill which seems to have had a bit of bad reputation regarding a variety of side effects. Taking these pills over a span of 18 yrs
must have some relevance to your symptoms.

Secondly..'and i'm nearing quite the end' describes as you seem to show symptoms of calcium deficiency(and a few more minerals, but mainly calcium) which also exaggarates with a pre existing
parathyroid and premenopausal condition.

Embrace yourself to a tougher situation during menopause, for which you may have a variety of
treatment options from a Gynaecologist or Endocrinologist.

Besides you need to follow a good diet plan including calcium,vitamin d and protien supplements. sure its a complicated situation but your doctors are to help you deal with it. Let us begin by knowing your bone mineral density by Dual xray absorbtiometry, serum calcium levels/minerals profile,
serum parathormone.

If this brings out something then you'll need a calcium Vitamin D combination with a bisphosphonate like residronate or ibadronate to prevent resorption of calcium from bones) and not to forget exercises. Your doctor will know about my recommendations. Please speak to him as well.

Hope we're getting somewhere with your ordeal, be patient,

Everything'll be alright

Good luck

Above answer was peer-reviewed by
Follow-up: Why do I have fatigue and weakness? 6 hours later
Thank you for your kind reply. I thought that my issue was more hormone related and my priority was to find a solution to balance my hormones and eleviate my fatigue which has been the most prominent/ annoying factor. I wasn't really focusing on the bone and mentioned it as it might shed some light on the other imbalances which stemmed from the hormones. I was curious to know if my physical symptoms, low testosterone and high lymphocyte reading were due to Hashimoto disease or something similar.
Now that you have discussed the bone issues then I will request a bone density test that you mentioned to see if perhaps I am lacking in something that is essential. I have had mild scoliosis all of my life (2 curves 1 is 17 degrees and 1 is at 13 degrees). I also had a whiplash accident about 6 years ago and have ongoing pains with that. As far as back pain, I've resigned myself to live with the pain as I can function...the thing I can't function with is the ongoing fatigue and lack of will to do anything in life. This is what I really want to deal with...I think I am just tired of being tired and confused about everything happening in my body... hahaha I thank you for your time and if there is anything else you or the other Doctor can think of to balance my hormones, alleviate my fatigue and live somewhat of a normal life, I would appreicate any additional advice. I am a Homeopathic Doctor and Clinical Herbalist and I eat very healthy and have a healthy lifestyle otherwise... Thanks again for your time..have a wonderful day..
Answered by Dr. Manuj Sharma 16 hours later
Thanks for the query.

I am glad we were able to draw attention to an important issue, but I have a reason to believe that your bone health is more or less still is related to your hormonal situation.

I would not agree about hypothyroidism since there are many symptoms you don't seem to suffer
included in that. Even if so, do consult the endocrinologist for a final opinion.

Let us go ahead with the bone density,serum mineral profile, serum parathormone levels too.

The scoliosis seems well under control, i mean hopefully non progressive. You don't have to put up with back pain all the time.

Take analgesics/antiinflammatory drugs for some time, and start back strengthening exercises.

That's the only long term solution to most of your problems and not medicines.

You are an educated person and i trust you when you say you have a healthy diet, but just for the sake let's not miss something there as well,since we all have our concepts of nutrition. so do consult a dietitian for confirmation.

Don't be confused or frustrated, try to cheer up and take control of things.

Your letter doesn't create an impression that you suffer depression, and thats amazing.

It is just taking some time thats all. But we hope you'll do just fine.

Awaiting further reply and reports.

Take care
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