Hello,
Thanks for your query.

It is sad to know about your problem, but same time I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     53 year old male
•     Complaints of: dizziness, feeling uncomfortable, tiredness, inability to feel fresh after rest or sleep, lack of concentration, weakness, falling hair and burning eyes.
•     No response to B-12 and multivitamins.

From your complaints, i suspect presence of anxiety and depressive disorder in your case. Common symptoms of anxiety and depression which may or may not be present in your case: nervousness, restlessness, mild irritability, excessive worry regarding own health, tremor, inability to relax, muscle spasm, tiredness, dizziness, heaviness in body, easy fatigability, headache, poor concentration, poor sleep, palpitation and dry mouth. You already have many of these symptoms.

Apart from that, I would like to consider multiple possibilities in following hierarchy:
•     Anxiety and depressive disorder: As mentioned above. To confirm diagnosis you may need detailed assessment by psychiatrist
•     Insomnia: some time sleep disturbances due to poor sleeping habits can present with above symptoms.
•     Vitamin deficiency: So continue multi vitamins as they are easily available.
•     Side effect of substance use: Specially alcohol. So, stop use if present.
•     Thyroid related problem: get thyroid hormonal assay done

As you do not want treatment with anti depression medicines, which means your physician has suspected depression in your case and advised you medicines. Many people do not want to get treated with medicines as they feel medicines are harmful or they will become addicted on medicine, but it is not true and medicines are very safe, if used under supervision of physician.

Mild to moderate anxiety and depression can be treated with lifestyle modification, sleep hygiene and cognitive behavior therapy (CBT). In cognitive behavior therapy, in-person counseling sessions conducted several times a month, by trained therapist. So you can search for CBT therapist in your area and can take their help to recover.

Advise for lifestyle modification:
-Recreation and social activities - essential for maintaining concentration, and motivation. Should be programmed daily in small quantities.
-Nutrition - don’t skip meals. Eat plenty of fruit and coloured vegetables
-Exercise - the amount can be varied. Incorporate some stretching exercises and some aerobics like skipping or same place jogging.
-Relaxation - use a muscle relaxation technique, breathing exercise or any form of meditation that doesn't take more than a few minutes.

Steps of sleep hygiene:
•     Fix a bedtime and an awakening time. Do not be one of those people who allows bedtime and awakening time to drift. The body "gets used" to falling asleep at a certain time, but only if this is relatively fixed. Even if you are retired or not working, this is an essential component of good sleeping habits.
•     Avoid napping during the day
•     Avoid caffeine 4-6 hours before bedtime. This includes caffeinated beverages such as coffee, tea and many sodas, as well as chocolate, so be careful.
•     Avoid heavy, spicy, or sugary foods 4-6 hours before bedtime
•     Exercise regularly, but not right before bed. Regular exercise, particularly in the afternoon, can help deepen sleep.
•     Use comfortable bedding.
•     Find a comfortable temperature setting for sleeping and keep the room well ventilated.
•     Block out all distracting noise, and eliminate as much light as possible.
•     Reserve the bed for sleep. Don't use the bed as an office, workroom or recreation room. Let your body "know" that the bed is associated with sleeping.
•     Practice relaxation techniques before bed. Relaxation techniques such as yoga, XXXXXXX breathing and others may help relieve anxiety and reduce muscle tension.
•     Don't take your worries to bed. Leave your worries about job, school, daily life, etc., behind when you go to bed. Some people find it useful to assign a "worry period" during the evening or late afternoon to deal with these issues.
•     Establish a pre-sleep ritual. Pre-sleep rituals, such as a warm bath or a few minutes of reading, can help you sleep.
•     Getting Up in the Middle of the Night :Most people wake up one or two times a night for various reasons. If you find that you get up in the middle of night and cannot get back to sleep within 15-20 minutes, then do not remain in the bed "trying hard" to sleep. Get out of bed. Leave the bedroom. Read, have a light snack, do some quiet activity, or take a bath. You will generally find that you can get back to sleep 20 minutes or so later. Do not perform challenging or engaging activity such as office work, housework, etc. Do not watch television.
•     A Word About Television: Many people fall asleep with the television on in their room. Watching television before bedtime is often a bad idea. Television is a very engaging medium that tends to keep people up. We generally recommend that the television not be in the bedroom. At the appropriate bedtime, the TV should be turned off and the patient should go to bed. Some people find that the radio helps them go to sleep. Since radio is a less engaging medium than TV, this is probably a good idea.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,

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Hello again,
Thanks for follow up.

If you feel dizzy with vitamins then do not use them, in-spite of that take healthy/vitamin XXXXXXX diet like fruits, salad, XXXXXXX vegetables and egg white in meals.

Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.

Wish you good health.
Regards.

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