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Feeling tired, fatigue. Blood test normal. Now excessive sweating during exercise, stuffy head. Linked?

Dec 2014
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Practicing since : 2007
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I am a 29 yo female and I have been excessively tired/fatigued for at least three years now and have had every blood test under the sun. They all came back fine but I know I'm not making this up.

Lately when I have been exercising, I sweat a lot and it smells really sweet which is weird. I also sweat during my sleep at night time but don't realise until the next morning when I wake and my shirt is wet at the back. Upon waking I feel stuffy in the head and face, almost like a headache. It's painful and I often need a painkiller so I can go to work. I have to push myself very hard to get through the work day. Do you think this could be linked to my tiredness? I work long hours and have a busy life but I'm otherwise completely healthy.

I really need help because I'm so sick of feeling this exhausted all the time without an apparent cause......

Thanks :)
Posted Wed, 17 Apr 2013 in General Health
Answered by Dr. Seikhoo Bishnoi 1 hour later
Welcome to health care magic

You have problem of Tiredness and easy fatiguability since last3 years. There is no significant past history apart from history of measles. You are a young working woman and you have continuous work load through out the day. You have problem of excessive sweating, you feel stuffiness in head in morning and you have continuous headache in morning. Some times you even have to take pain killers.

Now coming to management. For proper work up of your condition I will advise you few tests, even your blood investigations were normal.

- Hemoglobin levels, Serum Vitamin B12 levels, Serum Folate Levels, Thyroid Function Tests.

Low hemoglobin levels or anaemia is most common cause of fatigue. Other test like B12 and folate levels are also very important. A lot of individuals have low vitamin B12 which cause excessive tiredness. Normal B12 are in range of 300-900.

Although I advised Thyroid Functions Tests, but they are not much important in you as you have complaint of excessive sweating also. We can suspect hypothyroidism in you but excessive sweating don't occur in hypothyroidism.

If these tests come normal then you should also get your Cortisol levels done. Elevated cortisol levels may indicate chronic stress response. If cortisol levels come in higher side then next investigation is DST (dexamethasone suppression test). DST is definitive test for this.

And as you have mentioned about sweet smell in sweat, I will advise you to go for Urine tests for ketone bodies, blood sugar. Fruity smell in body fluids may occur in hyperglycemia.

- As per my opinion by these investigations we can rule out all major possibilities. But tiredness, fatiguability, heaviness in head in morning, sweating etc symptoms may occur due to Anxiety mixed with Depression. As you have mentioned that you have to work for long and this is a stress factor. Due to excessive work you remain under continuous stress. This cause non specific anxiety and depressive symptoms which are manifesting as tiredness and weakness. For this I will advise you to please visit your attending doctor or any good Psychiatrist for expert evaluation. Depression and anxiety manifest as somatic symptoms like tiredness, heaviness in head.
You can control these symptoms by Progressive Muscle Relaxation Techniques, Deep Breathing Exercises, Meditation etc. Only in some cases medicines are needed.

Hope I cleared your doubt, If you have more questions you can ask again in follow up.

Dr. Seikhoo Bishnoi, MD
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