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Feeling Weak, Anxiety And Lethargic. Diagnosed With Glandular Fever And Autoimmune Disorders. Any Ideas?

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Posted on Mon, 18 Feb 2013
Question: Hi,

For the past 4 weeks I have been experiencing weakness (like after a really tough workout but 24/7) in all my limbs and am very lethargic to the point that going about daily tasks like housework is very difficult. Some days seem worse than others, but about 30% of the time I also feel like my head is really heavy and wants to tilt to one side. Sometimes this feeling becomes extreme (every 3 or 4 days) and I have what feels like some kind of 'seizure' when my head gets so heavy and faint I have to lie down and feel almost unable to lift it for about 20 mins - 1/2 hour, when it begins to ease off gradually over the next couple of hours. When it happens it's very frightening as I feel as though something has just 'gone off' on my head and is then shooting down into the rest of my body and I feel completely disorientated. One time the attack was accompanied by a really awful screeching sound in one ear (like the screeching of a train braking sharply) These ‘attacks’ seem to mainly occur in the evenings. They are also accompanied with a tingling sensation that starts in my chin and creeps up one side of my face and on a couple of occasions one of my hands felt numb and tingly too. I have had this sensation on my face before (intermittantly) in the past 3 years, and I've also had some funny jolting sensations in my head (NOT caused by anti-depressant use I hasten to add, but they seem to be similar to the effects associated with them), however the other symptoms are all new in the last few weeks.

This recent illness all seemed to start with what I believed to be an appetite – which is a new experience for me! I really don’t know whether the ear problem is linked with what’s been happening since or is just a coincidence.

I know this sounds like a crazy mixture of symptoms and I think my GP thinks it must all be in my head as I've suffered depression in the past and I had health anxiety after my mum died. However, these symptoms are very real and very frightening. Because of the glands being up (The 2 big glands under each side of my chin had actually been raised for months but I’d just ignored it as I didn’t even know they were glands until the doc told me recently), the doctor sent me to haematology for a check-up with a specialist who felt the glands and said it's not lymphoma causing my symptoms as they don't feel abnormal. Since then, I feel the doctor has decided that I'm probably just experiencing some kind of anxiety problem as they don't seem interested, other than mooting the possibility of an ENT referral maybe if it continues. In my 20s (I’m now 41) I did experience panic attacks but they were nothing like this, did cause my head to feel heavy, did not bring my glands up for 4 weeks on end or cause debilitating weakness 24/7. They caused a raised heart rate and slight giddiness for about 5 mins andwere nothing like this!

To be honest I’d be grateful if someone would just acknowledge that this is real and I’m not exaggerating or being a hypochondriac, as even my friends are implying it must be psychosomatic. I’m scared and struggling to cope with looking after my son. I haven’t dared to drive for about 3 weeks in case I go weird when I’m driving - plus my concentration is absolutely terrible at the moment.

I really would appreciate suggestions you may be able to offer regarding the cause of this as I NEED to get it dealt with - I can’t go on like this. Plus I’m really scared that one of these strange ‘attacks’ might one day be so severe that I completely lose consciousness, which would obviously be very frightening for my son.

Thank you very much for taking the time to read such a long posting. I wanted to be thorough as I always seem to fail to explain things properly to the GP and I really don't know what's significant and what’s not.
Oh, I forgot to say that I've had lots of bloods taken and the doctor has ruled out glandular fever, any obvious autoimmune disorders etc and he said he checked for various markers that might indicate malignancy of some kind.
Thanks.
XXXXXXX
doctor
Answered by Dr. Sundar Gnanavel (4 hours later)
Hello XXXXXXX .....
Thanks for your query. I understand your concern with the unexplained symptoms. Neverthless you should be glad that malignnacy and autoimmune diseases have been ruled out. I acknowledge that your symptoms are genuine as we do XXXXXXX many such patients in our practice. After going through your symptoms, the possibility that arises in my mind is "chronic fatigue syndrome"/CFS. It is characterised by lethargy, weakness, body pain, anxiety symptoms and occasionally depressive symptoms. The aetiology is unknown. The probable hypothesis include viral/chlamydiae infection and a subclinical autoimmune response that cannot be detected. We do not have very effective interventions for this disorder as of now. What we however suggest is a combination of low dose antidepressant along with a form of psychotherapy called cognitive behavioural therapy that can be effective at times. Additionally, graded work assignments are also helpful for the condition. Hope you find my suggestions useful. Wish you speedy recovery.
Regards
Dr Sundar
Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sundar Gnanavel (5 hours later)
Hi,

Thanks for your response. I had already considered something like this, but don't see how this could account for glands which are actually swollen. The GP agrees that my glands are all swollen, but they've been ruled out as showing any sign of lymphoma. The other thing is that I realy don't understand how something that stems from psychiatric causes could affect me when I'm feeling relaxed. The first time I had a really bad spell was towards the end of a lovely day (boxing day) when I'd just been chillling at home with my family and a couple of friends playing board games etc. I was probably about as telaxed and happy as I could be!

Also in the last couple of days, my partner has become ill and been taken to hospital. Under these sort of circumstances I'm generally very capable and bustle around organising everything - I like to do this. However, these symptoms have carried on regrdless of my attempting to just get on with it, and are actually preventing me from doing so, when all I want in the world is to take care of my son, my partner and my home.

If you think that some kind of chronic fatigue problems could still account for it, bearing in mind the glands being up etc, then I'll accept that as a diagnosis, but I'm worried that because I experienced some depression and anxiety a few years ago, this might be clouding the GP's judgement and preventing them from checking out other possible causes. Obviously, not being a doctor, I have no idea what could cause this range of symptoms, but I suppose I was wondering whether it could be either neurological or related to a problem with the inner ear. Do you feel this is definitely not the case?

Many thanks,
XXXXXXX
doctor
Answered by Dr. Sundar Gnanavel (33 minutes later)
Hello XXXXXXX ......
It does not appear to be a neurological problem or inner ear problem. The gland enlargement alone can be due to an infection. However, the investigations have come out be negative. So, it should settle down over time. For chronic fatigue syndrome, you can try out the treatment options i suggested. Depressive/ anxiety symptoms can accompany CFS. Wish you speedy recovery.
Regards
Dr Sundar
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sundar Gnanavel

Psychiatrist

Practicing since :2009

Answered : 632 Questions

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Feeling Weak, Anxiety And Lethargic. Diagnosed With Glandular Fever And Autoimmune Disorders. Any Ideas?

Hello XXXXXXX .....
Thanks for your query. I understand your concern with the unexplained symptoms. Neverthless you should be glad that malignnacy and autoimmune diseases have been ruled out. I acknowledge that your symptoms are genuine as we do XXXXXXX many such patients in our practice. After going through your symptoms, the possibility that arises in my mind is "chronic fatigue syndrome"/CFS. It is characterised by lethargy, weakness, body pain, anxiety symptoms and occasionally depressive symptoms. The aetiology is unknown. The probable hypothesis include viral/chlamydiae infection and a subclinical autoimmune response that cannot be detected. We do not have very effective interventions for this disorder as of now. What we however suggest is a combination of low dose antidepressant along with a form of psychotherapy called cognitive behavioural therapy that can be effective at times. Additionally, graded work assignments are also helpful for the condition. Hope you find my suggestions useful. Wish you speedy recovery.
Regards
Dr Sundar
Psychiatrist