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Dr. Andrew Rynne

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Hi doctors My husband suffers from chronic fatigue and stress

Answered by
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Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 1265 Questions

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Posted on Wed, 30 Jan 2019 in Medicines and Side Effects
Question: Hi doctors
My husband suffers from chronic fatigue and stress. In the morning his heart pulses might be as low as 40. We did some testing that showed DHEAs 54L, testosterone 291L and ratio T/S HBG 0,2L. We did the testing with dry blood in a USA lab.
The strange thing is that we repeated the tests here in Cyprus and they show that everything is normal. Any suggestions??
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Follow up: Dr. Antoneta Zotaj 0 minute later
Hi doctors
My husband suffers from chronic fatigue and stress. In the morning his heart pulses might be as low as 40. We did some testing that showed DHEAs 54L, testosterone 291L and ratio T/S HBG 0,2L. We did the testing with dry blood in a USA lab.
The strange thing is that we repeated the tests here in Cyprus and they show that everything is normal. Any suggestions??
doctor
Answered by Dr. Antoneta Zotaj 1 hour later
Brief Answer:
Kindly asked for test results to be uploaded and some more information as explained below
Detailed Answer:
Hello,

The pulse as low as 40 is unusual and needs some heart checks like ECG and heart ultrasound.

As for the blood tests you have mentioned it would be helpful for me to see the original lab results. I need to see well the units used and if they are normal or not. It would be very helpful if you could upload the test results.

The age of your husband is needed as well because some of the test results are interpreted according to range changes with age.

Fatigue and stress are very general symptoms that do not specifically lead to a certain medical condition and thorough history and physical examination and possibly general blood tests might be needed like: CBC, ERS, creatinine, electrolytes, ALT, AST, bilirubin, sugar levels, lipids, TSH FT4, etc, might be helpful as a quick check. If your husband has done these tests please upload them in possible so I can see the results.

Important information:
- for how long has he had the fatigue and stress?
- is it continuous or comes and goes and how has it progressed (the same or worsening)
- anything that makes it worse or better
- any smoking, alcohol, drug use
- any chronic condition like diabetes, heart or lung problems problems, joint pains, skin rash, etc?
- any medication used often (prescription or over the counter)?
- any weight changes recenlty?
- any fever or night sweats?
- how is sleep, concentration, interests, does life have a meaning and is worthy, any suicidal thoughts?
- how old is your husband?

Having the answers to the above questions would help us better understand the cause of the fatigue, please copy and paste my answers to your reply and answer underneath each question so you don't miss them. If possible please upload the test results you tried to explain above and also if other tests done recently (within a year).

Waiting to hear from you soon.

Kind regards,

Antoneta Zotaj, General & Family Physician
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Antoneta Zotaj 0 minute later
Brief Answer:
Kindly asked for test results to be uploaded and some more information as explained below
Detailed Answer:
Hello,

The pulse as low as 40 is unusual and needs some heart checks like ECG and heart ultrasound.

As for the blood tests you have mentioned it would be helpful for me to see the original lab results. I need to see well the units used and if they are normal or not. It would be very helpful if you could upload the test results.

The age of your husband is needed as well because some of the test results are interpreted according to range changes with age.

Fatigue and stress are very general symptoms that do not specifically lead to a certain medical condition and thorough history and physical examination and possibly general blood tests might be needed like: CBC, ERS, creatinine, electrolytes, ALT, AST, bilirubin, sugar levels, lipids, TSH FT4, etc, might be helpful as a quick check. If your husband has done these tests please upload them in possible so I can see the results.

Important information:
- for how long has he had the fatigue and stress?
- is it continuous or comes and goes and how has it progressed (the same or worsening)
- anything that makes it worse or better
- any smoking, alcohol, drug use
- any chronic condition like diabetes, heart or lung problems problems, joint pains, skin rash, etc?
- any medication used often (prescription or over the counter)?
- any weight changes recenlty?
- any fever or night sweats?
- how is sleep, concentration, interests, does life have a meaning and is worthy, any suicidal thoughts?
- how old is your husband?

Having the answers to the above questions would help us better understand the cause of the fatigue, please copy and paste my answers to your reply and answer underneath each question so you don't miss them. If possible please upload the test results you tried to explain above and also if other tests done recently (within a year).

Waiting to hear from you soon.

Kind regards,

Antoneta Zotaj, General & Family Physician
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Antoneta Zotaj 21 hours later
iI just need to know if you received the tests I sent you
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Follow up: Dr. Antoneta Zotaj 0 minute later
iI just need to know if you received the tests I sent you
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Follow up: Dr. Antoneta Zotaj 3 minutes later

My husband is 58 years old.
We did all the necessary tests for the heart and everything is perfect.
His thyroid is also fine
He had this problem for several years but the last year worsen very much.
Yes, it is something continuous but if he is bothered by something it becomes even worse.
No smoking or drinking
He takes Zoloft 150 mg and Lexotanyl 3X6mg and Stillnox 10mg for sleeping. I will send you the other set of tests tomorrow since what I have is in Greek. Thanks for your time snd interest
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Follow up: Dr. Antoneta Zotaj 0 minute later

My husband is 58 years old.
We did all the necessary tests for the heart and everything is perfect.
His thyroid is also fine
He had this problem for several years but the last year worsen very much.
Yes, it is something continuous but if he is bothered by something it becomes even worse.
No smoking or drinking
He takes Zoloft 150 mg and Lexotanyl 3X6mg and Stillnox 10mg for sleeping. I will send you the other set of tests tomorrow since what I have is in Greek. Thanks for your time snd interest
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Follow up: Dr. Antoneta Zotaj 1 hour later
This is the second tests we did here in Cyprus which shows different results
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Follow up: Dr. Antoneta Zotaj 0 minute later
This is the second tests we did here in Cyprus which shows different results
doctor
Answered by Dr. Antoneta Zotaj 2 hours later
Brief Answer:
I would recommend another repeat of the tests to confirm which is accurate

Detailed Answer:
Hello,

Thank you for uploading all the documents. I did not answer earlier because I would need you to upload all the results so I could better understand.

I noticed that there are two pairs of tests with some being normal and the same tests at a different time being abnormal.

Generally when there is a discrepancy in test results it is important to repeat the test as it is difficult to determine which of the two is the accurate one. It is needed to repeat only the ones that have different results in different labs (testosterone, SHGB, and DHEA), the rest that are normal in both labs there is no need to repeat.

You might need to try a different lab to do so. Sometimes human error can happen and results might be altered so it is best to confirm which test result is accurate, especially if treatment is expected to be long term.

Low testosterone can happen with age, generally after age of 40 and might worsen with time. Men with low testosterone might have low mood, fatigue, depression, low sex drive, etc so if the repeat of the tests confirms he has low testosterone then very likely he will need to take some supplements and testosterone and try to have active and healthy lifestyle. The prostate has to be checked first because taking testosterone might increase risk for prostate cancer so a good balance of benefits and risks should be done.

I did not notice there other tests like CBC and ERS (for anemia), ALT, AST, bilirubin for liver, creatinin and electrolytes for kidney function and sugar levels and lipids. Just to make sure he has done these common tests and rules out common conditions.

I would note the use of lexotanil, this is a benzodiazepine, similar do diazepam, and is generally not recommended for regular use in patients as it may cause dependence and tolerance and sometimes if used for long time can worsen depression. You might need to talk with your doctor related to its use and safety. Please do not stop it immediately due to risk of withdrawal symptoms that may develop, just discuss it with your doctor related to future use.

I hope this answers to your question but please feel free to let me know if I can assist you further.

Kind regards,

Antoneta Zotaj, General & Family Physician
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Antoneta Zotaj 0 minute later
Brief Answer:
I would recommend another repeat of the tests to confirm which is accurate

Detailed Answer:
Hello,

Thank you for uploading all the documents. I did not answer earlier because I would need you to upload all the results so I could better understand.

I noticed that there are two pairs of tests with some being normal and the same tests at a different time being abnormal.

Generally when there is a discrepancy in test results it is important to repeat the test as it is difficult to determine which of the two is the accurate one. It is needed to repeat only the ones that have different results in different labs (testosterone, SHGB, and DHEA), the rest that are normal in both labs there is no need to repeat.

You might need to try a different lab to do so. Sometimes human error can happen and results might be altered so it is best to confirm which test result is accurate, especially if treatment is expected to be long term.

Low testosterone can happen with age, generally after age of 40 and might worsen with time. Men with low testosterone might have low mood, fatigue, depression, low sex drive, etc so if the repeat of the tests confirms he has low testosterone then very likely he will need to take some supplements and testosterone and try to have active and healthy lifestyle. The prostate has to be checked first because taking testosterone might increase risk for prostate cancer so a good balance of benefits and risks should be done.

I did not notice there other tests like CBC and ERS (for anemia), ALT, AST, bilirubin for liver, creatinin and electrolytes for kidney function and sugar levels and lipids. Just to make sure he has done these common tests and rules out common conditions.

I would note the use of lexotanil, this is a benzodiazepine, similar do diazepam, and is generally not recommended for regular use in patients as it may cause dependence and tolerance and sometimes if used for long time can worsen depression. You might need to talk with your doctor related to its use and safety. Please do not stop it immediately due to risk of withdrawal symptoms that may develop, just discuss it with your doctor related to future use.

I hope this answers to your question but please feel free to let me know if I can assist you further.

Kind regards,

Antoneta Zotaj, General & Family Physician
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Antoneta Zotaj 2 hours later
We already arranged to repeat the tests but I will have the results after the 26th. We will be in Cape Town and he will do the tests there. Is there a way to get in touch with you and update you, send you the results?
He did also the tests for prostate and everything is fine as well as the insulin resistance.
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Follow up: Dr. Antoneta Zotaj 0 minute later
We already arranged to repeat the tests but I will have the results after the 26th. We will be in Cape Town and he will do the tests there. Is there a way to get in touch with you and update you, send you the results?
He did also the tests for prostate and everything is fine as well as the insulin resistance.
doctor
Answered by Dr. Antoneta Zotaj 10 minutes later
Brief Answer:
You can access me through "Ask a Doctor" service here

Detailed Answer:
Hello,

That's great you have already arranged to have the tests done again. You can access me through Healthcaremagic in "Ask a Doctor" service and upload the results so I can see how the new tests come out.
Cape Town is nice to visit in this time of the year and i wish you will have a nice time while you are there. Meanwhile let me know as soon as you have the results available.

Kind regards,
Dr. Antoneta Zotaj, General & Family Physician



Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Antoneta Zotaj 0 minute later
Brief Answer:
You can access me through "Ask a Doctor" service here

Detailed Answer:
Hello,

That's great you have already arranged to have the tests done again. You can access me through Healthcaremagic in "Ask a Doctor" service and upload the results so I can see how the new tests come out.
Cape Town is nice to visit in this time of the year and i wish you will have a nice time while you are there. Meanwhile let me know as soon as you have the results available.

Kind regards,
Dr. Antoneta Zotaj, General & Family Physician



Above answer was peer-reviewed by : Dr. Prasad
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