Suggest remedy for low grade fever and fatigue

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Posted on Wed, 18 Mar 2015 in Lupus
Question: I have had a low grade fever for one month, with the temp no higher than 98.6. my normal temp is usually around low 97. so to me this is my low grade fever, even though others don't think it is. I have been fatigued a lot more than usual lately. My blood work came back ok, but I had a positive Ana Screen with speckled pattern, and the titer was 1:80. I was referred to a rheumatologist. I need to get to the bottom of this, I cannot feel like this any more. I just got off my birth control pills at the end of Dec, and I Started feeling hot throughout the day starting the 2nd week in XXXXXXX I had my hormones checked and the gyno said my estrogen and progesterone were low for my age. I am 30. I don't know what else to think or do as this has consumed my life and has taken over. I need any advice I can get. thanks
doctor
Answered by Dr. Muhammad Ahmad 1 hour later
Brief Answer:
This is general malaise..cause to be found.

Detailed Answer:
Hi,

Thanks for writing to Health care Magic.

I am Dr Muhammad Ahmad.
Resident M.D.
I would like you to answer a few questions of mine.


1) When did this all start?

2) Were you completely Ok before that?

3) Does your body aches?

4) Do or did you have any flue symptoms lately?

5) Any medicial conditions you habe?

6) Any joint pains?

7) What blood work did you go through? did you get Thyroid profile and vitamine D done?

8) Whats your height and weight?

9) Whats your Hemoglobin levels?

10) Any meds you have been taking for ANY thing?

waiting
for your input.

Dr.Muhammad Ahmad

Resident.M.D
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Ahmad 1 hour later
This all started after I stopped my birth control. 2 weeks after I felt all this.
I was diagnosed with gastritis before that
My body doesn't really ache
I have mild fever and a sore throat last night only.
no medical conditions that I know of
no joint pains really
I had all blood work done numerous times. vit d was checked she said it was good. they checked all lupus, sed, inflammation and liver, and hepatitis and mono . the mono test was weird. it showed a titer of 8 one time and the following week it showed 4. not sure what this means.
I am 5'2 and weigh 110lbs
I guess hemoglobin was good as she didn't mention anything bad
I was given protonix which I stopped taking thiking it was causing this, but its not. I am not taking anything else but vitamins.
please get back to me.
thanks
doctor
Answered by Dr. Muhammad Ahmad 39 hours later
Brief Answer:
Looks like infalammatory sequence.

Detailed Answer:
Hi,

Thanks for writing back,

It's good to know that your blood works were good,

well as far as mono results were concerned they don't look significant.


As your blood works and liver works are ok it looks like you are having inflammation inside body, that might be due to your arthritis , as you get your blood works back and start on meds things are expected to get better.

98.6 is not fever its normal temp if your still feel fevrish this is called lethargy and general malaise in medical terms.

This occurs in settings of inflammations and autoimmune.

Plz follow your labs and consult doctor with the lab results when meds get started you will feel fine..

Till then you can use over the counter meds like Tylenol 500 mg this will relieve your symptoms by controlling inflammatory mediators in body.

Hope things wil get back in some time, don't panic your issues are very treatable just be patient.


Stay blessed.

Dr.Muhammad Ahmad

Resident M.D.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Ahmad 29 minutes later
I received a call back from the rheumatologist who stated that I don't have any lupus or any autoimmune. One did come back slightly elevated which she said she wants to check again soon, but other than that, she said nothing came up positive. which is weird? I had one test show positive ana while another one didn't show it? I am just so confused. I know how hard it is to diagnose someone with an autoimmune disease. what is my next step here? I am lost and need answers.
doctor
Answered by Dr. Muhammad Ahmad 7 minutes later
Brief Answer:
Don't panic and recheck in a month.

Detailed Answer:
Hi,

Having a negative test is always a good news but having a positive test then a negative is strange,

In a few conditions there are false positive test and false negative as well ...

For this we ask the patient to take anti inflammatories like Acetamenophen 500 mg to reduce symptoms and we recheck antibody essay after a month..


so i will ask you not to panic and not to get disturbed , hope for the best,

Meanwhile get a psychiatric evaluation as well to rule our psychiatric influences in your symptoms..

Things will get better with time but you have to get causes ruled out ...get an autoimmune check-up again in a month if that's again negative then we can consider other options ..

Don't let it get on to your nerves, your symptoms also arent really typical of autoimmune may be its sub-clinical or may be it was just one attack,


I hope re checking again comes out negative.

Till the get a psychiatric evaluation .

Stay blessed.


Dr.Muhammad Ahmad

Resident M.D.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Ahmad 20 minutes later
Can my anxiety and stress coming off the pill be making this worse? I have never had anxiety and stress the way I do coming off these birth control pills. My gyno took my blood and told me that my estrogen and progesterone was low. I am going to see an endo to get all my other hormone levels checked as well to see if there is anything else off. I am sure my cortisol levels are through the roof recently. What do you mean by psychiatric evaluation.? Do you think this is mental ? So with my temp not being over 98.6, what is this then? elevated body temp or hot flashes??
Please elaborate. thanks
doctor
Answered by Dr. Muhammad Ahmad 9 minutes later
Brief Answer:
Yes Hormones can be a culprit too.

Detailed Answer:
Hi,

Thanks for writing back,

Hormonal imbalance is definitely a possible cause worth ruling out. That's why in my response i asked you if your hormones like Thyroid and cortisol are ok?

Yes getting off birth control can also cause this symptoms specially if your own hormones are being produced in lower quantity by the body.

Getting off birth control doesn't effect many because body starts producing its own hormones but if this doesn't happen and hormone level stays low this can cause disturbance in functionality of the body.

You indeed need to get an endo chek-up if hormones are low then he might want to run some tests to didn't out why they are low and then treatment can be started... i believe if this is because of hormone it is really treatable plus it will also relieve your lethargy and stress...

Just stay calm and get your hormones checked up and see what endocrinologist suggests. Hopefully there wont be a major issue... Here we also have to find out if only estrogen progesterone are effected or others too then we can find the cause and treat it,,, it will take time and patience but hormonal issues are usually reversible and treatable mostly.. so don't worry and set-up an appointment with endo as soon as possible.

Do get your fasting blood sugars and HBA1C done as well.

If you have more queries i am happy to answer.

Dr.Muhammad Ahmad

Resident M.D.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Ahmad 2 hours later
what is the Fasting blood sugars and HBA1C? I also haven't gotten my period this month yet. I got it last month the last week in XXXXXXX . As of now, still waiting on it.
doctor
Answered by Dr. Muhammad Ahmad 14 hours later
Brief Answer:
You need gynae and endocrinologist consult.

Detailed Answer:
H,
Thanks for writing back,

HbA1 C tells you last 3 months of sugar control... Fasting sugars mean sugar before breakfast... in hormonal issues sugars can get disturbed ..

If your periods are disturbed then wait for some days and then again consult gynae ... periods are disturbed most probably because of hormonal imbalance, This should be addressed indeed.

So strategy here is to first do something about your hormones ... with endocrinologist and gynae consult.. then you can go for rheumatology checkup in a couple of months... most of your symptoms are expected to get better as hormones get better,

But re re evaluation of antibodies issue is necessary to make sure you don't have autoimmune.

Deal with things calm without losing patience, things will get better with time.

Dr.Muhammad XXXXXXX

Resident M.D.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Ahmad 8 hours later
I have been getting like migraine headaches too. I read online that Aleve won't help if this is due low estrogen ? I also have had red eyes and burning eyes for the past week. I am stumped and lost at this point. I have to wait two weeks for endo blood work. What else can I do in meantime ?
doctor
Answered by Dr. Muhammad Ahmad 35 minutes later
Brief Answer:
Here is what you can do.

Detailed Answer:
Hi,

Thanks for writing back,

low estrogen can cause head ache and the anxiety you are in can also do so...

Here is something you can do, i will tell you over the counter meds .

1..Take Tylenol or aleve 500mg twice a day
2.. Tab citerizine 10mg at night.
3.. use simple over the counter eye cleaning dops. for better lubricatio and cleaning.
If you are a migraine patient before then i could have told you a migraine specific med but without a diagnosed migraine lets not touch it.

Do what i suggested and hopefuly it will get better.

Stay blessed and healthy.

Regards

Dr.Muhammad Ahmad.

Resident M.D.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Ahmad 5 hours later
So mote blood work came back and my mono ebv titer went from 8 to 13. Does this mean my mono is reactivated???
doctor
Answered by Dr. Muhammad Ahmad 3 hours later
Brief Answer:
Did they tell you type of antibody?

Detailed Answer:
Hi,

thanks for writing back,

Did you get the tests from different labs?.because your tests really show a strange behavior once your AnA comes positive then it gets negative then your mono comes negative and suddenly becomes positive it can also be lab error.

By 13 you mean 1:13? can you attach the report?

Did they tell you type of antibody found? is it IgM or IgG?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Muhammad Ahmad

General & Family Physician

Practicing since :2012

Answered : 1308 Questions

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