Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

175 Doctors Online
Doctor Image
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Suggest remedy for sudden fatigue and joint pain in a person with severe anxiety

Answered by
Dr. Ashok Kumar


Practicing since :2000

Answered : 422 Questions

Posted on Tue, 3 Nov 2015 in Mental Health
Question: Hi, I’m a 35,Caucasian woman, who has suffered from Bulimia (recovered 3 years). I suffer from anxiety and depression. I take daily meds: 20 mg Prozac, 50 mg topamax , 15 mg of proprananol & .05 mg of ativan as needed.
I have had sudden fatigue and joint pain. Especially in my hands/wrists and feet/ankles. I was sent to the Orthopedist who explained to me I was aging.
I called my Internist back because I know there is something wrong with my body. She ordered test s and I received them back but she is on vacation for 2 weeks. Can you give me some insight on my results below?/attached

I am very frustrated and nervous about my health, I would be extremely grateful for any help!

One additional piece of info, about 4 months I suddenly started getting severe facial flushing. I saw a dermatologist who said it could be rosacea and prescribed Mirvaso cream, which helped a little. To help further my internist gave me a beta blocker to help. Before being prescribed the beta blocker my bp was around 110/70 and is now 99/69 but my flushing is much better.
Test D Test Result H/L Range Note
Laboratory test finding -C-Reactive Protein Not Yet Available
Laboratory test finding- Vitamin D 25-Hydroxy,Total,Immunoassay Not Yet Available
Laboratory test finding -Rheumatoid Factor Not Yet Available
Ana Choice (TM) SCR W/RFX To Titer Ifa- Not Yet Available

Comprehensive Metabolic
Sodium 136 mmol/L 134-149
Potassium 3.7 mmol/L 3.6-5.5
Chloride 102 mEq/L 94-112
Carbon Dioxide 24 mEq/L 21-32
Glucose 111 mg/dL 70-118
BUN 9 mg/dL Low 10-26
Creatinine 0.7 mg/dL 0.6-1.4
BUN/Creat Ratio 12.9 CALC
Calcium 8.9 mg/dL 8.5-10.5
Total Protein 6.4 g/dL 6.3-8.1
Albumin 4.5 g/dL 3.8-5.5
Globulin 1.9 g/dL
A/G Ratio 2.4 CALC
Alk. Phosphatase 66 U/L 42-128
Alt (SGPT) 101 U/L High 10-40 2
Ast (Sgot) 75 U/L High 9-44 3
Total Bilirubin 0.9 mg/dL 0.2-1.3
GFR Non-African XXXXXXX >60 ml/min/1.73m^ >=60
GFR XXXXXXX XXXXXXX >60 ml/min/1.73m^ >=60
Lipid Profile 10/16/2015 Cholesterol 179 mg/dL 140-200
Triglycerides 121 mg/dL 30-150
HDL Cholesterol 56 mg/dL 35-85
LDL (Calculated) 99 CALC
HDL Risk Factor 3.2 CALC

Complete Blood Count
WBC 8.8 x10^3/UL 4.1-10.9
RBC 4.29 x10^6/UL 4.20-6.30
HGB 14.6 g/dL 12.0-18.0
HCT 43.4 % 37.0-51.0
MCV 101.0 fL High 80.0-97.0
MCH 34.1 pg 26.0-36.0
MCHC 33.8 g/dL 32.0-37.0
RDW 13.3 % 11.5-14.5
PLT 234 x10^3/UL 130-400
MPV 9.3 FL 7.0-11.0
Gran # 6.2 x10^3/UL 2.0-7.8
Lymph# 2.1 x10^3/UL 0.0-6.0
Mono# 0.5 x10^3/UL 0.1-0.6
Gran % 70.1 % 40.0-80.0
Lymph % 24.4 % 13.0-47.0
Mono% 5.5 % 0.0-10.0
Laboratory test finding 10/16/2015 Esr 9 mm/hr 0-20
TSH 0.770 mIU/mL 0.250-5.000
Answered by Dr. Ashok Kumar 23 minutes later
Brief Answer:
There is no abnormality with your tests

Detailed Answer:
Thanks for using Healthcaremagic.

I have reviewed your blood reports and glad to inform you that it is completely normal and there is nothing serious as per reports. There are SGOT and SGPT (liver enzymes) are beyond the lab reference limits but they are still considered normal.

There is one abnormality I detected, which is increased size of red blood cells. Most commonly it is caused by deficiency of either folic acid or vitamin B12. To confirm particular deficiency there is need to go for estimation of serum concentration of both vitamins. This is not a serious kind of problem and it can be corrected with supplementation of either folic acid or vitamin B12 or combination.

I hope this helps you.
Thanks and regards

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
Follow up: Dr. Ashok Kumar 1 hour later
Great, Thank you! I did recently switch to a vegetarian diet.

I should say that I went back to a vegan diet. Could this deficiency be causing my fatigue and joint pain?
Answered by Dr. Ashok Kumar 10 minutes later
Brief Answer:

Detailed Answer:
Thanks for reverting back to me.

The deficiency is not enough to cause any symptoms as you have perfectly normal hemoglobin. This is early sign of deficiency but not enough to cause any symptoms.

Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
Thanks and regards
Above answer was peer-reviewed by : Dr. Raju A.T

The User accepted the expert's answer

Share on
Question is related to
Drug/Medication ,   ,  
Lab Tests ,   ,   ,  

Recent questions on  Rheumatoid factor

doctor1 MD

I recently got my blood tested because I injured my knee and also my ankle from running I m 37 year old woman and my labs came back as ESR 55 CRP 6.0 Rheumatoid factor 12 ANA neg uric Acid 8.5. Now they want me to see a specialist and I don t understand why???

doctor1 MD

Hello; I am a 25 year old male. I am living with the following symptoms and cannot get a diagnosis. These are my symptoms. Weakness in the arms and legs. Sensory symptoms such as numbness or tingling in arms and legs. Body pain all over, as high...

doctor1 MD

Hi. My son is 10 years old and started complaining yesterday afternoon about his knee "feeling weird." By bedtime it was very swollen and we wrapped it and iced it. This morning it is better, but the cause is mysterious. He didn't do any exercise...

doctor1 MD

I have been having flu like symptoms for 3 or 4 months, I feel disoriented, my vision blurs as the day goes on, just generally feel terrible all over. I have had a physical and blood work. Everything looks good. I work for forestry and spend a lot...

doctor1 MD

My daughter is 11 years old and has auto immune issues since she was 5. Right now her Rheumatoid factor is 21.5, and she feels bad. She says her whole body just hurts and she has no energy. Her sed rate is normal. A couple of months ago her Rheumatoid factor was 23. One minute she seems fine and the next she feel bad. She also has joint pain in her ankles. They get stiff and swell a little swollen. We have seen a Rheumatologist, but since her Rheumatoid rate isn t real high should we go see her again? What can I do for my little girl?

doctor1 MD

"I am a 33 year old female that had joint pain/swelling for about a period of one week. In the middle of that week I went to the doctor for my symptoms and the doctor took blood to test for many things but said my problem seemed to point to a virus: parvo virus. After researching, it all made sense since I am a 4th grade teacher and fifth disease was in our school at that time. Based on the research I did, parvo virus is the same virus as fifth disease in children. Anyway, the symptoms disappeared in about a week and everything was all better. When the doctor called with my blood work they said I tested positive for the rheumatoid factor (107) and referred me to a rheumatologist. I have an appt. with the rheumatologist in 3 weeks - that was the soonest they could get me in. In the meantime I was sent my blood work results and am concerned about some of the numbers and no one from my regular doctor has called me back. Like I said, my rheumatoid factor was 107 and my ana titer was 1:160 with a homogeneous & nucleolar pattern. Also, I am positive for the parvo virus according to the blood work. I am so confused by what this means and would like some clarification if possible since I do not see the doctor for three weeks. My symptoms have disappeared and I feel fine. Today, however, I feel like my muscles in my upper arms are sore and I haven't done anything that would have made them sore - not sure if this is coincidence or something else to be concerned about. My grandma also had rheumatoid arthritis so it does run in my family. If I had parvo virus could that have affected my blood work and made my rheumatoid factor and ana titer positive? How do doctors diagnose rheumatoid arthritis - is it purely based on the blood test or other things as well? Thank you so much for your help,Jennifer

doctor1 MD

I have a high SED rate. It has continually been between 65-69. I have been tested for Lupus & Rheumatoid Arthritis, both came back negative. Years ago, I had a positive AIDS test and was tested further and found to be negative. I was told then that I probably have another autoimmune disease. What next?