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    Suggest treatment for chronic fatigue and body aches

Posted on Sat, 12 Aug 2017 in Environmental and Occupational Hazards
Question: Hi, I've had persistent body aches and fatigue for about 15 years to varying degrees. I am being treated by the VA. My primary care Dr. is more or less ignoring these symptoms, simply saying I need to lose weight. I have been prescribed 3400mg of Gabapentin per day, 3200 Ibuprofen, vitamin D, Methylphenidate, and 50mg tramadol 2x a day. I have gone through the VA chronic pain rehabilitation outpatient program, which helped with some of my joint pains, but even after being off all opiods for more than 6 months, the body aches persisted. At the the time, the pain specialists thought the body aches were due to opiods, but they existed before and after being treated with opioids. I don't know what else to do. I was deployed in an area of Iraq that had been attacked by chemical weapons, and had daily exposure to burn pits, depleted uranium and aerosolized debris. None of these factors has been considered.
Answered by Dr. Uday Nath Sahoo 3 hours later
Brief Answer:
CFS and no need of any painkillers

Detailed Answer:

Thanks for your question on HCM

I do understand your concern

With such a presentation in my clinic, I would first rule out chronic fatigue syndrome by a physical examination only and to confirm it you need few pathological investigations like complete blood count, ESR, TSH and a sleep study. If confirmed treatment will be supportive and you may need prescription medication like [fluoxetine] and this will improve sleep and relieve pain as well as stress. Try to avoid caffeine, alcohol and nicotine and make a regular sleeping time. Do consult with your physiotherapist to make an exercise plan for you.

Hope that helps
Above answer was peer-reviewed by : Dr. Raju A.T
Follow up: Dr. Uday Nath Sahoo 29 minutes later
Thank you. I have undergone sleep study and use a CPAP. I have also been prescribed fluoxetine in the past, but it had little effect. What is an ESR and TSH?
Answered by Dr. Uday Nath Sahoo 8 hours later
Brief Answer:

Detailed Answer:

Thanks for your follow up reply

“As “per your reply is concerned ESR and TSH are blood tests and it is done to rule out pituitary and chronic disorders. Regarding use of CPAP I may say that you must have [obstructive sleep apnea (OSA)] & it is one of cause of your chronic fatigue syndrome.so do some life style modifications first : -

1)Do check if you are overweight or obese by calculating from your weight and height and if overweight then discuss with your nutritional expert to lose at least 5% may help.
2)Do exercise every day and make a plan for at least 150 mins every week
3)Try to avoid alcohol, painkillers and sleeping pills
4)Always sleep on your sides and to achieve it keep a tennis ball on your back side
5)If you have nasal congestion use saline spray at night

Do modifications like this and after 30 days do [polysomnography] and [oximetry] again to proceed further.

Hope that helps

Above answer was peer-reviewed by : Dr. Yogesh D
Answered by
Dr. Uday Nath Sahoo

General & Family Physician

Practicing since :1969

Answered : 2462 Questions


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