Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Chronic Fatigue Syndrome
Question: i am very tired all of the time. when i do any house work or go shopping my heart jumps in my neck. i can feel it pounding. legs and arm wobble. i just have to sit down. legs went from under me last week just as i was carrying in the groceries, had bloods done a few times over the passed year. all fine. im out of work. My job is stressful. DR has me on Escitalopram. I dont feel any better. I had a discsectomy of 5/6 cervical spine. if that has any relevence.
YYYY@YYYY
YYYY@YYYY
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your concern, I would explain that it is important performing a comprehensive differential diagnosis between different causes that may lead to this symptomatology:
- Low blood pressure or chronic hypotension. What are your actual blood pressure values?
- Thyroid gland dysfunction. Have you checked your thyroid hormone levels? It would be necessary to exclude this possibility.
- Cervical myelopathy. Chronic damage of the cervical spine can lead to this symptomatology. It is important performing a cervical spine MRI, in order to examine for possible myelopathy. Even though you had discectomy, the disk problem may have led to chronic degeneration of the cervical spine, which sometimes are not reversible.
- Heart failure can also cause chronic fatigue and fainting. A cardiac ultrasound would help examine your cardiac function and structure.
- Anxiety and chronic fatigue syndrome can also play an important role in all this symptomatology.
Coming to this point, If your blood pressure is normal, and if your tests (thyroid hormone levels, cardiac ultrasound, cervical spine MRI) are normal, I would recommend discussing with your doctor on the possibility of raising the dose of escitalopram to 20mg daily, as it can help against anxiety or chronic fatigue syndrome.
Another treatment options would be switching to another antidepressant like duloxetine, which is very effective in chronic fatigue syndrome.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your concern, I would explain that it is important performing a comprehensive differential diagnosis between different causes that may lead to this symptomatology:
- Low blood pressure or chronic hypotension. What are your actual blood pressure values?
- Thyroid gland dysfunction. Have you checked your thyroid hormone levels? It would be necessary to exclude this possibility.
- Cervical myelopathy. Chronic damage of the cervical spine can lead to this symptomatology. It is important performing a cervical spine MRI, in order to examine for possible myelopathy. Even though you had discectomy, the disk problem may have led to chronic degeneration of the cervical spine, which sometimes are not reversible.
- Heart failure can also cause chronic fatigue and fainting. A cardiac ultrasound would help examine your cardiac function and structure.
- Anxiety and chronic fatigue syndrome can also play an important role in all this symptomatology.
Coming to this point, If your blood pressure is normal, and if your tests (thyroid hormone levels, cardiac ultrasound, cervical spine MRI) are normal, I would recommend discussing with your doctor on the possibility of raising the dose of escitalopram to 20mg daily, as it can help against anxiety or chronic fatigue syndrome.
Another treatment options would be switching to another antidepressant like duloxetine, which is very effective in chronic fatigue syndrome.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for that information. My blood pressure is up even though im am on valsartan 80mg. put me on Deltacortril 5mg x2 for 10 days. also gave pain killers for my neck shoulder and head. when they pain me. XXXX
also forgot to mention. When I had the discectomy done 5 years ago.I Was told they were 2 more discs bad.But he just did the worst one. I also have degenerative disc in my lumber region. XXXX
also forgot to mention. When I had the discectomy done 5 years ago.I Was told they were 2 more discs bad.But he just did the worst one. I also have degenerative disc in my lumber region. XXXX
Brief Answer:
My answer as follows:
Detailed Answer:
Dear XXXXXXX
I would recommend performing the above mentioned additional tests (cardiac ultrasound, cervical spine MRI and thyroid hormone levels) to investigate for the possible cause.
If all the above tests result normal, it means that the most probable cause would be chronic fatigue syndrome. In such case duloxetine would be a good treatment choice to consider.
Regarding your elevated blood pressure values, they could be related to Deltacotril, which is a steroid and can cause a raise in the blood pressure as an adverse effect. It is used to treat inflammation and the pain. Your blood pressure values will come back to normal after stopping Deltacotril.
Hope to have been helpful!
Kind regards,
Dr. Iliri
My answer as follows:
Detailed Answer:
Dear XXXXXXX
I would recommend performing the above mentioned additional tests (cardiac ultrasound, cervical spine MRI and thyroid hormone levels) to investigate for the possible cause.
If all the above tests result normal, it means that the most probable cause would be chronic fatigue syndrome. In such case duloxetine would be a good treatment choice to consider.
Regarding your elevated blood pressure values, they could be related to Deltacotril, which is a steroid and can cause a raise in the blood pressure as an adverse effect. It is used to treat inflammation and the pain. Your blood pressure values will come back to normal after stopping Deltacotril.
Hope to have been helpful!
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
