Suggest treatment for moderate sleep apnea and exhaustion
Sorry to learn about your symptoms.
I can help you look into some potential hormonal causes of your symptoms.
When I see someone like you in my practice, I order the following tests (obviously after a thorough examination):
25 hydroxy vitamin D
Fasting is not necessary but it is important to do these tests at 8 am strictly.
Results of these tests will give clues towards the possible reasons for your condition.
Low vitamin D, testosterone and cortisol or thyroid problems can explain the problems you are experiencing.
Check with your primary care provider regarding Lyme's disease.
It is good to see the type of social work you are doing now
CBC will reveal if you have anemia or not. Low blood hemoglobin levels can cause fatigue
CMP includes liver and kidney function tests along with electrolytes and glucose. Abnormalities in any of these can also result in a sense of exhaustion, in addition to other symptoms.
TSH, Free T4 will test your thyroid function. If it is not normal, then it you have either an under active or an over active thyroid.
25 hydroxy vitamin D, when low, affects bone and muscle health.
Low testosterone can present with a variety of symptoms. Exhaustion is one of them. SHBG allows one to compute the free testosterone levels in the blood using an online calculator.
Serum cortisol drawn at 8 am is a good screening test for adrenal insufficiency. Anything above 15 is considered good. Below that cut off, the endocrinologist needs to examine you systematically and decide if further testing is necessary based on his or her clinical judgement.
It is not possible to give you absolute cut offs for these laboratory values indicating a threshold above or below which things are abnormal. You have to remember doctors treat people, not reports.
Labs can give ranges and flag abnormal values but it takes many years of intense training for doctors to decide which abnormality is worth treating. This typically entails the opportunity to evaluate the person live.
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