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What causes fatigue along with body pain?

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Posted on Tue, 10 May 2016
Question: I am completely fatigued and have body aches, almost like I have the flu. My blood tests are all normal. What could it be? I feel as tired when I wake up as when I went to bed.
doctor
Answered by Dr. Naval Mendiratta (5 hours later)
Brief Answer:
Chronic Fatigue

Detailed Answer:
Good evening

Thank you for writing on health care magic

I have gone through your history and the medications. I would like to ask you a few more queries to see where we are heading...Is it a pathological problem or someting else..

1. Do you have any symptoms of dry eyes/dry mouth....Like a constant urge to have something to drink during meals??

2. Any history of weight loss or appetite loss recently?

3. Has your Vitamin D levels been checked in the past??

4. Any history of irritability or forgetfulness??

5. Is your sleep pattern ok... Like do you get a good sleep or is it disturbed??

6. How about your Sex drive....At this age lot of horomonal issues crop up which can drain you out

Do let me know these queries. Would do my best possible way to guide you

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Naval Mendiratta (13 hours later)
I have no dry mouth but my eyes burn all the time, like a flu symptom. I have no weight or appetite loss. I take a 50,000 vit D tablet every Friday. I have no irritability but some forgetfulness. I always get a good night sleep, waking once to go to the bathroom. I have below normal sex drive (I think) but could hormones be playing a part? What do you mean pathological problem or something else? I am getting tired of suffering like this for so long. There has got to be some relief.
doctor
Answered by Dr. Naval Mendiratta (24 hours later)
Brief Answer:
Chronic pain syndrome

Detailed Answer:
Good evening sir

Sorry for the late reply. Had a long duty

Well, there are 2 ways to approach the widespread pain you have. When i meant pathological, it means some process going on internally which we are not able to pick up . Since you have said, all your blood reports are good it still looks less likely. I am not sure if they have checked for your muscle enzymes( CPK, LDH) along with ESR and CRP( as markers of inflammation)

The other diagnosis is mostly chronic pain syndrome/fibromyalgia. But since you dont feel you have it, it could be kept as last on the list.

So only Way I would say to approach is to get a Bone scan/PET Scan done. If it picks up any inflammation going on in your body we know where is the cause. If this comes out to be normal, we can check for the testosterone levels as the deficiency in it can cause of fatigue. Lastly, if both are normal, we will have to treat it as Chronic Pain syndrome.

To summarize, hit the cause and the symptoms will improve. It is difficult to interpret things online as examination is always the superior one. If you could attach the reports, I can go through them to see if there is a missing link

Hope the information was useful

Do let me know for more queries

regards
Dr Naval
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Naval Mendiratta (5 hours later)
Dr. Naval, thank you for helping me. You just can't imagine how grueling this has been for me for such a long time. You say pain syndrome but I have no pain, just horrible body or muscle aches and fatigue. Is this the result of inflammation somewhere? As I mentioned I went to a rheumotologist less than two wks ago and she took 11 tubes of blood out of my arm. Some of that had to be checking muscle enzymes, etc. I go back next Wed for the results. Maybe the next step is the bone/PET scan? How is an inflammation treated? What does it mean if my eyes burn?
doctor
Answered by Dr. Naval Mendiratta (16 hours later)
Brief Answer:
Further course

Detailed Answer:
Good evening sir

Well, pain and Fatigue do go in parallel. There is an entity called Chronic Fatigue syndrome triggered by the viral infections which can cause prolonged fatigue without much relief. If your blood tests are normal, and still there is an element of doubt, a PET CT would be most definite. Although costly and a bit of radiation exposure, it picks up anything remote which we may be missing.

The only thing which bothers me to investigate more, is the age and you being a male. SO i wanna put Fibromyalgia/Chronic Fatigue at the end. If you were in mid 30s or so, we would have gone with this diagnosis. But I feel, we should investigate till the end. If no cause found, well and good .. You will also be convinced there is nothing serious and we also can treat Chronic Fatigue syndrome.

The treatment of inflammation will depend on the cause, once we have that then the treatment becomes easy.

As for your eyes burning, it can be due to long standing diabetes. It can cause dryness of the glands of the eyes. Also the anti depressants you are taking can lead to dry eyes or dry mouth.

Do let me know when the test results are available

REgards
Dr Naval


Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Naval Mendiratta (3 hours later)
Dr Naval, thank you again. I can't wait until the test results are available to write back because my time with you online will be up. I am praying that the blood tests reveal some abnormality. Is what I have very common and is chronic fatigue syndrome treatable? I have suffered tremendously while going to medical doctors and psychiatrists over a long period of time. What do you suspect? My family are tired of me being sick and can see no outside reason for it. My therapist told me it's all in my head because normal blood tests came back normal. Of course I haven't got the blood work back yet but what is your professional opinion?
doctor
Answered by Dr. Naval Mendiratta (23 hours later)
Brief Answer:
Chronic Fatigue Syndrom

Detailed Answer:
Good evening

Well, chronic fatigue syndrome does involve medications along with few other life style modifications like meditation, exercises. Medications only help in 30-40 % of the cases, rest is with life style modifications.

In my experience, when all the labs are normal and the scans go ok we normally treat them as chronic pain/fatigue syndrome. It is a common problem in people who have been having long standing comorbidities like diabetes or any other disease for that matter.

But I would still like to see your blood reports. In the end, it is you who has to be convinced it is nothing serious and hence you will be able to take the treatment for it and it will help you in a better way.

Hope the information was useful

REgards
Dr Naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Naval Mendiratta (21 hours later)
I should have suspected that the diabetes played a role in my symptoms. My next letter should be with the test results. Just a few more questions so I have a better understanding of my condition: Do these viruses ever disappear? What causes them? Does the doctor outline the treatment? Will I gain some relief from my fatigue and aches? Are muscle enzyme problems uncommon? I've had this longer than I am willing to admit and it was only after someone mentioned fibromyalgia that I started looking for the right doctor. The psychiatrist talked about ECT treatments! I've really been around the block. Thank you for listening.
doctor
Answered by Dr. Naval Mendiratta (18 hours later)
Brief Answer:
Chronic Fatigue

Detailed Answer:
Good evening

Pertaining to your queries

1. Well viruses normally trigger a process within. They are normally not present as such till late, but they initiate a process and go off...Most autoimmune problems have a viral trigger..which one? Still a question...

2. Muscle enzymes problem do happen but at a younger age. But since you say the muscle enzymes have been normal so far , there looks very less chances of inflammation

3. These problems do get better. With treatment along with other modalities like meditation, indulging in activities which take your mind of your health and where you tend to enjoy.

4. ECT...not an option in your case. Neither do you have severe depression or sucidal tendency for you to go through such a harsh therapy.

Do update me with blood reports. If all normal, we can treat on the lines of Fibromyalgia/Chronic Fatigue syndrome

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Deepak
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Follow up: Dr. Naval Mendiratta (10 hours later)
I got four pages of test results and all are normal or negative except the testosterone levels are low. I'm going to my endocrinologist next week to address this. She seems to think that this is the cause of my fatigue. I can only hope that this is a factor. Don't you think that I will need some lifestyle modifications? I have lived with this so long that I need some relief. What else can I do now?
doctor
Answered by Dr. Naval Mendiratta (22 hours later)
Brief Answer:
Low testosterone

Detailed Answer:
Good evening sir

Oh well, that was one of the diagnosis I told you initially...Low testosterone can cause low moods and fatigue as well.. It can happen with age and even with long standing diabetes. I am not sure if this was present since long time, but it is worth while correcting it. You will definitely feel more energy with treatment.

Life style modification, I would suggest daily exercises should be must. 30-40 minutes walk with little meditation would be useful...

DO let me know how you feel after treatment

I am glad we have some diagnosis at least to work on

Regards
DR Naval

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Naval Mendiratta

Rheumatologist

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What causes fatigue along with body pain?

Brief Answer: Chronic Fatigue Detailed Answer: Good evening Thank you for writing on health care magic I have gone through your history and the medications. I would like to ask you a few more queries to see where we are heading...Is it a pathological problem or someting else.. 1. Do you have any symptoms of dry eyes/dry mouth....Like a constant urge to have something to drink during meals?? 2. Any history of weight loss or appetite loss recently? 3. Has your Vitamin D levels been checked in the past?? 4. Any history of irritability or forgetfulness?? 5. Is your sleep pattern ok... Like do you get a good sleep or is it disturbed?? 6. How about your Sex drive....At this age lot of horomonal issues crop up which can drain you out Do let me know these queries. Would do my best possible way to guide you Regards Dr Naval