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Dr. Andrew Rynne

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What causes fatigue, pins and needle sensation and headaches?

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Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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Posted on Sat, 23 Aug 2014 in Medicines and Side Effects
Question: In March of this year I returned to XXXXXXX from a brief trip to South XXXXXXX (I'm South XXXXXXX and lived there most of my life). I experienced flu like symptoms and fatigue which I put down to over exertion and jet lag. I recovered after a couple weeks but then experienced similar symptoms a month later and have since had recurring symptoms with the most noteable being fatigue, nausea, headaches and malaise.

The fatigue has been unbearable at times. I have barely enough energy to make it through the day. I'm an active person - I would play soccer or run 3 or 4 times a week. I recovered briefly in April and was able to run around for a week or two. Once the fatigue returned I haven't had the energy to do strenuous activity since then. Climbing a flight of stairs can be taxing. At one point I took a week off work because I literally didn't have the energy to get to work and found that I wasn't able to concentrate or remember conversations I'd just had. I'm getting enough sleep each night, taking melatonin to help me fall into a deeper sleep. I've been taking vitamin b12 supplements to count out low b12. My diet is quite consistent. I eat mainly fresh fruit and vegetables and occasionally eat fish(once every two weeks). I stopped drinking alcohol 3 months ago to eliminate any toxins that might be hindering my recovery.

I've been experiencing the nausea on and off since March. Other symptoms include headaches or a dull pressure on the left side of my head. I also sometimes get pins and needles in my left arm/hand. I also feel discomfort in my left eye - like there's an irritant in it but it's not red. This symptoms come and go. More recently the nausea and headaches have been more persistent for the last 3 or 4 weeks. The general feeling of unwellness has never really left except for a brief period back in April.

I've been tested for Malaria, Mono, HIV and dengue fever. I've had a host of blood work done. Iron levels were fine. Liver function was fine. All results have come back clear. I had an ecg which was normal. I've had an ultrasound of the abdomen to check for an enlarged spleen related to a possibility of mono. I have the epstein bar virus but the spleen was normal. The ultrasound found a liver hemangioma but I was told it's probably nothing to worry about except to check back in a couple months just to be sure. I've had stool samples taken. The results showed I have blastocystis hominis. I went onto antibiotics (metronidazole) but the side effects of stomach pain were unbearable and I stopped the antibiotics after 3 days.

I've seen 6 different GP's without any one finding a definitive answer to my symptoms. I saw a tropical/infectious disease specialist and he couldn't think of anything at the time (2 months ago) that might cause these symptoms. It was around this time that I recovered briefly which coincided with my follow up with the tropical disease specialist and so no further action was taken.

I've also asked a neurologist on this site for advice and he suggested an mri to rule out "structural lesion such as infection, clotting of blood in brain veins, tumor (very rare), etc."

I'm unsure what other avenues to explore.

Are there any other areas of expertise that would be worth considering for an opinion?
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Answered by Dr. Shruti Rijhwani 7 hours later
Brief Answer:
Follows.

Detailed Answer:
Dear Sir,

Thank you for posting your query on HCM.

Well looking into your problem I would like to tell you that it will be difficult to give you a diagnosis based on this still we can discuss the possibilities .

First thing I will suggest you is to rule out lupus , it can present like fatigue and with all these complaints pins and needles sensation , headaches etc. You should get an ANA , ENA profile to see if anything autoimmune is going on .

Next myositis also present like this so CPK testing should be done to rule that out.

If all these come normal then chronic fatigue syndrome should be considered which can occur after viral infections or even without that also . You should discuss this possibilty with your treating doctor .

Take care.

Dr. Shruti

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