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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes persistent fatigue and nausea in an elderly person?

Answered by
Kathy Shattler

Dietitian & Nutritionist

Practicing since :1985

Answered : 872 Questions

Posted on Tue, 20 Oct 2015 in Weight & Lifestyle
Question: I am extremely tired all the time. This started last winter and has gotten worse. I am 76 but in good health and am an active person. Also I feel Nauseaous most of the time. I am on Weight Watchers so am not over weight.
Answered by Kathy Shattler 28 minutes later
Brief Answer:
So, it has been almost one year . . .

Detailed Answer:
Welcome and I would like to ask you some questions before my final recommendation. Would you mind telling me the name of the high blood pressure medication, your current average blood pressure, when you were put on the blood pressure medication relative to when the fatigue began.

Also, please list all supplements and how taken (all together, separately). Tell me your sleep habits.

Have you ever had your thyroid tested and when were your last lab tests run? Do you have allergies, does milk bother you (gassey) and did the nausea begin about the same time as fatigue? Can you relate any changes in your lifestyle with the onset of your symptoms.

Do you drink any special teas, take herbs or anything else that might give me a clearer picture of what happened last winter to initiate your symptoms?

Please answer the above questions and I am sure we can think of something to get you back on track and feeling great! I look forward to learning a little bit more about you before I try to assist the nausea and fatigue XXXXXXX Shattler, MS,RDN
Above answer was peer-reviewed by : Dr. Vaishalee Punj
Follow up: Kathy Shattler 4 hours later
I take Amlodipine for my BP and have taken it for years. 10mg. I also take Crestor 5mg. Taken for years. Levothyroxine .5mg and Ropinirole 1mg 2 x day for Restless legs. Have been on these meds for a long time. Cq10 200mg, omega 3 oil, Vit D, 1000 , vit C 500mg, again I have taken these a long time. No new meds since fatigue started.

My sleeping habits are not good. Up 4 or 5 times in the night to go to the bathroom. Also sleep with my dog, but have done that before fatigue started. Ifs I have a good night where I don't get up as often I still have this tired feeling
Answered by Kathy Shattler 34 minutes later
Brief Answer:
Thank you for providing the additional information

Detailed Answer:
I do see some prominent issues that may help alleviate your fatigue.

I noticed that you probably had sleep issues when I examined the picture you sent. It was obvious from looking at your eyes that you were not sleeping well. Therefore, the first thing I would like to suggest is to set a sleep pattern. Since urination is keeping you from getting the deep sleep you need, restrict caffeine and beverages 3 hours from bedtime. Darken your room, if light music helps, turn that on. Empty your bladder just before bed. Some physicians have recommended lemon balm tea 6 ounces before retiring (I know, more fluid).

Secondly, you are on a very low dose of Synthroid. Your photo indicates signs of hypothyroidism. Most doctors don't realize that treating the thyroid is not always effective by just giving T4 or the inactive form of the thyroid hormone (synthroid). First, one needs enough iodine to make the T4, but if only the T4 is provided and the diet or supplements don't have selenium and vitamin C, then there will not be activatation into T3(active hormone) peripherally. I suggest a good multivitamin with 100% iodine, selenium and vitamin C in it for proper thryroid function which will give you more energy and vibrancy. Continue with your synthroid dose and request a TSH next time you see the doctor. I like to see my patients maintain a TSH around 2.5 for optimal psychological and physical functioning.

Continue with Cq10,omega 3, vitamin D.

There are supplements and herbs as well that can provide energy. Green tea increases the metabolism and can make you feel more energetic with or without caffeine. Ashwagandha herb is an energizing herb. There is also the option to take a Thyroid Support Supplement found in such brands as Pure Encapsulation.

Oh and both Amlodipine and your Restless Leg Drug cause nausea. You may be able to reduce the nausea by taking with food. Ginger is very effective at reducing nausea. The problem with anti-nausea drugs is that at least one has the side-effect of restless leg syndrome,which you don't need.

Also consider that fatigue may be due to low iron or XXXXXXX anemia. Since you haven't had any blood tests I cannot comment except that it might benefit you to have a cbc done followed by (if necessary) a ferritin test, folate and/or B12 test to check for the most common types of anemia.

Please feel free to write back for clarification or any questions you may have. I have given you a great deal of information.It has been a pleasure sorting through the issues you should address to gain your energy back. The trick is to find which one or which combination of the above is causing your fatigue and nausea.
Above answer was peer-reviewed by : Dr. Raju A.T
Follow up: Kathy Shattler 17 hours later
Thank you so much for your answers. You have given me things to think about and to discus with my doctor. I had recently read about Ashwagandha and had ordered it from my internet supplier and received it yesterday. I get my supplements from Stop Aging Now. Thank you again.
Answered by Kathy Shattler 6 minutes later
Brief Answer:
I am happy to help, please visit me again

Detailed Answer:
Trying to help clients feel better through the internet is challenging indeed. Please feel free to visit me again if you gain some direction that you want more assistance with. My clients generally stay with me (like a primary) and we do both intensive work and minor follow-ups. The better I know a client, the more efficient I get at being able to help that person.

I have enjoyed working with you immensely. Please feel free to use me as your virtual clinic nutritionist. I also have a clinic in the US.

If I have answered your queries to your satisfaction, please close it out for administration and rate me. XXXXXXX J. Shattler, MS,RDN
Above answer was peer-reviewed by : Dr. Vaishalee Punj

The User accepted the expert's answer

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