question-icon

What causes severe fatigue, drowsiness, pain in ribs and stomach?

default
Posted on Wed, 11 May 2016
Question: I feel weak all the time very fatigued all the time. I'm tired and sleepy and I get this pain in my ribs where the ribs start and stomach ends. I can't lightly exersise or have sex and if I try to I get more discomfert in the ribs and abdomen and will feel like passing out.
I've had echocardiogram brain mri chest ct with contrast cealic testing CBC thyroid test numerous ekgs all normal. Except for gyneocasmtoa incidental) this fatigue has been progressi g slowly since November.
doctor
Answered by Dr. Binu Parameswaran Pillai (40 minutes later)
Brief Answer:
Tests

Detailed Answer:
Dear XXXXXXX

Sorry to hear about your symptoms.
Noted about the normal results.
May i suggest following tests ( especially since you have low energy, low sex drive, and gynecomastia) ,
a) Fasting serum testosterone level.( 7 to 9 am).
b) 8 Am serum cortisol.

Do you have any features or symptoms of depression?

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Binu Parameswaran Pillai (6 minutes later)
I think about death a lot, have panic attacks from time to time, have a mild b12 defciency level 350. I have mild anxiety and list my dad and grandpa on the same day nine months ago both of which I was very close to. Also could this be a heart issue. One thing I did notice is that I was masterbating a lot like 5 times a day and than one day I tried and I stated getting shaky that was back in late December. Exersise intolerance has been going down a slight decline since November

Also my sex drive is high, I just can't do anything with it because if I try I get shakey and feel like passing out this happens if I try to exersise as well :/
doctor
Answered by Dr. Binu Parameswaran Pillai (8 minutes later)
Brief Answer:
Depression is a likely cause.

Detailed Answer:
Extremely Sorry to hear about your loss.

Depression is the likely cause of your symptoms. It is good to see a psychologist and psychiatrist and discuss further. This is particularly important as you do think about death a lot. Altered sexual behaviour is a common symptom associated with many such psychiary disorders. Anti depresants and counselling will surely help you. Please do not shy away from seeking medical help.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Binu Parameswaran Pillai (7 minutes later)
I am seeing a therapist this week. But doctor can depression really cause all this pain. I can't throw a baseball without feeling like I'll pass out. When I move fast like a brisk walk or masterbate my ribs ( right around where the adrenal glands are stat to tingle and hurt) than I get shaky and feel like passing out. I was born with spinal bifida occtle had no nuerologic symptoms just schuemanns kyphosis 80 degrees (ever since 12, never felt like this) lumbar lordosis) and mild lumbar dextrosclosis i could this be the start of spinal muscular atrophy?

1 could this be a heart issue?
2could this be spinal muscular atrophy?
3 how execs fly does depression cause these feeling. I feel like I'm dying.
doctor
Answered by Dr. Binu Parameswaran Pillai (4 hours later)
Brief Answer:
Not to worry

Detailed Answer:
Good to hear that you are visiting a therapist soon. Spinal muscular dystrophy is a neurological disorder and your legs get weaker. You don't seems to have any such symptoms. However, it is good to mention about spina bifida to your doctor so that they could carefully look for any neurological deficit in your legs.

Believe me, masturbation has nothing to do with adrenal gland or pain in ribs. The pain during brisk walk is likely to be of muscular origin
This seems unrelated to a heart issue. You have had several EKGs which were normal.

Please stay relaxed and try relaxation exercise till you consult a psychologist/psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Binu Parameswaran Pillai (3 hours later)
Thank you dr, my last question here is can depression cause you to feel like passing out with only mild exersise like walking to quickly or trying to masterbate? The slightest arosual psychically will make me shake and feel like passing out. Weather if it's thirty seconds of masterbating or ten seconds of walking fast. Can depression really cause all this?


Can cancer be a cause or blood vessel issue? I had endoscopy in XXXXXXX looked good CBC the other day that looked great. Can cancer be cause? Thank you for your time doctor it means a lot
doctor
Answered by Dr. Binu Parameswaran Pillai (30 hours later)
Brief Answer:
Sincere apologies

Detailed Answer:
Dear XXXXXXX
Sincere apologies in the delay in reply.
Cancer is unlikely to cause your symptoms. However it's hard to comment with out
examining in person . I would like you to discuss with your doctor about a very rare hormonal condition called Pheochromocytoma which sometimes can present with such symptoms. Simple blood tests can rile this out.
Depression can manifest in all possible ways and since most of the tests were normal, I would consider it as a very strong possibility. Passing out during masturbation and wakling fast is an exeption which can not be explained on the basis of depression alone.Have you had a heart echo test done
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Binu Parameswaran Pillai (5 hours later)
yes I had an echocardiogram done and it came back normal. doc said the heart is suppose to pump 60-70mm per minute and mine pumped 65 so that's good. these symptoms of feeling like ill passout happens with any attempt to masterbate or walk fast for example; I can wake up in the moring with a full on erection and not feel any weaker than I generally do, but if I try to stimulate my self, no less than thirty seconds later I will feel panic and feel like im gonna fall over. but this feeling can also happen if I try to sing for awhile, even in a talking voice. ive head a chest x ray,echo cardiogram, brain mri,cartoid duplex all came back normal. several ekgs normal. the symptoms get worse with movement, and better at rest. I have a headache, my eyes feel heavy, I think of death all the time, I burp a lot and have muscle pain in my lower ribs and abdominal region. I have had social anxiety sine I was young and when my dad died I noticed that my anxiety was slowly getting worse, so I realize that there is a possibility that this can be all psychological. two things though

1. my doc orderd blood tests for b12,floate,zin,magnisum,vitimin d, and testrone,estrogen,and cortisol levels

2. I went to the hospital by ambulance because I got shakey and weak after playing basketball for about 2 minutes. the ambulance finger pricked me and took my blood glucose level which was 180, so they thought I was a diabetic, they rushed me to the hospital and did blood work and checked my blood glucose levels there, which was a halfhour later and the results said my glucose level was 93. whats going on here? was the meter in the ambulance wrong? this seems like a drastic drop for someone who is non diabetic. I had not eaten anything for two hours proior to the first reading of 180 on the finger prick test, and nothing between the blood from the vein test. the CBC with diffrental came back normal



some test results for you to review

Cortisol your value 22.9 mcg/dL 6.7 - 22.6 mcg/dL
Normal Reference Range:
AM Specimen: 6.7-22.6
PM Specimen: 0.4-9.9
tooknen at 2:35 pm

Component Results
Component Your Value Standard Range
Vitamin D, 25-Hydroxy, Total 15.6 ng/mL 30.0 - 80.0 ng/mL
This assay was performed using Roche Diagnostics Corporation reagents
and test kits. Values obtained with other assay methods or kits cannot
be used interchangeably.
NOTE:
Deficiency: <20 ng/mL
Insufficiency: 20-29 ng/mL
Optimum Level: 30-80 ng/mL
Possible Toxicity: >80 ng/mL
Most patients with toxicity have levels >150 ng/mL


omponent Your Value Standard Range
Folate, Serum 9.3 ng/mL 5.2 - 20.0 ng/mL
Reference Ranges:
Deficient < 2.5 ng/ml
Indeterminate 2.5 - 5.1 ng/ml
Normal 5.2 - 20.0 ng/ml
Component Results
Component Your Value Standard Range
Magnesium 2.1 mg/dL 1.7 - 2.8 mg/dL

Component Your Value Standard Range
Estradiol 18.2 pg/mL 23.8 - 52.2 pg/mL

Component Results
Component Your Value Standard Range
Testosterone, Serum 597.50 ng/dL 193.00 - 950.00 ng/dL

more tests pending
doctor
Answered by Dr. Binu Parameswaran Pillai (2 days later)
Brief Answer:
Depression and anxiety need treatment

Detailed Answer:
Dear XXXXXXX
Apologies. I am in a country side for the last few days and I don't have frequent Internet connection. Hence the delay in reply. Sincere apologies.
Your Echo was normal. all the blood reports except vitamin D is normal.
You need Vitamin D replacement and also sunlight exposure. your Cortisol levels are slightly on the upper side which can happen in anxiety .
Otherwise other results are normal including your testosterone.
You seems to have severe depression and anxiety and that need to be taken care of. Please meet a psychiatrist . that would give you a lot of relief.
regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

premium_optimized

The User accepted the expert's answer

Share on
What causes severe fatigue, drowsiness, pain in ribs and stomach?

Brief Answer: Tests Detailed Answer: Dear XXXXXXX Sorry to hear about your symptoms. Noted about the normal results. May i suggest following tests ( especially since you have low energy, low sex drive, and gynecomastia) , a) Fasting serum testosterone level.( 7 to 9 am). b) 8 Am serum cortisol. Do you have any features or symptoms of depression? Regards Binu