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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes sleepiness and fatigue in the evening?

Answered by
Dr.
Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Posted on Thu, 1 Sep 2016 in Thyroid Problem and Hormonal Problems
Question: Helo Doctor iam very tired right now a days . Evening when i reach home i feel very sleepy all the time . Iam not able to do sex with my wife as my sex organ is not becoming thick and also very tired and sleepy . Iam diabetic and iam taking obimet sr 500 tablet . I have checked sugar 3 months back and random showed 195 . My working hours are from morning 9 to evening 8 pm . I dont have time to do any exercises
doctor
Answered by Dr. Chintan Solanki 6 hours later
Brief Answer:
diabetes can cause erectile dysfunction

Detailed Answer:
Hello XXXXX,

Thanks for writing to us.

Your symptoms of sleepiness and fatigue can be due to stress/depression or nutritional deficiency like vitamin B12 and vitamin D.

Depression/stress can cause erection problem or erection problem can lead to depression. What occurred first decides the treatment.

You do not have time to exercise and you work almost 11 hours a day. This suggests you are likely living stressful life.

I recommend going for serum B12 level, serum Vitamin D level, Serum testosterone level (total and free),fasting blood sugar, ppbs Thyroid function tests and HB1ac (to check control of diabetes for last 6 months). Revert back to me with reports.

For a while I recommend taking tetrafol plus containing pyridoxal-5-phosphate, mecobalamin and l-methylfolate (trade name tetrafol plus) is very helpful in my patients. It has shown improvement in 50-60 patients of mine with ED with diabetes. You should take it after meal twice a day. You should continue for at least 2 months. You may get this medicine over the counter as it is vitamin product.

- Sad mood, lack of interest in routine/pleasurable activities, weeping/crying spells, hopelessness, reduce appetite, excessive fatigue or weakness, lack of concentration, sleep disturbances, death wishes, suicidal ideas : among these symptoms which are there in your case and since when? Please narrate briefly.

I will be happy to help further after your response.
Regards,
Dr.Chintan Solanki.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki 14 hours later
Yes Sir iam very much disturbed sad mood , no interest in work , sometimes death symtoms appear , fatique etc appears in me and iam so much disturbed now .
doctor
Answered by Dr. Chintan Solanki 1 hour later
Brief Answer:
it is depression likely

Detailed Answer:
Hi,

Thanks for information.

Your symptoms suggest that you are suffering from depression. For confirmation of diagnosis detail history and mental status examination are required to be done by a psychiatrist. I recommend consulting psychiatrist.

Treatment of depression includes both medicines and psychotherapy.

In psychotherapy I prefer cognitive behavior therapy (CBT).In mild cases only CBT is sufficient. In moderate to severe cases initially medicines and then CBT is added. And later on medicines stopped gradually.


In medicines SSRI group of drugs (fluoxetine, paroxetine, sertraline, escitalopram) are main stay of the treatment. There are other group of drugs as well with different mechanisms and excellent results.
Benzodiazepines group of drugs (clonazeapm, lorazepam or etizolam) are used initially for short duration for fast symptomatic relief.

One can stop medicines gradually after 100% recovery according to doctor's guidance.

Consulting a psychiatrist personally will surely help you to live better life.

Feel free to discuss further.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
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