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Dr. Sohaib
Dr. Sohaib, Doctor
Category: Health
Satisfied Customers: 4709
Experience:  M.B;B.S ; FCPS Experienced in all Medical Specialties
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I am very tired all the time. I can be very sluggish at my

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I am very tired all the time. I can be very sluggish at my job. I have noticed a great decline in my performance in the past year.

Hello and thank you for the question.
Answers given are for informational purposes only and are not meant to replace an exam by an in-person.

I am Dr. Sohaib, a practicing Internal Medicine Specialist and i will do my best to help you today.


You need to answer a few questions first which will help me assist you in a better way.

Whats your gender?

Are you over weight?

Cold intolerance?

Constipation?

Get body aches and pains?

Sleep issues?

Problems at work and relationship issues?

Customer: replied 3 years ago.

i am female. i am slightly average weight. no problem with the cold. no problems with constipation. I do get achy. Some sleep issues . No problems at work or at home.

Thank you very much for the useful information Jill.

Well the first thing i would like to rule out is an un-diagnosed and/or under-treated thyroid disorder. This is a very common problem especially amongst females and give you severe lethargy and fatigue.

Different labs have different reference ranges for TSH (thyroid test) (usually 0.5 to 5.5); but recently new guidelines for the upper level of TSH have been set forward. The new upper limit of TSH is 3 as per AACE (American Association of Clinical Endocrinologists). Many doctors are not aware of this, so if you have a Thyroid test done, please review the report and discuss with your endocrinologist. If not done already, have it done and get the report interpreted keeping in view these details.

Other causes for similar symptoms (lethargy and excessive fatigue) include autoimmune disorders like Addison's disease (that can be associated with hypothyroidism), which can also present clinically in a similar way.

Vitamin D deficiency, a very common finding in all the age groups can also cause excessive fatigue and lethargy.

Sub clinical viral infections (but fatigue due to this is usually short lived lasting for few weeks), chronic fatigue syndrome etc should also be included in the differentials.

Talk to your doctor regarding all these possibilities and proceed with necessary tests.

You and your doctor working together can chalk out a best management plan that will suit best to your need.

Until you see your doctor, following measures will be helpful;

Adequate hydration

Daily exercise

Gentle stretching of muscles

Massage

Vitamin E (400-600mg daily)

Co-Enzyme Q-10 will also provide a symptomatic relief.

Also, sometimes clinical depression can give you fatigue and exhaustion, but we need to rule out all other possible causes for your symptoms before attributing this to depression.

I would have been worried too if I were at your place, but let me reassure you that this is a treatable condition and carries a good prognosis with appropriate management.

It was a pleasure assisting you and thank you very much for visiting us.

My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to Rate my service.

If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

Customer: replied 3 years ago.

i currently do not have a primary care doctor hence why i turned to this online questionnaire. can i simply go to a new doctor and request a thyroid test?

Thank you Jill.

Yes sure you can.

It was a pleasure assisting you and thank you very much for visiting us.

My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to Rate my service.

If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

Dr. Sohaib and 3 other Health Specialists are ready to help you