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Dr. Randy Peters
Dr. Randy Peters, Doctor
Category: Medical
Satisfied Customers: 57
Experience:  General Practice for 16 years, member of the American Society of Bariatric Physicians
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Im always tired, sleepy, headaches, blurred vision, memory,

Customer Question

I'm always tired, sleepy, headaches, blurred vision, memory, brain fog, muscle leg pain, stiff neck. I have had these symptoms for 30 years, but unable to get answers.
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Salar replied 4 years ago.
you should see a rheumatologist n discuss chronic fatigue syndrome or fibromyalgia. i am assuming that you have already ruled out thyroid, anemia, sleep apnea, anxiety, hepatitis or similar common causes.
Customer: replied 4 years ago.
Relist: I have already been told that I might have what you suggested but have been taking vitamins and supplements to help but nothing as been working. This as to something very complex since I have had these symptoms for 30 years..
I have already been told that I might have what you suggested but have been taking vitamins and supplements to help but nothing as been working. This as to something very complex since I have had these symptoms for 30 years.
Expert:  Dr. Salar replied 4 years ago.
vitamins and supplements wil not help. it will require medicines like savella, cymbalta and lyrica to get better. talk to your doctor about them and see how you feel.
Customer: replied 4 years ago.
Relist: I have been getting information from a nutritionist in the US and she suffers from Fiberomygia and said that vitamins and supplements as helped her. My Doctor as never mention fiberomygia or any other Doctor..
I have been getting information from a nutritionist in the US and she suffers from Fiberomygia and said that vitamins and supplements as helped her. My Doctor as never mention fiberomygia or any other Doctor.
Expert:  Dr. Randy Peters replied 4 years ago.
Many, many, disease states can cause these overlapping and cumulatively disabling symptoms. But the vast majority of them, after three years, would eventually become self-evident or diagnosed with the numerous tests that you have no doubt had. Fibromyalgia is definitely high on the list of possible diagnoses. No one really knows what causes fibromyalgia. No one knows how to cure it. But the current best practices all include the use of aggressive lifestyle changes (healthy diet, healthy exercise) and not just for lip service. These changes make a difference in patient's pain levels and ability to function. You are already using nutritional supplements, and the previous expert named several medications newly approved for its treatment.

Just one other thing to consider: consider asking your physician for a blood test to help rule out celiac disease (colloquially, gluten sensitivity). People can live a long time without being aware that they have this, and it can almost perfectly mimic fibromyalgia. The blood tests to screen for it (anti-gliadin antibody tests) did not exist 10 years ago. Unlike fibromyalgia, celiac disease can be very effectively treated with dietary changes. Conversely, you can try an aggressively gluten-free diet for 1 month and see if it helps to relieve any of your symptoms.


Lastly, the treatment of fibromyalgia is worth a try. The previous expert gave names of medications only recently approved for the treatment of fibromyalgia. You are already using
Customer: replied 4 years ago.
What percentage out of 100 would you give that I am suffering from Fibromyalgia? my nutritionist also said that I might have toxins in my body. The Nutritionist introduced me to take certain vitimins, which haven't help. Maybe if fibromyalgia is ruled out medication would be the solution. What I don't understand is why my other doctors have never ruled this out. know it's been along time, but I conplained about these systoms to my doctor maybe 6-7 years ago. My situation started all of a sudden when I was 15 years old. I was in school and strugleing because I was to tired to learn my memory was not good I felt very sleepy. I am forgetful, confused, it's like my brain knows what's going on but cannot do anything. I just woke up but feel that I havn't sleep much. The thing is that these systoms as stayed the same and hasn't got worse. But maybe if I was 20 years older it be very difficult. This as been a very stressful 30 years for me. it's like I have been robbed of my life.
Expert:  Dr. Randy Peters replied 4 years ago.
This is a good question. Your frustration is understandable. Fibromyalgia is called a "diagnosis of exclusion", meaning that there is no way to test for it. The only way to diagnose it is to rule out everything else, which is why it is so difficult to do and takes so long. If there were one blood test for it, it would be a simple
matter. When you have something like this it's important to re-evaluate the diagnosis every few years in light of newly identified diseases and tests. That's why I suggested getting screened for celiac disease; anti gliadin antibodies were not used to test for this a decade ago. With respect to specific vitamins and supplements, that's a bit outside my area of expertise. And I apologize for not being willing to quote a pecentage probability on the diagnosis. would need to review carefully with you all the tests and history of thirty years and that is just not possible in this context. You have obviously suffered a great deal with this. The most important thing is to find a doctor who you feel comfortable working with and periodically checking on new developments in the field, especially if your symptoms change.
Expert:  Dr. Randy Peters replied 4 years ago.
Re-reading your follow-up reply to your question, if you and your doctor have NEVER talked about fibromyalgia, it would certainly be appropriate to get a consultation with a rheumatology specialist to evaluate the possibility. They generally have the most expertise in this diagnosis, which is probably why the first expert to respond to you suggested it.
Customer: replied 4 years ago.
I your opinion do you think that there is a very high possiabilty that I do have Fiberomyalgia or celiac disease. What is celiac disease symptoms?
Expert:  Dr. Randy Peters replied 4 years ago.
Based on everything I've read so far (and making a lot of assumptions about your evaluation to date), it does seem moderately likely that you suffer from fibromyalgia. It's less likely that you suffer from celiac disease. However, the symptoms are similar to yours (albeit with more GI involvement), and (like your symptoms) can go for years without diagnosis. But it is so easy to treat that it's worthwhile checking to make sure that you don't have it. Celiac Disease is actually a group of disorders that are characterized primarily by gluten-sensitivity (somewhat colloquially known as wheat allergy) and sometimes problems with malabsorption and lactose intolerance. Although it is results from problems in the small intestine, it affects many organ systems non-specifically, so everything you listed overlaps with it. It can also be treated very well by getting rid of gluten in the diet and watching your nutrient intake (as you are already trying to do). So it's less likely that you have it, but it's important to eliminate as an easily treated possibility.
Customer: replied 4 years ago.
So the best thing to do at this point is to get tested for celiac disease.and have my Familly Doctor send me to see a rheumatology specialist. What you are saying is that I am more likely to have fibromyagia then celiac. Also you are saying that medications are needed to treat fibromyalgia, not vitimins.
Expert:  Dr. Randy Peters replied 4 years ago.
Yes, I am recommending testing for celiac disease. Yes, I am recommending getting an opinion from a rheumatologist but only because you said your family doctor has never talked about fibromyalgia with you. If he or she is knowledgeable about fibromyalgia and willing to discuss it then it would be better to speak to your own doctor instead. But if not, then a rheumatologist has the greatest expertise on the subject. Yes, I do think that fibromyalgia would be somewhat more likely than celiac disease. No, I don't think that medications are needed in preference to vitamins. There are medications now for fibromyalgia, but they are all very new, and their side effects are not yet well-known. So to minimize risk, you should decide (with your doctor or a rheumatologist) how likely fibromyalgia is to begin with. You and I have discussed it a lot, but I've never examined you and you've never discussed that possible diagnosis with the physician who knows you best. So start there, because if you've never tried even the standard care for fibromyalgia, you don't want to try medications that are new to market first.
Expert:  Dr. Randy Peters replied 4 years ago.
We've talked about so much that I'm worried I may have been confusing. Here's a very simple strategy that covers what we've discussed that you can take to your doctor: Ask your doctor to test you for celiac disease/gluten-sensitivity (or even just try a lactose-free and gluten-free diet yourself for at least 6-8 weeks...it's what you'd do anyway if the test came back positive). If that test is negative, or if the diet is not helpful in reducing your symptoms, then talk to your doctor about fibromyalgia. If he or she is not knowledgeable or comfortable, ask for a referral to see a rheumatologist. Don't think about using newly advertised meds until you've done all of these things and tried standard therapy. But they are there if you need to try them down the road. I know this was a lot of information. I hope this summary helps.
Customer: replied 4 years ago.
What is a lactose-free and gluten free diet? and should I continue taking vitimins and supplements?
Expert:  Dr. Randy Peters replied 4 years ago.
Lactose-free diet gets rid of dairy products primarily (small amounts of cheese and butter are usually ok).




Gluten-free diet eliminates foods processed with wheat and wheat flour (which is many, many processed foods...you'd be surprised how many foods contain gluten additives).


Here is a link to tips on a gluten-free diet (from the Mayo Clinic): http://www.mayoclinic.com/health/gluten-free-diet/MY01140




I don't know what vitamins/supplements your friend gave you, but if she is a registered dietitian, then I would trust her judgment, and I wouldn't stop them.

Please click "ACCEPT" if I answered your question to your satisfaction so that I may get credit for my work.




Customer: replied 4 years ago.

If I am diagnose with fibromyalgia, will medication control the symptoms? If for some reason I don't have fiberomyalgia, what else could be the reason for my symptoms.

 

Thank you

Expert:  Dr. Randy Peters replied 4 years ago.
There is no cure for fibromyalgia. Patients with fibromyalgia often benefit from lifestyle modifications (as alluded to previously), and also, importantly, treatment for the depression that invariably accompanies it. The medications that were mentioned before are new so I personally don't feel comfortable recommending them, that's why I think you should see a specialist.




There are many other possibilities, far too numerous to mention. It's sort of like asking, "what causes fatigue?" The answer can basically be, "everything." So it's really far outside the scope of what can be discussed by question and answer in an online forum. At some point, you need to actually sit down face to face with a physician and get a thorough history and a detailed physical examination (not to mention review of your previous studies). The good news is, that's what a rheumatologist (or other specialist) does, and many of the other possibilities will have already been eliminated by the work that you have done with your physician in the past 30 years.




So, botXXXXX XXXXXne answers:


Will medication control the symptoms?
Other things to try first, see the rheumatologist before trying it.


What else could be the reason?
Probably depression, but again, you have to start with what's in front of you and start with a plan to work it up. You can't pursue everything simultaneously. That's why I suggested a strategy that you can take to your physician in a previous answer.









Dr. Randy Peters, Doctor
Category: Medical
Satisfied Customers: 57
Experience: General Practice for 16 years, member of the American Society of Bariatric Physicians
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Dr. Randy Peters
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General Practice for 16 years, member of the American Society of Bariatric Physicians