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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 31330
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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i have been feeling very weak lately. No energy and I want

Customer Question

i have been feeling very weak lately. No energy and I want to just go to sleep. I have no desire to do any of the things that used to keep me occupied. i am 61 and have always been energetic and on the go constantly. I had breast cancer 15 years ago and have been on diploprovera shots for a couple of years now because I couldn't function at work and at home. The shots seemed to help for a long time but now I don't feel the same energy and memory booster that they used to give me. i don't understand what is happening to me, I can't concentrate and when I try to carry on a conversation I get distracted from what i was saying.
Submitted: 6 years ago.
Category: Medical
Expert:  Dr. Arun Phophalia replied 6 years ago.



Do you have muscle pains, fatigue / tiredness, mood disturbances like depression and anxiety, sleep disturbances?

Were any investigations done for weakness, lack of energy?


Dr. Arun

Customer: replied 6 years ago.
I am feeling very fatigued/tired and have trouble sleeping thru the night. I have not seen my personal physician yet but this seems to have come on within the last couple of weeks. I don't know if this is depression because I have never been told that i am depressed.
Expert:  Dr. Arun Phophalia replied 6 years ago.


Episodes of fatigue or tiredness (or persistent symptoms) need to be classified in;

1) chronic fatigue syndrome; unexplained, persistent or relapsing fatigue with unrefreshing sleep, muscle pain, concentration problems, headache, sore throat etc.

2) idiopathic fatigue; it does not meet the above criteria.

Fibromyalgia, lupus, sleep disorders are the other disorders which should be looked for your symptoms.

Following investigations are essential;

1) Complete blood count,
2) Erythrocyte sedimentation rate,
3) Thyroid function tests,
4) Muscle enzymes;
5) Anti-nuclear antibodies (ANA)
6) Adrenal function test
7) Anti-dsDNA
8) Anti-Sm
9) Anti-SSA (Ro) or Anti-SSB (La)
10) Coombs test
11) Anti-histone


Fibromyalgia is a chronic condition, which may have following of the manifestations;

1) widespread muscle pain, "myalgia,"
2) excessive tenderness in many areas of the body
3) fatigue,
4) sleep disturbances,
5) headaches,
6) mood disturbances, such as depression and anxiety.

A consultation with either a rheumatologist or a clinical immunologist would be prudent. You may seek a referral if necessary by your primary care physician after the preliminary investigations.

Please feel free for your follow up questions.

Dr. Arun

Customer: replied 6 years ago.
I don't have muscle pain or tenderness in any areas. I do have headaches and feel extremely fatigued. I have gone thru extensive blood work and nothing has indicated any specific problems. could this be just depression?
Expert:  Dr. Arun Phophalia replied 6 years ago.



Yes. This aspect also should be considered and depression can cause your symptoms of lack of energy and no desire to do anything.


Your primary care physician should consider referring you to a specialist to explore this aspect.


It is privilege assisting you.


Dr. Arun