Wanna be doc, finished MS-1 here,
Trying to figure out why get a weird "fatigue
" and proximal anterior thigh weakness with moderate exercise. Can also get lightheaded but never fainted in my life. The weird fatigue is almost similar to description of hypoglycemia (but not).
I've been through with other doctors and now trying to come up with a likely differential.
Levothyroxine, no other meds
Three months ago dx with sub-clinical hypothyroidism
. Three months later, mid-normal levels of TSH, fT4, and T3. If the exercise intolerance was from this, should we expect some reduction in symptoms with normal levels at this point?
Holosystolic murmur best heard in the upper right sternum. Increased supine. And pretty sure decrease with Valsalva (semi hard to do on self). Had a echo about 7 years ago and only should trival MVP or regurg (can't remember which) and stress was also done about 7 years ago. Normal EKG as recent as of fall 2012. The exercise symptoms have been around before this point. With these old findings, does it rule out cardio?
Neurological exam yielded no abnormalities.
I've also self tested the use of a glucose meter and no decrease in blood sugars during the fatigue.
Also pulse ox shows no decrease in O2 saturation before and after exercise.
Blood work has been ran during my past and is always normal except for chronically slightly (and very slightly) elevated ast/alt.
My resting heart rate is about 55-60 (bradycardia) and resting BP is normally around 105/60 on average. Testing my BP after exercise once today showed 140/60 on automatic machine.