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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Medical
Satisfied Customers: 52038
Experience:  Medical Doctor Trained at a Top Academic Institution
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I have been diagnosed with the following conditions, major

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I have been diagnosed with the following conditions, major depression, fibromyalgia, IBS, sleep apnea, among other general health problems. I have what I call are attacks of extreme fatigue, which when they start begin with weakness of the muscles, at times shakiness and then so tired I can't function. I feel extremely cold 90% of the time, I can't sleep without the aid of medication, (insomnia), these are just a few of my different health symptoms. I see a psychiatrist , rheumatologist, gastroenterologist & family physician. I have had a colonoscopy, x-rays, & some blood tests recently. I really want some answers especially with the fatigue, feeling cold all the time, muscle weakness, etc. The most recent blood test was a general one to test the adrenal gland with blood being drawn at 8:00 a.m. & midnight, my physician said that the tests came back in the normal range. This is hard to try to explain, so forgive me for being so vague. I just feel with all of the physical problems that something is being missed. I have not had a day where I have felt completely well in months. I just really want to feel good again. At my last visit with my psychiatrist he suggested possibly going to Mayo, my question is do you feel I would benefit from coming to the Mayo clinic for more extensive testing or just stick with the findings from the different doctors I've seen?
Hello. I'm Dr. Phil, licensed and practicing Internal Medicine Physician. Excellent service is my goal.

Thanks for this question

Do you take any medicine?

If so, what?
Customer: replied 2 years ago.

Levothyroxine - 100 mcg 1 daily; Triamterene HCTZ - 37.5-25 mg 1 daily; Estradiol - 1 mg 1 daily; Fosinopril - 10 mg 1 daily; Drisdol - Vit D2 - 1.25 mg (50,000 units) l a week; Wellbutrin HCL - 1.25 mg 3 daily; Lorazepam - 0.5 mg 2 @ bedtime Focalin XR - 40 mg 1 daily; Provigil - 200 mg 1 daily; Omeprazole DR - 40 mg (I've been taking as needed); Hydrocodon - APAP 5 325 as needed

I think your symptoms could be med related Kathy

Is that possible?
Customer: replied 2 years ago.

The first 4 meds listed I have been on for at 5 years or longer, I have been on Wellbutrin for 4 years. I'm not sure if I feel comfortable taking the Focalin (I've only been on it 4 weeks), The Provigil I started taking approx. 4 months ago which was when I was diagnosed with sleep apnea and started using a CPAP machine.

I think this mix of meds is just wearing you out.

You have some that increase energy and some that decrease energy and in the end your body is just being fatigued from it.

Is that possible Kathy?
Customer: replied 2 years ago.

Which do you feel are working against each other? Even though you have not examined me in person which would you eliminate if needed?

focalin, provigil and wellbutrin are all increasing norepinephrine

lorazepam and hydrocodone are all causing fatigue

I think these are working against each other.

I would eliminate focalin, and either wellbutrin or provigil

Then I would get rid of either lorazepam or hydrocodone

Taking away these meds would help you greatly I believe Kathy.

I hope this helps. If you have more questions, just reply. :)
Customer: replied 2 years ago.

The lorazepam I take at bedtime to help sleep, the hydrocodone I only take when absolutely necessary to deal with the fibro & low back pain. I don't want to risk getting dependent on pain killers. I have felt uneasy about taking the focalin every since it was prescribed. I will talk to my psych dr. at my next visit. Do you have any other suggestions to help with the insomnia rather than the lorazepam?


Do you think feeling cold all the time could be due to the fibro or do you feel the adrenal gland could be causing the extreme fatigue or being uncomfortably cold all the time? Is the blood test that was performed sufficient?

Thanks for the reply Kathy

I think limiting the meds and regular exercise will help

I think the adrenal or thyroid could be the culprit. The blood test should be sufficient but not optimal. If that makes sense.
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