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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 10341
Experience:  14 years as clinician in the field of Family Practice
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Have felt lathargic for past few months. Doctor has tested

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Have felt lathargic for past few months. Doctor has tested blod and she says everything checks out. She wants me tested for sleep apnia.
I am 64 and have been in good health. The last few years I have worke on taking weight off . I lost 50lbs in 2 years. I now weigh 240.
Any ideas? My wife thinks I should take an antibiodic. I have had several urinary track infections in past 6 months. DC here suggested i take an over the counter drug which worked.
Anthony Bray MD :


Anthony Bray MD :

There are different qualities of the complaint of FATIGUE >> which is a very broad complaint (andf very common...)

Anthony Bray MD :

First of all when you say that you feel lethargic do you feel abnormally sleepy during the day??

Anthony Bray MD :

ld be culprits as well)Sleepiness is a quality of fatigue that indeed could be a red flag for sleep apnea as a possible cause. (Hypothyroidism and other sleep disorders cou

Anthony Bray MD :

If not sleepy do you feel tired ot our of breath with exerion???

Anthony Bray MD :

This would be a different subset of likely culprits....

Anthony Bray MD :

Pulmonary problems, anemia, iron deficiency, deconditioning (=lack of adequate exercise) could be possible causes and there are several others in this category as well...

Anthony Bray MD :

If you feel a lack of "get up and go" or find it difficult to make yourself do routine things then i would wonder about depression as a possible culprit...

Anthony Bray MD :

If you respond to my questions above then I will get back with you to discuss further.... I see that you left to rate question but i was actually just getting started.....

Anthony Bray MD :

I will try to help further but need input from you if you are willing...

Anthony Bray MD :

Best Regards ***** *****

Anthony Bray MD :

Anthony Bray MD

Anthony Bray, MD and 3 other Health Specialists are ready to help you
Customer: replied 4 years ago.

Yes.. seem to need a nap everyday. I am still working so that is not very helpfull to me as a realtor.

My wife says I shuffle now

Customer: replied 4 years ago.


I just lost my 92 mother last week after 6 month's of going downhill. She was bed bound at end. Plus blind, unable to walk and virtually deaf. Since we were 2,000 miles apart Mich (me) San Diego (her) We would talk via phone everyday..

Next we lost 2 houses in short sales due to economy.

My job has changed (real Estate) I was making over $100K a year 4 or 5 years ago.. Now maybe $10,000

next our dog of 12 years has cancer

Does this help you??


Hello again,

I have answered your questions is a follow up message scheduled for tomorrow....

Customer: replied 4 years ago.

I don't want to dwell on thi but we lost all our retirement when we forced to short sale our houses.

I am sometimes feel dizzy and unsteady on stairs etc.

We are also in a gray, cold and damp area -Michigan. ..

I love walking on beach with my wife.. I have worked out in past but seem unmotivated lately

Customer: replied 4 years ago.

I have in last 12 months had a hard time getting to sleep. I will take a xanax periodicaly. Once a week.. to help sleep or stem anxiety..

Blood test ( Thyroid included) were fine according to my primary doctor.

The depresion resonates with me.. My wife is there too

Hello again,

It does sound that depression is part of the picture with you with regard to your dense of fatigue. It may be that this fatigue has more than one componant as well..

I would advise that you discuss your depression further witrh your primary doctor. It may well be based on your history that you could feel some benefit from an anti-depressant medicine.

I do think that addressing the questions and issues with regard to your sleep is worthwhile as well.

I hope this is helpful. Sorry for delays but the Q and A part of the site has its quirks and makes it more difficult to reply back. You have a similar message that I sent to you yesterday....

Let me know if you have further questions. I would be interested in your progress as well...

Best regards,

Anthony Bray MD

Anthony Bray, MD and 3 other Health Specialists are ready to help you
Customer: replied 4 years ago.


I am Male 64 years old- 6' 240Lbs

Have not tried anything yet my primary doctor is still testing blood . She is looking at my testasarone. Was going to check my sleeping with a test..

My wife thinks I should have an antibiotic.. She thinks my urinary track may be problem. I had an infection 2 months ago and took care of it with over the counter drug . I have had 2 more occurrences.

Oh yea .. I have an enlarged prostate if that means anything. I take avodart, flow max vesacare and a number of supplements from a company called Isagenix. Try my wife and I have been using vitamins, shake in morning and afternoon for several years

Anything more?

(sorry about spelling ) I am not a typist.

Hello agian,
This is Dr Bray from >> I tried to start answer your question but I think you accepted to quickly as I was just getting started. As you say that you nep everyday then this makes me think that obstructive sleep apnea or other sleep didorder definitely needs to be ruled out with sleep study as your docotr has p-lannned for you. The shuffling gait that you mentioned can be a symptom of Parkinson's disease and you might have a neurologist eveluate you further if there has been a definite change in the pattern of your walk....
Hypothyroidism may have likley been part of the blood work up that you have already had that has returned normal. Just double check with your doctor on this. Hypothyroidism causes fatigue with increased need for sleep among other symptoms..
In its current form the question thread is out of the chat format and into Q and A format which currently on the site hasa limitations. I would get back with you sooner otherwise. If you have further questions or points of discussion then let me know and I will be happy to get back wioth you!
Yes I saw your follow up message as well. I'm sorry that I am unable to get back with you except through this follow up message scheduled for 1/10...I know that you must think that I don't care BUT I DO!! It does sound that you have MAJR stress in your life and that depression would be very likly as a cause for your sense of fatigue. This does change sleep patterns as well >>some people sleep more and others can't sllep as much>>often a pattern of waking up ealy AM and can't get back to sleep with discuss this with your doctor as well. This would be part of my advice for you. I hope that some of these negatives turn around for you...may your life have some unexpected blessings!!
Best Regards,
Anthony Bray MD
Customer: replied 4 years ago.


told my sister about what I was feeling her husband is a gastrologist . She blew her lid. She said the these cleanses cause problems. My brother -in law has seen it when he performs colonoskpy

does this make sense ?I have taken cleanse, vitamins and meal alternative shake for almost 2 years ...I used cleanse for weight loss..

What do you think? Easy enough to stop and see. Question would be how long before I saw any indicators... plus could it have damaged me permentaly?

Customer: replied 4 years ago.

Did you get this question?

Hello again,

I agre with your brother -in -law that the colon cleqanse rotuine is not good for you. This is not a real benefit and may cause problems. I would advise that you stop.

I do not think it would be likley to have caused any permanent damage to you however. (not unless really overdone over time would this be the case)

I think that stopping may help you to feel some better in general over 1 to 2 weeks.

I doubt this completely solves the problems all together by itself as I do think you have other factors as we have dicscussed.

I hope this helps. Let me know if you have further questions. I will be glad to help further if I can!!

Best Regards,

Anthony Bray MD

Anthony Bray, MD and 3 other Health Specialists are ready to help you
Customer: replied 4 years ago.

Thanks Anthony!

FYI - company calls it "a full body cellular cleanse"

Does that make a difference. Thank you for your input and advise.

My Best, Allan

Customer: replied 4 years ago.

HI Anthony.. I have had trouble with Just Answers and took ahile to get back.

Update I have had an MRI 2 months ago. The MIRA Tech (doctor) diagnosed me with hydrocephalus however the neurosurgeon who was referred to us doesn't agree. My gait is not as slow as he thought he would see. My memory is average and according to him I am NOT incontinent but have an issue with urgency. I am using herbs and some chiropractic from my son.

Still have some issues but not as bad as when we started corresponding


Hello again,

It is good to hear back from you. I am glad to hear that you are feeling better at least than when we last corresponded.

Sorry that you have had trouble with >> I hope this is better and without problems now...

With the issue that you bring up that does seem a bit troubling that you have two specialists that should BOTH know your issue and the potential diagnosis of NPH (= Normal Pressure Hydrocephalus) quite well and yet they appear to disagree on your diagnosis. It sounds that you are now familiar with the potential problems associated with NPH (( trouble with gait//potential problems with your thinking, concentration, memory// and finally incontinence)) I think that I would take the advice of the neurosurgeon on this as this specialist would have been in the position to treat other patients with a shunt of the cerebrospinal fluid. I would also be cautious of potential worsening along these lines... (I'm thinking what if you had a mild end case... could they both be right in a sense??)

So anyway I would advise that you be alert to having increased suspicious symptoms... hopefully this will not be the case. Follow up if you should have more trouble along these lines.

I hope this helps. Let me know if you have further questions or concerns. Take care!!

Anthony Bray MD

Customer: replied 4 years ago.

Thanks Anthony..

My thought too.. My wife is keeping an eye on me. She was quite upset with results of MRI. She wanted me to try the shunt as it appears to help many people. Plus she wants the "old" Allan back. I wanted to try holistic treatment first and keep the shunt as a back up. So far so good.

If this does continue to arrode my health is there a hospital and doctor that you recommend?

I am ini area with Munson Medical... and saw Dr ***** *****


I am not familiar with your area to really recommend specific doctor to you...

I would follow advice of the neurosurgeon to hold off at this time BUT I agree with being vigilant to watch for worsening symptoms that might be due to NPH and follow up if this should be the case. (We all hope of course that this is not the case..) I would favor the expertise of the neurosurgeon in general on this issue as I said this specialist sees all sides from his perspective.. he would be used to seeing patients clinically, MRI results and surgical anatomy results... so I would take the advice of this specialist to hold off... On the other hand I agree that the radiologist finding that the MRI was not normal in this regard would be disturbing to me as well...

Let me know if you have specific concerns of your symptoms currently. I reviewed our previous conversation to refresh my memory on your symptoms. I recall that you had a set of problems and may have different factors contributing... Let me know if you are still particularly bothered by specific symptoms such as the fatigue for example...

I hope this is helpful for you. Best Regards,

Anthony Bray MD

Anthony Bray, MD and 3 other Health Specialists are ready to help you
Customer: replied 4 years ago.

Hello Again Doc...

Well can't seem to shake this ... my doctor wants me to try "NutraEval” Genova diagnostics - to see what is going on that they haven't seen or caught. They take urine and blood samples

My prostate appears to have worsened, I have more urgency and several times didn't make it to bathroom in time. I see the Urologist at end of June. I am going to suggest he perform "turp" . He is quite capable . In meantime I have resorted to Mans diaper as a backup.

I have also decided to have my varicose veins done

He says it may cure my feeling of "heavy legs"

I am also doing Physical therapy for balance

Right now I feel OK not tired (today) My balance is out of whack

I think you may be right – Depression..

I can't seem to get myself to work. I am a realtor

Thanks for reading...


I wish that you were feeling better. It does sound complex with your different problems. I think that treating the depression would probably help you if this is not being treated now... I wonder with your trouble with balance if you may be becoming more symptomatic due to NPH. If balance worsens then this may be your cause. Follow up evaluation with your neurosurgeon may be needed. If the urinary troubles are due to hypertrophied prostate then the TURP procedure may help. ( I worry a bit here as NPH may also be a possible cause of incontinence though... )
Let me know if you have further questions and I will be happy to get back with you!
Best regards,
Anthony Bray MD
Customer: replied 4 years ago.

Dr Bray...

Thanks for your reply...

What would you do in my situation? ..delay Turp until discussing again with NS? If NS was not really sure he could have ordered a spinal tap..

Just thoughts I have..

Physical therapy is working on balance and remarked I have been improving.

I appreciate your input ..


Hello again,
I think that it may be worthwhile to discuss your symptoms further with the neurosurgeon--yes. In parts you seem to have conflicting reports with regard to the balance issue. It sounded to me that you were concerned with worsening but then you seem to indicate that it is improving with physical therapy??
I would agree that a spinal tap to remove some CSF would be temporary but I think it would be helpful diagnostically. If you improved following a tap then that would support you having symptoms due to NPH.
I would make sure that the urologist was aware of the NPH question. He may be able to differentiate between the neurological problem vs BPH but I would definitely make sure that the urologist knew of the neuro question before undergoing the TURP.
I hope this helps. Let me know if you have further questions. Take care,
Anthony Bray MD
Customer: replied 3 years ago.

Are you still there?

I have had TURP done afetr 3 rips to emergency room on our vacation.. all doctors suggetsed the Turp... legs with varicose veins...

Lastes is I may have Parkinson.. nuerolgist didn't want to see how I am doing by Nov. I talk no drugs for PD. Hand shakes a bit

Wanted to get your opinion - Allan Thanks

Hello again,
Yes I can see that Parkinson's disease would be considered in the differential diagnosis of some of your symptoms. Parkinson's may cause some resting tremor which is typically first noted in one hand . It may tend to make a person walk differently than they are accustomed to with slowed pace and having some difficulty with first standing and with making turns. It can affect swallowing, voice and handwriting....
So I agree from your history that Parkinson's may fit with some of the neurological symptoms.
I would remember to be pro-active a discuss follow up on the NPH question unless you were doing so much better than previously that this could make a comparison study unnecessary
I hope that you get good results from the TURP procedure..
I hope this is helpful! Let me know if you have further questions. Thank you and best regards,
Anthony Bray MD...