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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 34998
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I fainted when I was 12 weeks pregnant, Sept 2012. Since

Customer Question

Hi I fainted when I was 12 weeks pregnant , Sept 2012. Since then I have felt constantly spaced out, tired , not myself. All doctors have said over the past 3 yrs is that it's anxiety. Im not ruling it out but I don't think it is anxiety as to me anxiety is lots of thoughts, over thinking etc which then cause physical symptoms .I have no thoughts - just the physical side. It's really affecting my life and my role as a parent
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 1 year ago.


I am Dr. Arun and will be helping you today.

I am sorry that your question was unanswered for long.

What are the investigations done, in this duration?

What are the specialists you have consulted?

Customer: replied 1 year ago.
I have only been to GP and all they have said is that it's anxiety
Expert:  Dr. Arun Phophalia replied 1 year ago.


Your symptoms can be chronic fatigue syndrome. It is manifested as following;

1) state of chronic fatigue that persists for more than 6 months,

2) no clear cause, and

3) accompanied varied intensity of cognitive difficulties.

You may discuss this with your doctor. Meanwhile following investigations should be done if not already performed:

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

12) MRI of the brain

13 EBV virus

14) Comprehensive metabolic panel

15) Sleep studies in a sleep clinic.

The other diagnostic considerations would be;

a) Chronic anemia

b) Thyroid issue

c) Adrenal problem (Addison disease)

d) Sleep apnea

e) Anxiety.

All these can be concomitant to chronic fatigue syndrome.

Any chronic physical disorder will cause mental symptoms like anxiety. In long term these may intermingle too much and physical issues may be masked, causing difficulty for clinician to diagnose and on surface only anxiety may be perceived.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  Dr. Arun Phophalia replied 1 year ago.

The other diagnostic consideration by your physician would be fibromyalgia. 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.

Laboratory studies and investigative work up mentioned above are done to help rule out diseases with similar manifestations and to assist in diagnosis of certain inflammatory diseases that frequently coexist with fibromyalgia.

If fibromyalgia, lupus, sleep disorders etc can be ruled out; consideration would be;

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.

A consultation with either a rheumatologist or a clinical immunologist would be prudent for an evaluation.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

Please consider a positive rating if this interaction has been satisfactory, as this is the only way we experts are credited and compensated for the time and work. You are not charged again for giving a rating.

Thank you.

Wishing you all the very best in life.

Customer: replied 1 year ago.
Thank you I will book an appt with my GP and discuss all this with them. Hopefully an answer will be found
Expert:  Dr. Arun Phophalia replied 1 year ago.

You are very welcome.

Let me know how it goes and please do not forget to rate the interaction.

Thank you.

Expert:  Dr. Arun Phophalia replied 1 year ago.

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited for my work.

Now, I will provide an Additional Service offer so that you have this option available on your question list to get a hold of me directly in the future.

This additional service offer can be used for

- if you would like to schedule a new, private email session or to ask me directly a new question. It's up to you.

Thank you.

Customer: replied 1 year ago.
I will rate once I have been to GP and updated you with what they have said based on the info you have said to me. Thank you
Expert:  Dr. Arun Phophalia replied 1 year ago.



My best,

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