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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35763
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Approximately 2-3 years ago I started complaining to my GP

Customer Question

Approximately 2-3 years ago I started complaining to my GP about always feeling fatigued. Was put on SSRI and told to slow down and take it easy. Last summer I had an episode of muscles jerking while sitting down. I have passed out approximately 5-6 times since I was a teenager the lastet one was this past Tuesday which ended up in an ER visit and home on a heart monitor for 30 days.... I'm a 39 year old Caucasian female who is definitely ,not pregnant, with a laundry list of symptoms that make me feel like I'm losing my mind! These symptoms include Fatigue, Muscle weakness (particularly in thighs), Headaches, Dizziness, Foggy (can't think straight), Startle easily, Joint aches, Numbness and tingling in face, hands and feet (sometimes), Heat intolerance, Excessive sweating, General ill feeling, Severe reflux, Occasional GI issues (diarrhea), Floaters (occasionally), Hair loss, Feel like I can't take a deep breath in (occasionally), Muscles jerk when I'm resting, Heart Palpitations, Chest tightness, activity intolerance, bradycardia, hypotension, depression (developed after dealing with these symptoms) ..... I've been telling my GP over these past 2 years without any answers. My thyroid panel was normal. No signs of vitamin deficiencies. Ect.... could you offer some insight to what could possibly be going on? The most debilitating symptom is the fatigue and weakness. I have trouble everday just taking part in daily activities. Even brushing my teeth is a major chore. Any thoughts on what might be the culprit?
JA: Do you know if your family has a history of heart disease? In general, how would you describe your health lately?
Customer: Father had a heart attack but it was mild and he dint need any stents. Both mom and dad take bp and cholesterol meds. That's about all I know
JA: Anything else in your medical history you think the doctor should know?
Customer: I was diagnosed last year with reactive arthritis with possible ankylos!ing spondylitis but it is still up for debate if that's really the problem
Submitted: 1 month ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 1 month ago.

Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

Customer: replied 1 month ago.
Thank you
Expert:  Dr. Arun Phophalia replied 1 month ago.

You symptoms are likely due to;

1) Autoimmune disease

2) Hormonal issue; adrenal function tests, parathyroid hormone assay are advised.

3) Fibromyalgia

4) Chronic fatigue syndrome.

Some of the investigations which are necessary to be repeated are;

1) Thyroid-stimulating hormone

2) 25-Hydroxy vitamin D level: Low levels can cause muscle pain and tenderness

3) Vitamin B-12 level: Very low levels can cause pain.

4) Iron studies including iron, total iron binding capacity, percent saturation, and serum ferritin

5) Magnesium: Low levels can lead to muscle spasms, which are common in fibromyalgia; magnesium supplementation can also improve symptoms in some fibromyalgia.

6) The erythrocyte sedimentation rate (ESR)

7) Antinuclear antibody (ANA)

8) Rheumatoid factor.

9) Serum electrolyte level measurement

10) Immunoglobulin M (IgM)/immunoglobulin G (IgG) coxsackievirus B titer

11) IgM/IgG human herpesvirus 6 (HHV-6) titer

12) IgM/IgG C pneumoniae titer

13) Autoimmune panel

14) Anemia panel.

15) Antipolymer antibody assay; present in approximately 50% of patients with fibromyalgia. This biologic marker may provide conclusive evidence for a subgroup with fibromyalgia.

16) Sleep studies.

These are likely to reveal the line of management.

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 month ago.

Was this information helpful to you? I would be glad to answer any further questions.

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