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I have been tired, with head aches, achy tender muscles,

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I have been tired...

I have been tired, with head aches, achy tender muscles, restless sleep (limb movement) ever since I can remember and no one can seem to help me figure out what’s wrong.

Doctor's Assistant: Is the headache episodic or daily? And what about nausea?

All of these symptoms are daily

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I have depression, but I don’t think that would cause me to be able to sleep for 72 hours straight

Submitted: 9 months ago.Category: Health
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Answered in 11 hours by:
10/20/2017
Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 9 months ago
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 38,746
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 9 months ago

What is your age and gender?

What are the investigations and treatment done?

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Customer reply replied 9 months ago
I’m a 42 year old female. I’ve had 2 sleep studies and I’ve been diagnosed with a slight case of sleep apnea. Other than that, nothing has really been done, other than blood work to rule out thyroid issues and Lyme disease.
Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 9 months ago

You may have fibromyalgia. Following investigations are advised (some are already done for you);

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) Sleep studies

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

The other possibility to look for can be restless leg syndrome (RLS) which can be concomitant.

Restless legs syndrome (RLS) is a common cause of sleep disruption. RLS can develop as a result of certain conditions or factors, particularly iron deficiency and peripheral neuropathy. Other causes are folate or magnesium deficiency, amyloidosis, diabetes mellitus, lumbosacral radiculopathy, or vitamin B-12 deficiency. The other causes to consider would be;

1) Neuropathy
2) Nocturnal leg cramps
3) Peripheral Vascular Disease
4) Radiculopathy

Following investigations are advised;

1) A complete iron panel including iron levels, ferritin, transferrin saturation, and total iron binding capacity.

2) BUN,

3) creatinine,

4) magnesium,

5) thyroid-stimulating hormone (TSH),

6) vitamin B-12, and folate.

Following measures would be helpful;

1) Avoidance of caffeine, alcohol, or nicotine (if take them).

2) Exercise before the bed time

3) Medications

a) Pramipexole (Mirapex)

b) Ropinirole hydrochloride (Requip)

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.

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Customer reply replied 9 months ago
Ok. Thank you for that information, but why am I so tired that I can actually sleep for 96+ hours straight, only getting up to use the bathroom & eat a bowl of cereal a few times?
Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 9 months ago

You are very welcome.

These investigations will be able to tell the reason for the persistent tiredness. Following causes need to be looked for;

Thyroid disease

Connective tissue diseases

Chronic anemia

Chronic infections like Epstein Barr virus

Endocrine diseases (Addison disease).

Chronic fatigue syndrome

Myasthenia Gravis.

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Health Professional: Dr. Arun Phophalia, Doctor (MD) replied 8 months ago

Just Answer is based on honor system. Experts are paid for time and expertise only when a positive rating is received.

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