[templelane]

I am so tired all of the time, I can’t seem to cope with working. I come home and I just want to go to sleep straight away. If it wasn’t for my boyfriend I doubt I would manage to even eat dinner. Sometimes I just cry myself to sleep I’m so physically exhausted.

When I’m on my course full time I get to take naps two or three times a day which helps – but obviously this isn’t an option now.

I really don’t know what to do. I eat a really good diet I think (loads of fruit and veg, lean meat and wholegrain bread ect) and drink mostly water. I also walk a lot and my job involves me being on my feet all day – so if it wasn’t for the excessive tiredness I would say I was rather fit. I did have to give up running/ going to the gym as I don’t have the energy anymore.

I have had my blood counted and I’m not anaemic. I've been to the doctor but I think (due to the time of year) he thought I was looking for a note to get out of exams because he was less than useless. I’m completely stumped as to what to do, but I can't continue like this much longer – any possible suggestions are more than welcome. I hope somebody can help. :(

Thanks in advance TL

[J_9]

Before I go on, does this happen all the time or only certain times of year?

I am also wondering if you have been checked for Chronic Fatigue Syndrome

[templelane]

It is all the time so I don't think it is SAD. Yeah I have thought about CFS before and I have a ex-flatmate who used to suffer from it. I'm not sure it is as severe as some of the cases I have read about/ she could be.

If it is that how could I go about getting a diaganosis/ confirming or disproving the theory? I'm in the UK so I have the great NHS to contend with. Getting appropriate treatment is like getting blood out of a stone. Should I make a record of symptoms? How should I approach this with my doctor ( who seems to take personal insult with you asking for the tests you want.)

[J_9]

Okay, I wasn't sure if you considered SAD or not.

I don't know too much about the UK health system, but can you get another doctor?

I am going to C&P some things here from that website I gave you that may help.

Diagnostic Criteria

Your clinician should consider a diagnosis of CFS if these two criteria are met:

1. Unexplained, persistent fatigue that's not due to ongoing exertion, isn't substantially relieved by rest, is of new onset (not lifelong) and results in a significant rEducation in previous levels of activity.
2. Four or more of the following symptoms are present for six months or more:
* Impaired memory or concentration
* Postexertional malaise (extreme, prolonged exhaustion and sickness following physical or mental activity)
* Unrefreshing sleep
* Muscle pain
* Multijoint pain without swelling or redness
* Headaches of a new type or severity
* Sore throat that's frequent or recurring
* Tender cervical or axillary lymph nodes

Exclusionary Conditions

Chronic fatigue syndrome can resemble many other illnesses, including mononucleosis, chronic Lyme disease, lupus, multiple sclerosis, fibromyalgia, primary sleep disorders, severe obesity and major depressive disorders. Medications can also cause side effects that mimic the symptoms of CFS.

Because CFS can resemble many other disorders, it's important not to self-diagnose CFS. It's not uncommon for people to mistakenly assume they have chronic fatigue syndrome when they have another illness that needs to be treated. If you have CFS symptoms, consult a health care professional to determine if any other conditions are responsible for your symptoms. A CFS diagnosis can be made only after other conditions have been excluded.

It's also important not to delay seeking a diagnosis and medical care. CDC research suggests that early diagnosis and treatment of CFS can increase the likelihood of improvement.

As well as:

How Physicians Diagnose CFS

If a patient has had 6 or more consecutive months of severe fatigue that is reported to be unrelieved by sufficient bed rest and that is accompanied by nonspecific symptoms, including flu-like symptoms, generalized pain, and memory problems, the physician should further investigate the possibility that the patient may have CFS. The first step in this investigation is obtaining a detailed medical history and performing a complete physical examination of the patient. Initial testing should include a mental status examination, which ordinarily will involve a short discussion in the office or a brief oral test. A standard series of laboratory tests of the patient's blood and urine should be performed to help the physician identify other possible causes of illness. If test results suggest an alternative explanation for the patient's symptoms, additional tests may be performed to confirm that possibility. If no cause for the symptoms is identified, the physician may render a diagnosis of CFS if the other conditions of the case definition are met (see What Is CFS?). A diagnosis of insufficient fatigue could be made if a patient has been fatigued for 6 months or more, but does not meet the symptom criteria for CFS.

And a little bit more:

Appropriate Tests for Routine Diagnosis of CFS

While the number and type of tests performed may vary from physician to physician, the following tests constitute a typical standard battery to exclude other causes of fatiguing illness: alanine aminotransferase (ALT), albumin, alkaline phosphatase (ALP), blood urea nitrogen (BUN), calcium, complete blood count, creatinine, electrolytes, erythrocyte sedimentation rate (ESR), globulin, glucose, phosphorus, thyroid stimulating hormone (TSH), total protein, transferrin saturation, and urinalysis. Further testing may be required to confirm a diagnosis for illness other than CFS. For example, if a patient has low levels of serum albumin together with an above-normal result for the blood urea nitrogen test, kidney disease would be suspected. The physician may choose to repeat the relevant tests and possibly add new ones aimed specifically at diagnosing kidney disease. If autoimmune disease is suspected on the basis of initial testing and physical examination, the physician may request additional tests, such as for antinuclear antibodies.

Psychological/Neuropsychological Testing

In some individuals it may be beneficial to assess the impact of fatiguing illness on certain cognitive or reasoning skills, e.g. concentration, memory, and organization. This may be particularly relevant in children and adolescents, where academic attendance, performance, and specific educational needs should be addressed. Personality assessment may assist in determining coping abilities and whether there is a co-existing affective disorder requiring treatment.

Theoretical and Experimental Tests

A number of tests, some of which are offered commercially, have no demonstrated value for the diagnosis of CFS. These tests should not be performed unless required for diagnosis of a suspected exclusionary condition (e.g. MRI to rule out suspected multiple sclerosis) or unless they are part of a scientific study. In the latter case, written informed consent of the patient is required. No diagnostic tests for infectious agents, such as Epstein-Barr virus, enteroviruses, retroviruses, human herpesvirus 6, Candida albicans, and Mycoplasma incognita, are diagnostic for CFS and as such should not be used (except to identify an illness that would exclude a CFS diagnosis, such as mononucleosis). In addition, no immunologic tests, including cell profiling tests such as measurements of natural killer cell (NK) number or function, cytokine tests (e.g. interleukin-1, interleukin-6, or interferon), or cell marker tests (e.g. CD25 or CD16), have ever been shown to have value for diagnosing CFS. Other tests that must be regarded as experimental for making the diagnosis of CFS include the tilt table test for NMH, and imaging techniques such as MRI, PET-scan, or SPECT-scan. Reports of a pathway marker for CFS as well as a urine marker for CFS are undergoing further study; however, neither is considered useful for diagnosis at this time.

[templelane]

Thanks J_9 I managed to change my doctor (my mother came up with the cunning idea of asking for a femal one) Unfortunately haven't got round to finding out why I get so tired as I came down with labyrinthitus so can't look into that until this clears up. You really help me find the courage of my convictions. If that makes sense...

Thanks again for the help - sometimes you just don't trust your own thoughts - I feel like a complete hyperchondriac half the time - especially when people insist I'll be fine if I just get up and get going. Ah if only it were that easy!

[J_9]

I am happy to hear you were able to change doctors!! That is great news.

Now, something that I have been wondering too, is it possible that you may have depression? That can cause these symptoms also.

And getting up and getting going is NOT always possible. I hate it when people say that.

[findmeapassword]

Dear templelane your sympthoms sound as if you are suffering from a bit of depression. And changing your doc to one that you might be more willing to open up to is a good move.Let me make it clear that suggesting depression is not a lable nor a put-down. It is an extreamly common condition that can be very easly treated with counciling and/or meds. Your doc will suggest the best option for you and above all don't be afraid to accecpt help or even if it's to confide in a friend don't feel that you are on your own this is my first time answering a question hope its OK

[Xrayman]

Mm depression more likely, however CFS may be the reason. You could ask for a small time on an "upper' from your new doctor, to rule out CFS, as it will not respond to medication such as this. If your mood does not change with medication then id lean towards CFS-perhaps the job/environment you work in is also affecting you-again this is a symptom of stress/depression-work related.

Cheers

P.S. another thought is that if you were excersising too much (athletes sometimes are diagnosed with CFS) then you could bring on the symptoms of CFS-I'm glad you gave the exercise away for a while-at least until you are better.

[inthebox]

templelane:

Cfs is a diagnosis of exclusion - post 4 has good details -

Things to consider and / or rule out include :
Depression
Hypothyroidism
Diabetes
Chronic Hepatitis
Medication side effect [ for example - some cholesterol medications ]
A variety of autoimmune or collagen vascular disorders such as rheumatoid arthritis
Congestive heart failure

etc..

You do not give your age or gender so the possibilities are enormous.


Hope you get to the bottom of this and feel better




Grace and Peace

[templelane]

Hi thank you inthebox that is a very good set of info there.

I'm in my early twenties and female, I don't smoke or take recreational drugs, I am a moderate drinker. I have had my cholesterol tested recently in was low . I doubt it is hypothyroidism unless you can have it without the weight gain - although I do get extremely cold (turn blue, shake violently). I'm on no mediaction except the contraceptive pill and the stemitil (prochlorperazine) for the labrynthitis (only recently though- started way before it)

Hmm hope its not some of the others on the list! I'm going to the doctor again soon. Can't really test for anything until this inner ear nonsense is sorted. It's getting worse :(

Thanks for the feedback- it is interesting to hear some other possibilities.

[pompano]

My friend had the same problem.She had bloodwork to check for the presence of two certain viruses,and both came back positive.Epstein barr virus and cytomegalovirus.Both are non-curable,and no one has been able to help with the symptoms.If you ever had mono you more than likely have epstien barr,so go have more blood work.The other virus is affecting her liver,and is contagous via saliva or bodily fluids.

[Cinnabar]

Put a sleep disorder such as narcolepsy or sleep apnea high on your list. Consider having a sleep study done.

[amolson]

Oh dear, you have a lot of different conditions that are being thrown at you and I am sure you are just realing with confusion. However, chronic fatigue is a common symptom of a lot of conditions. I have a liver disease and I dealth with fatigue for many years. I have since had a transplant and am feeling much better. I think the best thing for you to do is once your labrynthitis is gone, get some blood work done on everything. Check your liver enzyme levels, your kidney functions, etc. If your skin has a yellowish tinge to it, then you may want to consider more along the lines of liver inflammation.

Definitely don't get worried about any of it until you hear from your doctor. This could be something, or nothing at all.

[billyjean]

Get a test kit from the Igenex lab. And be tested for lyme disease. Their number is 800-832-3200. Order tests number 188 and 189.
They will send you the kit free but it costs around 200.00 to be tested.
How long have you been tired? Do you hurt any where?
Do a search for lyme disease on the web and read about it.
Here is a good site: Lymnet

[templelane]

Hi billyjean, I don't think I have lymes disease as I don't live/ or have ever been anywhere with the ticks carrying it. Thanks for the suggestion though. I have been tired most of my life, I remember collaspsing at the top of stairts when I was eight/nine a lot. I went to the doc then - couple of blood tests then sent away - it's why I don't have much faith in them.

Thanks everyone this has really open my eyes and given me some confidence to go see my doc (always worried they will think I'm making it up). Should go soon, just want to make sure the virus is out of my system so that any blood work cannot be dismissed as post viral.