Long term undiagnosed symptoms

[slimjim28]

I've had undiagnosed symptoms for 4 months:

4 to 3.5 months ago - severe sore throat and cold symptoms
3.5 to 3 months ago - dizziness and fatigue
3 to 2 months ago - cold and flu symptoms
2 months ago to 1 month ago - nausea, dizziness, extreme fatigue, sinus blockages

Now I'm experiencing brain fog, some nausea, occasional tenderness near my spleen and liver, and extreme fatigue.  So much so that I have trouble even going to work.  I sleep for 9-12 hours a night and wake up tired.  I also have puffiness around my eyes (people say I look very tired all the time).

I've been tested for glandular fever/mononucleosis (had it before but not now - which I already knew), cytomegalovirus (no exposure), leukaemia (negative), pertussis (negative), legionnaires disease (negative), & mycoplasma (negative).

I had a full blood picture done and my liver/kidneys are all fine. Nothing was outside of normal levels.  The full results are too long to fit in the 2000 character limit.

I have had sinus and facial CT scans done but am waiting for results.  Some doctors believe I have a sinus infection.  I took amoxicillin, cefaclor and now doxycycline for this.

I did show signs of Vitamin D depletion (not deficient), and my B12 levels are low but within normal ranges (172 pmol/L).  I'm now taking supplements for both to try and raise the levels.

To make this more complicated, I am a recovering alcoholic and am on:

moclobemide - 300mg twice a day (300mg daily for the last 6 years, twice daily for the last 5 months)
esomeprazole - 50mg every second day (for 6 years - due to reflux problems.  Endoscopy in 2003 showed no other problems)
naltrexone - 50mg a day (started 5 months ago.  Stopped a week ago and it has resolved my nausea).

I stopped drinking 4.5 months ago.  I had a 1 week relapse 3 weeks ago but am sober now.

Do you have any suggestions for my doctor?  I'm tempted to think this might be chronic fatigue but am hoping not as the long term outlook for that is pretty grim.

[Kevin Pho, MD]

You have had a thorough evaluation, with would exclude many of the major causes for your symptoms.

I agree with the sinus imaging, and I would treat any facial or sinus infection with appropriate antibiotics.

I also agree with the thyroid and vitamin B12 testing, along with the tests for the various viruses.  If you are male, couldn't tell by your story, I would also add on a testosterone level.

At this time, allergy testing might be in order, as it can lead to the majority of symptoms you describe.  Asking your doctor for the appropriate referral will set this in motion.

Chronic fatigue is a vague diagnosis that should be considered if all the other diagnostic avenues have been exhausted.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.

KevinMD.com
Twitter.com/kevinmd

[hava]

This will relax you and with the extra oxygen flowing through the body, will help you improve your health gradually.You can do this and continue any medication.
The Yoga Pranayam (breathing exercises) will  help with your problems.
Build up your timing gradually. If you feel tired or dizzy, stop and resume after 1 minute.

Bhastrika - Take a long deep breath into the lungs(chest not tummy) via the nose and then completely breathe out through the nose. Duration upto 5 minutes.

Kapalbhati -(Do it before eating) Push air forcefully out through the nose about once per second. Stomach will itself go in(contract in). The breathing in(through the nose) will happen automatically. Establish a rhythm and do for 10 to 30 minutes twice a day. Not for pregnant women. Seriously ill people do it gently.

Anulom Vilom –
Close your right nostril with thumb and deep breath-in through left nostril  
then – close left nostril with two fingers and breath-out through right nostril  
then -keeping the left nostril closed  deep breath-in through right nostril
then - close your right nostril with thumb and breath-out through left nostril.
This is one cycle of anulom vilom.
Repeat this cycle for 15 to 30  minutes twice a day.
You can do this before breakfast/lunch/dinner or before bedtime or in bed.Remember to take deep long breaths into the lungs.You can do this while sitting on floor or chair or lying in bed.

Bhramri Pranayam -Close eyes. Close ears with thumb, index finger on forehead, and rest three fingers on base of nose touching eyes. Breathe in through nose. And now breathe out through nose while humming like a bee.
Duration : 5 to 12  times

[slimjim28]

Well just a follow up.  I found out that I was mistaken and my pertussis serology hadn't been returned.  I got the results an hour ago and I have tested positive for pertussis.  Funny thing is I haven't had a cough.  Apparently my sinus mucus layer is thickened (from the CT) so the theory is that I have pertussis in my sinus - and am going on clarithromycin starting tomorrow first thing.

[slimjim28]

Thanks for your help.  I am male so I will ask for a testosterone test to be done, and also for some allergy tests to be done.

Do you think my B12 is low enough to be causing the fatigue?  I'm taking 2mg a day at the moment in an effort to boost it up, but have only done so for a few days so am not expecting any results yet.

[slimjim28]

I forgot to mention that my throid was also tested, and is functioning normally.