Feeling tired with body aches and pain

[Jobo]

For the last 2-3 months I've been suffering from fatigue and my body aches all the time,especially legs and back.

I have little strength in my legs now.

Prior to this I went to the gym for a pretty solid workout 3 days a week and rode my bike once or twice a week.

I was very fit and healthy for a 60 year old, with lots of energy.

Now exactly the opposite is the case. I'm sleeping 8 -9 hours a night and still wake up feeling tired.

I started taking Thai lessons at about the same time these symptoms started to appear. Am I getting stressed from that?

I've had lot's of blood tests in that time and the conclusion is that I have a low level of Vitamin D. The level is/was 25 ng/ml. The absolute minimum should be 30 but 50 is better!

I'm on 30,000 i/u of Vitamin D3 a week for the past 2 weeks but nothing has changed - yet.

Could low Vitamin D possibly be the cause of the pain and weakness in my muscles and the fatigue?

Any help/advice appreciated before I seek alternative/further medical advice.

[tim armstrong]

Review your diet and the blood pressure. Same thing happened to me a few years ago. Change of diet - more protein, less carbs, and less food helped a lot. If you have a balanced healthy diet the vitamin thing will take care of itself. But High BP also makes you tired. What about alcohol ? - try an alcohol free month - if you can. Reduce coffee - those good tasting 3 in 1 sachets have about 65% sugar. Drink a lot of water and green tea. Worry less - life is still good.

[Jobo]

Thanks Tim. Don't have a BP or weight problem.

Don't drink much alcohol or added sugar in anything.

I have a balanced diet and drink lots of water.

So doing everything you say.

[Sheryl]

No, low Vit D will not do that, though it will increase your susceptibility to infections.

I suggest you get a basic physical exam and include in it the following additional blood tests:

B12 level

thyroid panel (TSH, T3, T4)

Testosterone level (assuming you are male)

sedimentation rate (ESR - add on to the CBC) (indicates if there is an inflammatory process somewhere)

rheumatoid factor (check for rheumatoid arthritis)

ANA (check for lupus)

C reactive protein (indicates if there is an inflammatory process somewhere)

Between them and the basic check up package will cover most causes.

I would also suggest yo ustart taking a high potency Vitamin B complex supplement.

If all the above tests come back negative and B Co doesn't help, and your legs are really weak then better see a neurologist. Or, if it is more a matter of fatigue, a specialist in sleep medicine to rule out sleep apnea which would leave yo ufeeling tired despite adequate time in bed.

[Jobo]

Thank you Sheryl,

Have done the ANA,B12, ESR,rheumatoid factor tests and testosterone - all normal.

I have had 2 thyroid function tests - TSH and FT4 - both normal.

The only one not done is the C reactive protein. Having some more tests next week so will include that.

Would you still suggest taking a B Complex supplement even though my B12 level was ok?

And waht might be a neurological problem?

[Sheryl]

If your legs are truly weak, have to rule out things like multiple sclerosis. It really dep3ends on just how weak/lacking strength they are.

I would go ahead with the BComplex as it contains many more b vits than just 12. Can't hurt, may help.

As your have already had pretty comprehensive blood work, all normal, looks like this comes down to:

- sleep disorder

- neuro problem

-chronic fatigue syndrome

[Jobo]

Thanks once again Sheryl.

This is all new to me.

Will explore those last 3 possibilities with the GP.

And of course find some B Complex vitamins.

[tim armstrong]

What else is going on in your life ? Do you have any life problems that might be contributing to your health issues ?

[CharlieH]

Worrying about something ? Fatigue, sleeping more etc are signs of depression, how is your stomach ?

[Jobo]

I may well have some form of anxiety/depression but that's only my own impression. Not been diagnosed yet.

In June this year my ex wife remarried and moved to America with my/our son. I am sure missing my son is causing me some mental issues which I've never had before.

However while it may be that this may be contributing to fatigue/over sleeping, the pain and weakness in my legs and back don't appear related to that.

A friend who has been treated for depression for years and who thought this may be what I've got has seen this pain first hand and thinks it's not related to

depression - at least not how his symptoms manifest.

So it may well be CFS or a neurological problem as Sheryl suggested.

No stomach problems btw!

[Sheryl]

Could you describe the leg pain and weakness a bit? I am wondering if it could be a problem in the lower spine.

Anything that is interfereing with the quality of your sleep would account for the fatigue, as might stress.

[angsila]

What was your blood calcium level? The normal range for your age group should be in the 9's.

[Jobo]

Could you describe the leg pain and weakness a bit? I am wondering if it could be a problem in the lower spine.

Anything that is interfereing with the quality of your sleep would account for the fatigue, as might stress.

Sheryl,

In fact I'm making an appointment with a chiropractor today to look at my back as I thought this too. Just for an opinion for now.

Very difficult to describe the pain in my legs. But it does cause me to have to lie down and take some paracetamol. Only lying down seems to relieve the pain - with the paracetamol of course.

However when standing up often it feels as if my legs are going to collapse from under me. This seems to be coming from the hips/pelvis area. This occurs at times whether I am experiencing pain or not.

BTW the pain is not always present nor is the fatigue. They just seem to appear at any time of the day but normally early to late afternoon.

Often even without pain I can't sit on the couch for any length of time as it becomes uncomfortable and have to put my legs up or lie down while watching TV.

As for my calcium levels that is fine.

My GP currently has me on a Vitamin B complex and anti-inflammatory drugs for 10 days and will review again then. So far (3 days) seems to be improving but I'll wait the 10 days to be sure.

[Madgee]

This might sound a little silly but check your mattress!

A few years ago I had similar symptoms and on the advice of a family friend practitioner I changed my mattress to a good quality orthopaedic one. Within a few days my aches and pains were gone and I woke up feeling refreshed.

Just a thought.

[Sheryl]

Might be wise to see an orthopedic surgeon specializing in spine. And to do so before allowing any manipulations to it.

If you are in Bkk, Dr. Wichian at BNH is tops.

[angsila]

The reason I asked you about your calcium was that if it was above 10.1 your symptoms would be consistent with a hyperparathyroid problem.

[Jobo]

Might be wise to see an orthopedic surgeon specializing in spine. And to do so before allowing any manipulations to it.

If you are in Bkk, Dr. Wichian at BNH is tops.

That was the next step proposed by my GP.

I'm in Chiang Mai. Any recommendations here?

[Sheryl]

Try:

Dr Sudhee Sudasna
Clinic:38/4 Chiang Mai - Lampang Road.
Mon , Tues, Thurs 1700 - 2000 hrs
Su: 0930 - 1200 hrs
Phone: 053 - 214 139

or

Dr. Paiboon Wongcharoen

Chiang Mai Ram Hospital

http://www.chiangmairam.com/NEW%20CMR/Physician%20Eng/Bone%20and%20Jionts%20Clinic%20Eng%20.html

[tim armstrong]

Maybe a bit out of left field, but what about dengue fever ? Do you have flu like symptoms ?

[Sheryl]

It's off 2-3 months duration so acute dengue is out.

Dengue always presents with fever -- usually high fever with chills. If something like that preceded this fatigue, then it could indeed be related, but no mention of it in the post.

[Jobo]

Not Dengue as had no fever and chills or rashes.

Dr Suthee has retired I believe though will see if his practice is still open. Was being run by his younger wife at one point.

As for Dr Paiboon he did my knee years ago and could not recommend him.

Is any orthopaedic surgeon ok for a consultation or should it be one specialising in spinal issues?

[Sheryl]

You want one specializing in spine.

I was of the impression that Dr. Suthee still works privately even though retired from govt.

If not, go to SriPat and ask for an acharn specializing in spinal issues.

[Jobo]

OK so here's the latest.

Had my back x rayed and the orthopaedic surgeon spots a collapsed disc in L5.

His conclusion is that this must be pressing on a nerve hence the pain in my legs. However is it not the case that this would produce a sharp pain in the lower back and in the back of my leg/s?

He seemed to ignore my explanation that I also occasionally get get what feels like an electric shock on either side of the groin area which effectively "takes out my legs from under me."

Just gave me some muscle relaxant,musculoskeletal pain relief and a tube of counterpain. He also suggested physiotherapy and traction.

My pain/aching is in the front of my legs so doesn't that rule out a L5 problem? It's more than likely that collapsed disc has been there for a long time.

The chiropactor suggested it was a L3 problem.

Still no final realistic diagnosis and still the symptoms persist.

Any more suggestions welcome.

[Sheryl]

Best I can offer is to come to Bkk and see Dr. Wicharn at the BNH Spine Center. He is the best spinal specialist in the country. If there is any question as to what is causing the pain, they have the capacity to do nerve tests to find out specifically what nerve pathways are involved.

[Jobo]

Thanks Sheryl,

Have you ruled out a possible neuro problem?

Could you give me the phone number for Dr Wicharn and address of BNH?

Thanks

John

[Sheryl]

No, cannot rule out neuro problem and if Dr. Wicharn does not feel that your spinal issues account for the pain and clinical findings a neurologost would be next stop.

http://www.bnhhospital.com/en/medical_services/detail/Spine-Centre for Spine Ctr contact info

http://www.bnhhospital.com/en/find_doctor Dr. Wicharn's bio and hours

You can make appointment by phone or online