Has patient been misdiagnosed?

December 21, 2012 By

Q: I have had problems with joint pain and exhaustion all my life. I do have some structural problems in my hips which have lead to arthritis but I don’t have arthritis anywhere else in my body. I had two knee operations for dislocating knee caps when I was 15 and they don’t always feel great but don’t appear to have arthritis.

The pain can appear in any joint in my body. The same exertions do not cause a consistent amount of pain. The exhaustion can come and go at any time during the day without rhyme or reason. I have noticed that when I eat carbohydrates I can get sluggish and occasionally nauseous. I have been tested for rheumatoid arthritis but the result was (happily) negative.

I also have problems with lung inflammation that can result in bronchitis and pneumonia and have occasionally been sick for months on end and lost as much as 60 pounds while sick. [Read more…]

Filed Under: Daily Column, Leading Letter Tagged With: , ,

Should 98-year-old’s diet be restricted?

December 10, 2012 By

Q: My 98-year-old father was way ahead of the times as his diet as early as I can recall was heavy on fish and fruit and he never ate much red meat and shunned heavy, fatty foods. He walked miles a day, long before that was considered a worthy form of exercise. His serious health issues have been rare, only having required a heart valve replacement/repair at age 95. At this time he was also implanted with a Pacemaker. Since the surgery, he seems to have lost considerable ability to taste food. He can still taste salty and sweet but that’s about it. He uses copious amounts of hot sauce and cayenne pepper on just about anything he eats. This all seems to play into his lack of interest in food in general, including fruit. He has started snacking on junk food such as chips, cookies and iced cream significantly more than he ever used to. We make certain that he does eat a proper diet in addition to the junk food.
[Read more…]

Filed Under: Daily Column, Leading Letter Tagged With: , ,

Is CSV to blame?

October 30, 2012 By

Q: I am a middle-aged female. I recently went to my family doctor because I have been feeling run down, tired, and have been having trouble with my memory. My blood pressure has been running higher than normal and I have gained 40 pounds in just three to four months with no change in my diet. I have also suffered with migraines for many years which I was told were menstrual related.

My doctor ordered blood work and the results were that I had a high CSV level and my vitamin B12 level was too low. She sent me to a hematologist who started me on weekly B12 shots. He reran the blood tests and the results came back with a high CSV level but my B12 was back to normal. He said my symptoms were not CSV-related and referred me to an endocrinologist. That specialist said my thyroid level was in the normal range but started me on Synthroid.
[Read more…]

Filed Under: Daily Column, Leading Letter Tagged With: , ,

Is B12 deficiency cause of extreme fatigue?

February 11, 2011 By

DEAR DR. GOTT: For years, I thought I was suffering from narcolepsy. I can barely stay awake at work, and when I’m home, I do nothing but sleep. This has gotten progressively worse over the past three or four years. I just recently found out that my B12 level is at 149, and my primary-care physician thinks that is the cause of the hypersomnia. I’m getting B12 shots every other week for two months and then will get shots once a month. After three shots, I feel no better. I’m missing out on life because I’m just too tired to do anything.

Walgreens carries a sublingual B12 supplement, which I am tempted to take. Do you think it will help? Is there some other factor that could be causing me to feel this way? Any suggestions you can give me would be greatly appreciated.
[Read more…]

Filed Under: Daily Column Tagged With: , , , , ,

Can allergy cause sore throat, tiredness?

August 11, 2010 By

DEAR DR. GOTT: Last fall, I developed sporadic itching that turned into hives. After that, I felt ill with a sore throat, general weakness and fatigue after very little exercise. I read about a ragweed allergy and its relationship to certain foods. I eliminated them and feel better. Could these hives be related to allergies and food combinations? Is the sore throat and lethargy related to an allergy?

DEAR READER: Maybe. Ragweed allergy, commonly known as hay fever, presents with itchy eyes, scratchy throat, runny nose and fatigue but not generally hives. Food triggers include sunflower seeds, chamomile, cantaloupe, bananas and some honeys. [Read more…]

Filed Under: Daily Column Tagged With: , , , , ,

Post-polio syndrome nothing to brag about

July 4, 2010 By

DEAR DR. GOTT: I’m having a running feud with members of my family that I need cleared up.

In 1955, at the age of 2, I contracted polio. I was immediately put in isolation in a children’s hospital, where I remained for several weeks in casts and braces. My left leg was drastically crooked and atrophied in a short amount of time.

I have since overcome most of the setbacks, but in 1985, I was diagnosed with post-polio syndrome. It was like a recrippling and decay of all my energy. Since then, I have gotten progressively worse. I have educated myself by reading much material, visiting polio clinics and attending support groups, so I feel quite knowledgeable on the subject.
[Read more…]

Filed Under: Daily Column, Leading Letter Tagged With: , , , , , , ,

Treating hypogonadism

March 5, 2010 By

DEAR DR. GOTT: My husband has been fatigued for several months. He’s a little heavier than his ordinary weight and thought that was the cause, but when he went to his doctor, he was found through follow-up blood work to have a low testosterone level. What on earth is that all about? We’re concerned.

DEAR READER: Testosterone is a naturally occurring hormone that stimulates the growth of male characteristics. Testosterone levels normally decrease with age; therefore, it is somewhat difficult to determine a normal level. Generally speaking, the range of total testosterone is 300 to 1,000 mg/dL, with some variation noted between laboratories. [Read more…]

Filed Under: Daily Column, Leading Letter Tagged With: , , ,

Reader finds help for chronic fatigue

January 26, 2010 By

DEAR DR. GOTT: Some time ago, you received a letter from a 47-year-old female who was always tired. There was a section where she stated that following breakfast, she had to fight to keep from taking naps all day long. This was a “light bulb” moment that made me think she may have the same problem that I did.

I, too, had the same confusing symptoms and fought them for 11 years. My doctors and I looked at many possible causes, such as depression, endocrine disorders, sleep problems, fibromyalgia, vitamin deficiencies, diabetes and more. I had no energy, always felt as if I had a hangover and was unable to work or even complete simple tasks of daily living. I felt as though I were disabled.

My endocrine specialists wanted me to try the drug acarbose for what I thought was unrelated insulin resistance and low blood-sugar episodes. [Read more…]

Filed Under: Daily Column, Leading Letter Tagged With: ,

Daily Column

May 16, 2008 By

DEAR DR. GOTT:
I have not seen anything in your column about fatigue or lack of energy.

I am a 77-year-old male. Last year I was jogging but six months ago I had to stop because I just don’t have the “get up and go” that I used to have. My health checked out fine and the doctor gave me a booster shot of vitamin B12 but it didn’t help me at all. Others have told me that I need a daily vitamin. There are so many on the market today that I don’t know which brand or strength is best.

DEAR READER:
A daily multivitamin may be all you need. I recommend you use one of the better known brands which may be a little more expensive than other brands but often has better quality control. Centrum and One-A-Day should offer you both the quality and variety you need. You may wish to shop around to find the best price or comparable brands.

I also urge you to have a full physical exam including a review of any medications you are taking, as well as testing for anemia, diabetes, congestive heart failure, vitamin deficiencies and more. Fatigue is a common symptom of many disorders. Because yours came on suddenly, I worry about potentially serious causes.

If everything checks out normal, it is then time to look at your diet, lifestyle, exercise and sleep habits, and stressors. These can be benign causes of fatigue and fortunately, are easily correctable with minor changes such as a more balanced diet, increasing exercise and reducing stress.

Start by adding the daily multivitamin followed by an appointment with your primary care physician.

To give you related information, I am sending you a copy of my Health Report “Vitamins and Minerals”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Filed Under: Daily Column Tagged With: ,

Treat the cause, not the symptoms

February 20, 2008 By

DEAR DR. GOTT: My situation is a bit complex but I will try to make it as brief as possible.

In 1997 I was short of breath, had stress tests and a heart catheter which indicated an 80% blockage in one artery and 50% in the other two. In the artery blocked 80%, I had angioplasty and a stent put in. Relief was immediate.

I felt fine until recently. I have arthritis and attributed the pain my left shoulder and upper arm to that. It started approximately two or three months ago. About three weeks ago I experienced extreme shortness of breath, weakness and fatigue. At the hospital I was diagnosed with blood clots in both my lungs associated with a low INR. I was in the hospital for six days on a course of Coumadin and shots of Lovinox. I was discharged when my INR reached 2.1. I take 10 mg Coumadin daily and felt fine for about a week. Then back to the ER with shortness of breath. Tests showed no clots but my INR had fallen to 1.7. I then consulted with my heart doctor and he ordered another stress test. Again everything was fine.

This leaves me in a dilemma. Chest X-rays and CT scans show nothing relative to the lungs and the stress test shows nothing relative to the heart. However, I still continue to be extremely short of breath, fatigued and weak. As far as I know, I was never diagnosed with asthma or emphysema. I used to be a heavy smoker (2 packs per day), but I stopped more than 12 years ago.

Please give me your expert thoughts on this. Should I opt for a second opinion at a place like the Mayo or Cleveland Clinics?

DEAR READER: Yours is a complicated ailment. For example, why did you develop blood clots in your lungs? Could this be a symptom related to a primary lung disorder or a clotting disorder?

Based on the information you gave, I am fairly confident you have a clotting disorder. Your INR (International Normalized Ratio, higher numbers mean less clotting ability, lower numbers mean more clotting ability) is abnormal despite treatment with an anti-coagulant. I recommend you make an appointment with a blood disorder specialist (hematologist). Bring your lab work and test results with you to the appointment. This will provide background information and aid the specialist in his diagnosis. He or she may choose to order more specific tests. If this specialist doesn’t find anything abnormal, I believe that a visit to a top-notch medical facility is entirely appropriate.

You need to know why you developed blood clots and why your INR is consistently low. In other words, your doctors may be treating your symptoms instead of searching for the cause. This needs to be remedied. Let me know how this turns out.

To give you related information, I am sending you a copy of my Health Report “Blood — Donations and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Filed Under: Daily Column Tagged With: , ,
Next Page»