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.
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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...]

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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.
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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...]

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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...]

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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.

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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.

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Not a bright morning when you’re still tired

January 29, 2008 By

DEAR DR. GOTT: In recent years I have been experiencing quite severe fatigue in the morning. It happens almost every day shortly after showering. I have occasionally thought it may be the shower water is too warm, but I don’t take hot showers. During the warmer months I take lukewarm to cool showers. Still, shortly afterwards, I am overcome with the same almost overwhelming fatigue, to the degree that I feel I could lie down and sleep several hours.

I’m 61 years old, retired six years and in fairly good health. My blood pressure is very good, usually in the 120-135 over 70-80 range. I have no heart problems whatsoever. I’ve never had any problems with my internal organs, no cancers and no allergies (except to horse dander, so we don’t have one). I have a mild hiatal hernia and take medication for it. I have prostatitis that comes and goes. I take Ditropan when it acts up. I seem to be immune to colds and the flu. It has been about 5 years since my last cold. I am a light smoker. It makes me slightly drowsy so I only smoke when I want to nap and before bedtime. I drink two glasses of wine a day. I am 5 feet 9 inches tall and weigh 160 pounds. I am not a diabetic. I am an above knee amputee.

My cholesterol is normal. My wife and I eat a healthful diet of lean meats and lots of vegetables. We have fish 2-3 times per week on average, year round. Being Atlantic Canadians, we love fish. We don’t go to fast food places and don’t eat or keep junk food in our house.

As for symptoms of my fatigue, I generally get a goodnight’s sleep. At times I do have a problem falling asleep but not very often.

My family doctor thought my fatigue could be due to sleep apnea and I wore a monitor for one night. It was negative. Because my general health is probably better than the average senior citizen he sees daily, he didn’t seem too concerned or suggest anything further.

This daily fatigue usually lasts about an hour; however, some days it can last several hours. It doesn’t seem normal to me. I’m becoming more and more concerned that something is amiss. What should I do?

DEAR READER: Periods of unexplained exhaustion can be caused by many disease states, so before advising you regarding invasive studies, I suggest that you have a thorough exam by your doctor, followed by a full panel of blood tests, including a complete blood count, metabolic profile, thyroid study and cardiogram. This is a good first step and sets up a basic start point for future tests.

To give you related information, I am sending you a copy of my Health Report “Sleep/Wake Disorders”. Other readers who would like a copy should send a self-addressed 4 ¼” X 9 ½” letter-sized stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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