From time to time we come across people with complex symptom combinations looking for help in online health forums because they don't know where else to turn. To give you some insight into the diagnostic process that we frequently treat and the detail that is often involved, the following extract is a thread from one such forum.
Of course if you 'don't know where else to turn', and you are located in Brisbane or the surrounding areas, please contact us to discuss your symptoms or take advantage of our Free Comprehensive Health Assessment offer.
YEARS of FATIGUE, adrenal exhaustion, 26/f, constant napping and oversleeping HELP
Ok so … I've had some symptoms over the past few years and whenever I go to the doctor there never seems to be an explanation for much, so I appreciate any input because I am at a loss.
Lets start with the basics. I am a 26 year old non-smoking female. I do not drink alcohol, wine, or caffeine, with the exception of an alcoholic drink on my birthday.
From 12-15 I had anxiety-induced IBS symptoms. Had an upper GI exam done and they found nothing abnormal. These days I'm nausea frequently and can't eat a lot in one sitting or I will barf.
I developed moderate psoriasis at 15. Since 19 it has been very mild and does not interfere with my everyday life.
From 12-23 I had painful TMJ in my jaw - I finally had corrective jaw surgery at 23 and have had no jaw issues since.
At 23 I had mononucleosis (verified positive by blood test) and had it for about 2 months before I felt bad to normal.
But since age 19 I've have been EXTREMELY fatigued, always tired, joint and muscle pain, frequent anxiety, feel physically weak a lot of the time, nauseous, brain fog, poor concentration (I'm going on my 7th year of being in college, the past 5 years I've been a part time student and part time employee because I cannot mentally or physically keep up).
I need to sleep at least 8-9 hours a night and most days I end up taking a 3-4 hour nap. If I don't allow myself to nap I will get a headache. I've tried multiple anti-depressants, probably 10 by now and they did not help. I'm a healthy eater, have variety in my diet, drink sufficient water, and I'll treat myself once in a while. I'm physically fit compared to most and have only about 20% body fat. I do some weight training at home when I feel up for it but aerobic activity causes me stress that I give up after usually 5-10 minutes. From time to time my words are slurred, charley horse cramps in my calfs at night, and am VERY sensitive to cold, especially my legs, although we live in a warm climate. I had an ultrasound on my legs, no clots.
I have also been very susceptible to UTI's. In 2012 I had 6 UTI's averaging one every two months but in 2013 I had only one. My husband and I pee before and after sex and are always fresh and *clean* so hygiene is not an issue. Saw a urologist who did an ultrasound of my bladder: normal. And when it comes to alcohol or even wine, I feel toxic after just two drinks. Toxic, not even tipsy. I do not feel better after drinking water or eating.
The last time I had blood work one of the abnormal things found was my CRP level. My CRP levels came in at 10x the max risk at 32.9 mg/L indicating 'obvious source of infection or inflammation'. A few other things were borderline but the doc said everything is "normal". This blood test had been one year since I recovered from mono.
Another doctor noticed that I had deficient testosterone levels (for a female!), and said it could contribute to the fatigue but not necessarily. I used a LOW DOSE testosterone rx cream daily for 5 months which boosted my testosterone level to a normal female level (and I did NOT grow a mustache! lol). But I did not feel better. This doctor also checked my thyroid and said levels came back normal. He said I may have adrenal fatigue (saliva kit was slightly off) but did not order any other tests or treatment.
My life has gotten to a point where it's difficult to enjoy things because I do not have the energy to get much done. Yes my house is clean, and my homework gets done eventually, but I had to quit working just to focus on finishing school and because I can hardly get through a day without napping. It's gotten that ridiculous. My husband doesn't understand and my friends say that I'm just lazy … that really hurts me.
It's getting back to that time of the year when I go for a routine physical and blood work, and I don't know what to tell my doctor other than I still feel the same as I did 5 years ago. Exhausted. Tired. I'm over feeling awful all the time. I would like to ask for maybe some specific tests but I don't know where to start anymore.
Centenary Natural Therapies Clinics initial response was as follows:
My name is Peter Mills, and I am the owner and Head Therapist at Centenary Natural Therapies Clinic, Brisbane. We frequently see these types of cases, and I am well aware that your symptoms are genuine, despite what your doctor, your husband and your friends may think. Feeling “EXTREMELY fatigued, always tired, joint and muscle pain” are typical of some types of fibromyalgia. In our experience, almost all cases of fibromyalgia involve a chronic infection in the body, and this seems to be supported by your blood test which reveals an "obvious source of infection or inflammation" in your body. It is a bit like constantly having a really bad flu, where your body aches and you feel wiped out all the time. Your immune system is like a country’s defence force- when it is at war, all of the available resources, every man, every dollar, every piece of equipment it can spare, go into the defence force. Similarly, when your body is trying to deal with an invader, all of your resources and energy go into your immune system, which can leave you feeling exhausted constantly.
The most common source of constant infection in the body is the mononucleosis (Glandular Fever) virus; are you aware that once infected, the patient carries the virus for the rest of his or her life? In most people the immune system is able to contain the virus, but in others the virus and the immune system are in a constant state of war. However, since you started to experience the extreme fatigue at 19 and did not contract the mononucleosis until 23, the virus obviously hasn’t caused your condition, but it would still be contributing to it and making your fatigue and body aches worse.
The second most common cause of chronic infection is sinus infections. Probably about 50% of people who have sinus infections are not aware that they have them, as they are not producing enough mucous to cause the congestion in the sinuses that results in pain. The sinuses are like caves in the skull, so the body does not have good access into them, and the immune system can struggle to get rid of any infections there. It is like the viruses or bacteria are in a castle, and your own army can’t get in and destroy them, and so the two forces just keep skirmishing between each other the whole time, leaving you feeling totally drained. (Just as the immune system doesn’t have good access into the sinuses, so too antibiotics are usually not very effective against sinus infections.)
Diagnosing a chronic ‘background’ sinus infection requires a skilled therapist. Over time, the immune system usually becomes too run down to deal with the infection on its own. When the immune system is too low, some viral infections can spread to the connective tissues in different parts of the body, which can result in bladder irritation, digestive dysfunction or menstrual discomfort. It sounds like you certainly have the first two, and this lends further evidence to the sinuses being the source of the problem.
It is also important to clean out any infected phlegm sitting in the sinuses, otherwise the infection will keep recurring. Chemists often sell FESS Sinu-Cleanse kits, which can be used to rinse out the sinuses to help clear out any infected phlegm. We recommend a simple, slightly different method of doing this which we feel is more effective and is not unpleasant, so please get in touch with me if you would like me to teach you the technique.
Once the body becomes too run down, it will often resort to using adrenaline to keep you going. Typically, your body will say “I need to rest!”, and your mind will say “No, you need to keep going!”, so your body produces more adrenaline to give it a boost and some extra energy so you can function. The trouble is, continually running off adrenaline will burn you out and make the problem even worse, so it becomes a vicious cycle. You may like to read our article on Adrenal Fatigue and Chronic Fatigue Treatment for more information.
Yours is obviously an advanced condition, and in these cases we often find other organs in the body start to struggle due to the lack of energy in the whole system. For example, if your liver is struggling, you will often have symptoms of nausea and sensitivity to alcohol. You will also have higher levels of toxins in your body, which can cause headaches, brain fog, lack of mental clarity, and sometimes psoriasis. (Your liver can be affected by many things apart from alcohol, such as medications or stress.)
The sensitivity to cold is typical of someone who has a low immune system and whose energy levels are very low. (Some people also experience a sensitivity to drafts or breezes.) It also sounds as if your body is so exhausted that your circulation is starting to become affected.
As you live a long way away, I hope you can find a therapist near you that understands your condition and is able to help you with it.
All the best,
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