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Doctors' Answers to "Frequently Asked Questions" - Fatigue

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Fatigue [posted 1/7/99]
Question:I have spent the last year and a half attempting to find a remedy for my chronic fatigue. I have just recently stopped taking Zoloft at 200 mg daily. The Zoloft was sought by me because of its energy related side effect, and in fact the Zoloft did a marvelous job at giving me the much desired energy. However, after 5 months, the positive effect abruptly vanished. So, I next decided to look into Desoxyn (the ADHD drug), which has been praised by CFS sufferers. Yet, prior to getting a prescription, my doctor suggested taking a testosterone test. Well, the testosterone level is indeed low, but I believe the low count is due to the serotonin (Zoloft) effect on the lateral hypothalamus, which has lowered sex drive and testosterone levels. I still believe Desoxyn is the better alternative. I am not interested in gaining energy at the risk of having any new gained energy directed primarily at libido.

Answer:If you get usual replacement doses and get a huge increase in energy what is the big deal. You have a documented problem that usually results in a huge increase in well being. A tip of the hat to your doctor for finding it, most wouldn't.

Chronic Fatigue
Question:My mother is on Lanoxin, Lasix, Insulin (regular), and Glucophage. She is experiencing alot of fatigue, so much that she naps 203 times each day, as well as sleeping 10-11 hours each night. Heot tysician wanted to add Prozac to the mix of her medications to see if that would lessen her fatigue. What are your thoughts on this? I'm a little worried for her to just add more medication to respond to a symptom of other medications. By her medication list, you can see that she has Type II diabetes, congestive heart failure, and probably COPD. She is a smoker (still).

Answer: I doubt that this amount of fatigue is related to depression. I would be absolutely certain that her basic disease processes are well controlled. That means that the glycosolated hemoglobin in her diabetes is 8-10 or better, her digoxin levels are not too high, and her blood counts and oxygen levels in her blood are ok. I would also get a chem-20 and thyroid functions and B12 level since these are common in diabetes mellitus and are easily fixed. If her physician has done these steps a trial of anti-depressant may be warranted;however, sleeping all day is not a common symptom of simple depression.

Yuppie Flu
Question:What is the proper medical term for the illness "Yuppie Flu"?

Answer: Chronic Fatigue Syndrome.

Morning Fatigue
Question: What is most commonly used to reduce morning fatigue?

Answer: Morning fatigue from the medicines or from the disease? There is no effective treatment for the fatigue associated with the disease since the primary sleep disorder is probably manifesting itself. If you can fix this problem many of the disease symptoms will diminish.

Chronic Fatigue
Question: Could I have some advice about what could be causing tiredness: when one feels generally tired, even extra walking and climbing is a chore? Could it be an anemic condition due to excessive menstrual flow? If it is this? Also, can iron be absorbed by the body readily?

Answer: Most young women who menstruate will experience iron deficiency. This can be manifested as anemia or merely low iron stores. Iron supplementation is the answer; but, there are problems. First, it is hard to absorb and usually causes nausea. Take the iron with Vitamin C on an empty stomach for best results; but, expect some nausea. Second is the constipation associated with iron. This can usually be reversed with milk of magnesia, or any magnesia containing antacid. A diet high in red meat will also help by supplying iron in the meat.

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