Question
Hi Dr Durnin,

A bit of a long letter I'm sorry...

I am a 32yr old female with ongoing problems with fatigue and more recently (in the past year) severe joint pain and stiffness in the mornings particularly in my fingers.

I have always suffered fatigue but lately it seems much worse.  I can only manage to work part-time and find I 'ration' my energy just to get the things I need to do done.

I do have diagnosed Hashimoto's thyroiditis which is treated with 125mc thyroxine per day and my t4 levels have tested as fine.  

I have been to doctors about it some time ago but am frustrated because when I disclose that I suffer from anxiety then my symptoms are immediately attributed to this.  

In the past 18 months I have worked very hard with cognitive behavioral therapy to make sure I'm in tip top mental condition.  I'm frustrated that I'm feeling so good mentally and so bad physically yet the physical seems to be passed off as 'all in my head'.  I don't know if I'm being unreasonable to think that if my physical symptoms can be caused by anxiety then if i'm less anxious, shouldn't the physical symptoms lessen?

I'm doing my best to accept that maybe this is 'just me' but I thought I might have one last go at finding an answer because the joint pain seems to me less likely to be stress related.

My symptoms in order of severity are these:

Extreme fatigue, joint pain  and stiffness all over but particularly in my hands and particularly worse in the morning, a deep ache in my chest originally attributed in June as coxsackie virus but still hurting a lot even now, short term memory loss, heart palpitations/racing heart particularly after eating sugar, nerve sensation on my legs like warm water or burning, no sense of smell, hair loss/breakage (it's in terrible condition) and a few other minor things which might or might not be related.

Could this all be stress or should I be rationing some of my energy toward finding a physical cause? I can't even go one day without taking ibuprofen which can't be good for me.  I take a B complex vitamin and magnesium evey day.

Thanks in advance for your help.

Anne.

Answer
Hi Anne,

This may be multiple things including food allergies, Rubella Vaccine anaphylaxis, auto-immune disease and a dozen other things. You need to see an Internist in person and get comprehensive blood work including an ANA, IgG and IgA allergy panel testing, mold testing and a whole host of other diagnostics. These symptoms have no business being diagnosed accurately online. Get a referral to an Infectious disease specialist AND an Internal Medicine doctor before things get irreparable. I could help if you live near Chicago, but I'm afraid you probably don't. None-the-less, get second opinions from someone other than a GP and your endocrinologist, this is a matter for an Internist.


Good Luck!

Dr. Timothy Durnin

Update:

An "Interest" is not an "intern", an Internist is a full fledged MD that specializes in diagnosing difficult diseases, not to be confused with a student MD.