Extreme Fatigue in a 26 y/o Female

prmenrs, RN · Apr 20, 2005

Encourage her to be persistent w/the doc; if he won't listen to her, call her insurance company for a new provider.

It occurs to me that poor Terry Shciavo (sp) had a heart problem in her 20's. (and please, let's not hijack the thread about that issue)

It is very not normal to be as tired as you describe, even w. 3 little kids. Are you living close enough to spend some time helping her? Can you go to the doc w/her?

Good luck!!

ARNPsomeday · Apr 20, 2005

Dear June55baby,

I'm just a student, and don't presume to know anything. It's just that this sounds familiar. I had hepatitis A twice! Have any blood tests for liver enzymes been done? It's just a hunch. How about her white blood cells? A differential count might provide a first idea of which way to go. Best wishes for your family.

maolin · Apr 21, 2005

I don't know what's going on w/ your daughter, but I'd stay proactive w/ the docs and get to the bottom of this.

One thing that sticks out in your description is the weight loss w/ hypothyroid. I'm still learning this stuff (nursing student), but if I recall, that doesn't fit - I thought hypothyroid pts had a tendency to put on weight (unless she's getting too much Synthroid, but then I would think she shouldn't be so tired).

Best wishes for your daughter - keep us posted on things.

Nurse831 · Apr 21, 2005

Hi, I don't know if this will help, but I hope it will. I work as a telemetry nurse in a heart hospital and they had patient a year ago with almost the same problem. Just gave birth to her 3rd child and was extremely fatigued. Doctors blew it off, saying exactly what you said they said to your daughter...it's completely normal. Well, it turns out that she developed cardiomyopathy post-partum, which was the cause of the fatigue. Her story was a different..a few other symptoms, but she wound up in the hospital for months. I don't mean to scare you, just want to make sure your daughter insists of further tests. Have her see a cardiologist to rule any cardiac problems. Good luck. Let me know what happens.

First I want to apologize for this post being so long, but I'm hoping to get some information and/or ideas on how to help my daughter.
My daughter is 26 years old, married, with 3 children. During her last pregnancy in 2003, she was diagnosed with Hashimoto's Disease. She has had symptoms of hypothyroidism on and off ever since the diagnosis was made and has had several adjustments made to her Synthroid and has always "bounced back". She has T4s, TSHs, and other thyroid tests drawn frequently, but they always come back normal.
In December, she had a viral syndrome and was hospitalized for 24 hours. Ever since that time she has had overwhelming fatigue along with a weight loss of about 15-20#. She went from a size 8 to a size 2 ! She describes the fatigue as more than just being real tired ... more like she has to rest after taking a shower and a trip down the driveway to the mailbox wears her out.
Recently, she has had trouble concentrating. She went to the doctor yesterday and the office nurse sorta blew her off saying, "anybody with three kids under the age of 5 is tired." Even the doctor sorta blew her off saying he couldn't find anything wrong with her, maybe she's depressed, maybe she's doing too much, maybe she not eating well.
She was a little offended, but refuses to be brushed off. She is taking very good care of herself, has stopped doing alot of outside activities (she is a stay at home mama), eats well, takes vitamins, etc. She is not anemic. She claims she is not depressed or anxious, is happy and seems to be so to me.
The doctor examined her and drew more blood for tests.
As an aside, I have Type 1 diabetes and Graves Disease, my father had rheumatoid disease, a cousin was recently diagnosed with MS... so autoimmune disease runs rampant in our family.
Do any of you have experience with Hashimoto's or Hypothyroidism? Any ideas of what could be causing the fatigue and weight loss?
I have thought of Addison's Disease, MS, heavy metal poisoning, Chronic Fatigue Syndrome, fibromyalgia, but I have no experience with any of these.
Any ideas or information/advice will be greatly appreciated.

Hopeful in Ohio · Apr 21, 2005

Hi,

I'm not sure if this will help or not, but I thought I would share my experience with you. I am the same age as your daughter. Married, but no children. In 2000, I noticed that I was sleeping alot more then normal. I could fall asleep at 7:00 in the evening and sleep until noon the next day. I went on like this for two years. During that time the fatigue became worse and I went from 145 lbs

(I'm 5'11) down to 122 lbs. I went to see my family doctor, who diagnosed me as being depressed - which I wasn't. I then went on to see many more doctors. Everytime I went to a new doctor they ordered blood work and couldn't figure out what was wrong. I finally found a doctor through the Cleveland Clinic. I went through an overnight sleep clinic and they diagnosed me as having narcolepsy. I have never fallen asleep while in the middle of something - which was what I always associated narcolepsy with. I've always tried to eat properly and exercise, which was why the diagnosis suprised me. I was then referred to a neurologist. The first thing he did was put me on Ritalin. I tried it for 6 months, and found that it made me feel worse, so I went off of it. I began to take specific vitamins, watch my caffine intake, so on and so forth. I still battle the constant fatigue, but it's now tolerable.

Be persistant and don't stop until you find a doctor who will listen to you, and not just assume that it's depression.

You are in my thoughts and prayers. If you need to talk, you can pm me.

Take Care,

Kelly

lifesaverwv · Apr 21, 2005

Hi,

I have fibromyalgia which has caused me to have fatique & chronic pain from it affecting my muscles & joints. Alot of days I don't feel like getting out of bed because I'm so tired. Your daughter could go to a Rheumatologist to see if she does have fibro. It can affect pretty much any system in your body. I don't understand your daughter's weight loss though. Have a doc check her trigger points of which there are 18. If she has severe discomfort in at least 11 areas that the doc presses on then she's positive for having fibro. There are wonderful support groups on the web if it turns out fibro is what your daughter has. I hope she starts very better, I'll keep her in my prayers.

sbic56, BSN, RN · Apr 21, 2005

I have Hashimoto's. My PCP sent me to an endocrinologist for further work up than just thyroid labs. Low cortisol levels sometimes occur with Hashimoto's and fatigue is an effect of low cortisol. These low levels effect the function of the thyroid gland. My levels were OK, but I was glad my doctor thought to send me to a specialist. That's where I would recommend your daughter start. Good luck to your daughter. She needs to get her oomph back to keep up with 3 kids!

HealthyRN · Apr 21, 2005

Hi,
I'm not sure if this will help or not, but I thought I would share my experience with you. I am the same age as your daughter. Married, but no children. In 2000, I noticed that I was sleeping alot more then normal. I could fall asleep at 7:00 in the evening and sleep until noon the next day. I went on like this for two years. During that time the fatigue became worse and I went from 145 lbs
(I'm 5'11) down to 122 lbs. I went to see my family doctor, who diagnosed me as being depressed - which I wasn't. I then went on to see many more doctors. Everytime I went to a new doctor they ordered blood work and couldn't figure out what was wrong. I finally found a doctor through the Cleveland Clinic. I went through an overnight sleep clinic and they diagnosed me as having narcolepsy. I have never fallen asleep while in the middle of something - which was what I always associated narcolepsy with. I've always tried to eat properly and exercise, which was why the diagnosis suprised me. I was then referred to a neurologist. The first thing he did was put me on Ritalin. I tried it for 6 months, and found that it made me feel worse, so I went off of it. I began to take specific vitamins, watch my caffine intake, so on and so forth. I still battle the constant fatigue, but it's now tolerable.
Be persistant and don't stop until you find a doctor who will listen to you, and not just assume that it's depression.
You are in my thoughts and prayers. If you need to talk, you can pm me.
Take Care,
Kelly

Be persistent! If doctors rule everything else out, your daughter should definately consider seeing a sleep medicine specialist and having a sleep study done. Narcolepsy is a disorder of excessive daytime sleepiness and does not always have unusual symptoms (like falling asleep while eating, etc.) associated with it.

To Kelly: There are some really great medications out there for the treatment of Narcolepsy. I work in a sleep clinic and the docs don't usually prescribe Ritalin because it isn't very effective. Ask your doctor about Provigil or Vivactil. You don't have to live with constant fatigue! Where are you at in Ohio?

Hopeful in Ohio · Apr 21, 2005

To Kelly: There are some really great medications out there for the treatment of Narcolepsy. I work in a sleep clinic and the docs don't usually prescribe Ritalin because it isn't very effective. Ask your doctor about Provigil or Vivactil. You don't have to live with constant fatigue! Where are you at in Ohio?

My doctor did mention Provigil after the diagnosis..but the neurologist pushed for the Ritalin - lucky me!!! I live in the Fairlawn/Cuyahoga Falls area. Originally from Cleveland area. Thank you for taking the time to respond :)

June55Baby · Apr 21, 2005

Thank all of you so much for your thoughtful and thought provoking posts.

My daughter called earlier today crying because she had called the doctor to get her lab results and the office nurse's attitude was judgmental and uncaring. My daughter asked to speak to the doctor and he called her later and his attitude was much more compassionate. He told her he really wants to help her and asked if it was OK for him to consult another physician. All her lab work was WNL, but she wants to be treated according to her symptoms rather than her lab results.

To answer some of your posts:

prmenrs and Nurse831- we have considered cardiac problems, but her PCP has ruled out that diagnosis. We live fairly close and help out alot by taking the grandkids EVERY weekend. Also, her husband is wonderful to help out.

ARNPsomeday - thank you for your post...liver enzymes were WNL

maolin thank you for your thoughts....she has Hashimoto's and the hypothyroidism is only a part of that disease. It seems you can have Hashimoto's and weight loss....

Hopeful in Ohio and Katyosu - thank you both for your information on narcolepsy - we haven't considered that as a diagnosis. We will definitely keep that in mind.

lifesaverwv - thank you...It seems most of her symptoms are more related to the thyroid. He PCP did look for the "tender points" and questioned her thoroughly about joint pain, etc. She wondered why he was doing that exam, now she knows! Thank you.

Sbic56 - Thank you for your suggestion to see an endo. She started out seeing an endo and when she was SO SICK in December, he just blew her off and told her that her symptoms had nothing to do with her Thyroid.... Needless to say, she never went back and we have very few trustworthy endos in our area.

She is now reading a book Living Well with Hypothyroidism and it seems to be written about her! She has heard of Dr. Ridha Arem at Baylor University in Houston, TX who also wrote a book The Thyroid Solution and she may even consider the 8 hour journey to Texas to see him, if it came to that. Have any of you heard of him? I haven't yet taken the time to check him out, but I will.

Thanks again! Your concern and caring was evident in all the posts...

If you think of anything, or hear of anything.... please post.

Thank you!

sbic56, BSN, RN · Apr 21, 2005

June55Baby

Wow...seems your daughter has done nearly everything imaginable to figure this thing out, at least locally. If I were her i'd make the 8 hour trip, if she thinks it will bring her an answer!