I am a 34-year-old female with a weight of 72 kilograms and a height of five feet. I have a complaint of unexplained debilitating fatigue for fifteen years. During the episodes of fatigue, I feel dizzy and become clumsy. I have difficulty in focusing or thinking clearly. I have studied ballet, jazz, tap, and gymnastics for ten years during my childhood and young adulthood. So I use to be very active. Still, I practice yoga and do lightweight exercise or cardio exercise every day. But now, after having these fatigue episodes, I need a nap after thirty minutes of walk. I have worked with fatigue for 5 years. I have done tonsillectomy before thirty years and laparoscopy before fifteen years. I took treatment for interstitial cystitis before twenty years. I had migraines before ten years.
I took treatment for PCOS and insulin resistance before ten years. I had difficulty in getting conceived and tried for a year. After that, I gave birth to a full-term baby before nine years through C-section. Currently, I am taking Hydroxyzine Pamoate 25 mg twice daily for interstitial cystitis with Gianvi 3 mg once daily as oral contraception. I am taking Atorvastatin 20 mg once daily for high cholesterol, Rizatriptan 10 mg for migraines, a Multivitamin tablet for general health.
I am using Calcipotriene 0.05 percent cream twice daily for psoriasis. I am using Clobetasol propionate cream twice daily for psoriasis along with Salicyclic acid six percent shampoo once or twice a week. I am taking Calcium citrate 1000 mg for overall bone health. I have consulted two public health care physicians, three endocrinologists, and one nephrologist. I have done a treadmill test one time and consulted a cardiologist one time. I have done a sleep study and failed to find the cause for unexplained fatigue. I have done several tests. I had a level of complement CH 50 of 20 U/mL. My ANCA test was positive. I have a high level of creatinine. All the other results are negative. Please suggest.