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Why do I have brain fog, tiredness and fatigue?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At March 17, 2018
Reviewed AtJune 22, 2023

Patient's Query

Hello doctor,

I have a brain fog, tiredness, and fatigue. Kindly guide me.

Hello,

Welcome to icliniq.com.

For your tiredness, you have investigated properly with liver, kidney, and thyroid profiles (attachment removed to protect patient identity). That reports are within range. So, liver, kidney, and thyroid illnesses are ruled out here. Your lymphocytes are slightly high. So, a temporary viral infection can be a possibility. For that, symptomatic management can be done, and Vitamin C tablets can be prescribed too. If fatigue remains persistent, then EMG (electromyography), and NCV (nerve conduction study) can be done to rule out neuromuscular illness, for which the neurologist should be consulted for neurological examination and the reports. Autoimmune disease, more work, lack of sleep, etc., also can be associated with fatigue. If no specific cause is found, then anxiety-related or chronic fatigue syndrome can be the possibility. If any other specific history is associated, then provide it for giving more comments. Consult a neurologist for your physical examination and discuss all these. Thank you.

Patient's Query

Thank you doctor,

The C-reactive protein say 5.30 which is higher than normal range. The iron studies are showing a total Iron binding capacity of 415, which is almost near the high range, and a transferrin saturation of 17.83, which is lower than the normal range. Do you suspect anything with these? I have had a history of low Vitamin B12 for the past four years, and Vitamin D3 is 24.82, which is lower than the normal range. The platelet count is also low (135). I want to rule out anything with iron deficiency or things related to vitamins. Also, I have blood with stool almost twice a week. Is there any issue due to this too?

Hello,

Welcome back to icliniq.com.

CRP (C-reactive protein) value up to 8 is considered normal. TIBC (total iron binding capacity) is also within range. Transferrin saturation is slightly low, but the picture is not strongly suggestive of iron deficiency anemia. Blood loss is present in stool which needs evaluation by endoscopic examination by a gastroenterologist (if needed). Before that, a stool routine micro examination and occult blood test can be done for a primary workup. For low Vitamin B12, take cyanocobalamin injection once a week for six weeks. For low Vitamin D levels which you have, you can take Cholecalciferol sachet 60000 IU once a week for eight weeks. Thank you and take care. Regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Goswami Parth Rajendragiri
Dr. Goswami Parth Rajendragiri

Pathology

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