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Q. I have chronic muscle ache in my shoulders, fatigued arms, and massive hair loss. Why is it so?

Answered by
Dr. Rahul Kackar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 05, 2021 and last reviewed on: May 12, 2021

Hi doctor,

I am a 38-year-old female with consistent muscle ache in my shoulders that makes my arms feel fatigued. They are chronically tired. I also have pretty substantial eosinophil disease, including EoE with >100 EOS per tissue sample. The back story is that I had a viral infection one year back (possible COVID-19 infection, but testing was limited) that sent my body into quite the tailspin. I had severe migraines and low blood pressure. They have resolved now. The only thing that remains is the muscle fatigue in my arms and shoulders and muscle spasms in my neck. I have also lost a massive amount of hair. What would be your possible diagnosis and treatment plan for me?

#

Hi,

Welcome to icliniq.com.

I noted all your history. The site of pain around the shoulders, arms, and neck is pointing towards fibromyalgia. Let us focus and treat the underlying process which brings this pain. I will like to know more about your menstrual history. Are your periods normal and regular, any use of oral contraceptive pills? Do you take junk food and carbonated drinks? How are your digestion and physical activity levels? Was any recent blood workup done? I would suggest you,

  1. Stop taking any antacids, strengthen digestion, take probiotics twice daily for two weeks, include fruits and vegetables in the diet, drink plenty of water, and do intermittent fasting 16:8.
  2. Add magnesium supplements 250 mg daily for three weeks.
  3. Do regular exercises.
  4. Take some vitamin E tablets 200 units and Carnitine 1 gm daily for three weeks.
  5. Correct if there is any vitamin D Deficiency
  6. Sleep well. You can take St. John's Wort 500 mg once a day after dinner for three weeks.
  7. Manage your stress levels.
  8. For pain, if needed, take Paracetamol 650 mg twice daily. If severe, you might need antidepressants, but I want to look into lifestyle correction first.
  9. Take holy basil green tea.
  10. Meditation and mindfulness for stress reduction.
  11. Maintain a daily diary to note down your symptoms.

Follow up after two weeks. Thank you.

Hi doctor,

I am thankful you have so many suggestions that lead to natural treatment too. I had a hysterectomy about five years ago. I still have my ovaries. I eat extremely clean because I try to keep my eosinophils down (I have significant allergies). I struggle with nutrition because my diet is primarily liquid or foods that I can break fully with chewing. I have to take a ton of PPIs, which I wondered about because it is 60 mg to 80 mg a day. My bowels are lazy, and I am trying to fix that as well. My last lab results indicated low magnesium and potassium. I am attaching my lab reports for you to go through.

#

Hi,

Welcome back to icliniq.com.

I will suggest you take a course of Albendazole 400 mg and Ivermectin 12 mg once tonight for high eosinophils. Stop PPIs (proton pump inhibitors), take digestive enzymes before meals, and you might try Betaine Hydrochloride tablets if you feel indigestion symptoms despite the enzymes. Take Psyllium Husk 5 gm at bedtime. Check your mood and see if there is underlying irritation. Magnesium is vital. Take some Pyridoxine and vitamin B supplements also. I hope this helps.

Hi doctor,

Thanks for the reply.

I will follow all your suggestions. I have a doubt. What is Ivermectin used for? Please reply.

#

Hi,

Welcome back to icliniq.com.

Take tablet Magnesium 360 mg daily. Increase your protein intake. Ivermectin helps you to clear specific interstitial bugs. If you do not want it, then just take Albendazole.

Hi doctor,

Thanks for the reply.

Do you think that my muscle fatigue, spasms, and general malaise could be due to nutritional deficiency? I am not opposed to Ivermectin, but I have heard of many people taking it here lately but only in reference to COVID-19 infection. So I am worried.

#

Hi,

Welcome back to icliniq.com.

The generalized fatigue you are experiencing is due to nutritional deficiency. The nutritional deficiency leads to disturbed gut leading to increased autoimmune process further contributed by stress, food, PPIs, exposure to environmental toxins, etc. Hope this makes it clear. Revert if you have more queries. Thank you.

Hi doctor,

Thanks for the reply.

I understood. I hate the PPIs. I lost full ability to swallow two years before and had my esophagus dilated. I will discontinue them.

#

Hi,

Welcome back to icliniq.com.

Medicines cure you and make you feel happy, but you will be healed when you get connected with nature. Until you can do it totally on your own, I suggest you take help from a good meditation instructor and books. Thank you.

Hi doctor,

Thanks for the reply.

If I do not have any progression of muscle loss or weakness, is there any concern about anything neurological or musculoskeletal? I will look for an instructor and books related to meditation. I am so eager to get my life back post-illness. I am a very energetic and ambitious woman with two 9-year-olds. I do not want a life of chronic pain. I am concerned about this.

#

Hi,

Welcome back to icliniq.com.

Even if you feel it is neurological or musculoskeletal, the underlying pathological process remains the same. Two 9-year-olds means the healers are with you, stop focusing on the illness. Do meditation till the pain is bearable. Just notice those sensations, do not label them as pain or anything, see how it feels, then, if it gets severe, take a painkiller. Devote time with your kids. Make them happy, and you will be happy.

Hi doctor,

Thanks for the reply.

I am overwhelmed by your prompt response. We need more doctors like you. You give me hope. Thanks a lot.

#

Hi,

Welcome back to icliniq.com.

As already mentioned, try reading some standard books related to meditation. This will aid in your healing. Thank you.

Hi doctor,

Thanks for the reply.

Surely I will follow all your suggestions. Thanks for the reply.

#

Hi,

Welcome back to icliniq.com.

You are welcome. I hope your queries were answered. If you have more queries, do not hesitate to revert. Thank you.


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