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HomeAnswersGeneral Medicinesevere fatigueI have a feeling of run down all the time. What to do?

I feel run-down all the time. Why?

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

Medically reviewed by

Dr. K. Shobana

Published At March 13, 2017
Reviewed AtAugust 17, 2023

Patient's Query

Hi doctor,

I returned from abroad feeling run-down with gastrointestinal issues. I thought that I might have gotten a parasite. Stool tests were performed, but no parasite was found. I then developed flu-like symptoms that lasted several weeks and still feel run-down and tired all of the time. My eyes look a bit discolored as well.

Hi,

Welcome to icliniq.com.

From the reports and the history of complaints that you have provided me, it seems likely that you are suffering from some sort of infective hepatitis. For confirmation of the same I suggest you to undergo certain blood tests like liver function tests and anti-HAV (hepatitis A virus) IgM and anti-HEV (hepatitis E virus) IgM. You might feel tired for some time because of the infection. The mainstay of the treatment is adequate rest, plenty of oral liquids and fruit juice. Avoid having spicy and oily foods for two to three weeks.

You can get back to me with the requested blood tests when you get the reports.

Take care and get well soon.

Patient's Query

Thank you doctor,

Thank you for your recommendation. I have attached blood tests and additional stool sample. I am still trying to figure out what is going on. I am wondering whether low RBC distribution is the result of my parasitic infection. I am not sure why my glucose level is low. I vaccinated myself as a child. But I do not have antibodies for my vaccinations. So we cannot rule out things like other normal people having immunity. Please mention whether I have another direction or test to do.

Hi,

Welcome back to icliniq.com.

I have gone through your investigations (attachment removed to protect patient identity). All the parameters are grossly normal. Though your RBC (red blood cells) distribution width is low, your hemoglobin still remains within normal limits. So there is nothing to be worried about. Low glucose levels can occur due to prolonged fasting before doing the tests. Please mention whether you still have symptoms persistently. As you have pointed out, the antibody levels against the vaccinable type of infective hepatitis seem to be low or undetectable, then you consider having vaccination against Hepatitis A and B if you do international travel frequently.

In case, if we have ruled out the infective causes of your symptoms, then we can consider inflammatory causes or irritable bowel syndrome. I could not find the reports of the stool tests that you have done. A stool calprotectin test should be done to rule out any inflammation in the intestines. If it is an irritable bowel syndrome, you need to take symptomatic treatment according to the phase of bowels, whether you are constipated or having loose motions. Keep yourself hydrated. You can consider taking probiotic capsules or sachets thrice a day. Keep your food high in fiber content. This will definitely help with your symptoms. You can get back to me if any further queries. Take care.

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

Dr. Kulkarni Rahul Suresh
Dr. Kulkarni Rahul Suresh

Internal Medicine

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