What causes extreme fatigue despite normal blood results?

Question

Hi doctor,

I am suffering from low-grade fever, hair loss, and extreme tiredness. There is pain and burning sensation in my stomach along with loss of appetite and weight gain. I got my ANA test done and it came positive. My ESR level has increased. All my other test results found to be negative. Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I went through your reports (attachment removed to protect patient's identity) and observed that there is no autoimmune disease present. Since you have been suffering from multiple joint pains for the past one year, you should have tested for rheumatoid arthritis (RA) factor and got done ASO (Anti-streptolysin O) titer. ANA (anti-nuclear autoantibodies) can be elevated even in slight fever, hence no need to worry for the same. Did you get affected by chikungunya anytime before?

It has been mentioned that your 3D reports are normal. Please do attach those reports for my reference. I would suggest you to kindly get the following tests done:

RA factor.
C-ANCA (cytoplasmic anti-neutrophil cytoplasmic antibody) and p-ANCA (perinuclear anti-neutrophil cytoplasmic antibody).
ASO titer.
Bone marrow biopsy; please get it done immediately with a pathologist.

Answer 2

Hi,

Welcome back to icliniq.com.

I have checked your reports (attachment removed to protect patient identity) and the tests you provided.

Long term fever can have many causes. Some viral fever can last for nearly six months and disappear by itself. Fever is one of the causes of your fatigue. Once fever gets reduced your fatigue too will reduce gradually. Burning sensation in the stomach that you have been experiencing since few days is mainly because of ulcer, fever is one of the causes for the same. There is a loss of appetite. It can be due to ulcer, indigestion, fever or the medications you have been taking for a long duration. Based on your CT abdomen, there is no lymph node in your abdomen.

Hair fall can be due to many reasons. Eating low protein diet because of loss of appetite too can be a cause. Only a few diseases can be corrected with the medicine intake like autoimmune disease and leukemia. That is why the above tests were needed, which you have not done until now. Once the actual cause gets identified and treated, then you can get pregnant as there is no problem with your uterus and ovaries.