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What could this be? EXTREME exhaustion.

(39 Posts)
PuddingsAndPies Thu 07-Mar-13 10:55:13

I am constantly exhausted - I am currently being treated for depression, and am on 45mg mirtazipine (specifically to try to improve the quality of my sleep at night, in the hope of reducing this). Despite this, I am still hardly able to function. Even with 12+ hours sleep, I am exhausted & can't watch television or read without finding myself falling asleep. My GP sent me for blood tests last week, but I haven't heard back yet - I'm not sure what they were testing for, although diabetes was mentioned (I had to fast for 12 hours beforehand). I'm not sure that it is diabetes though, as I don't have the constant thirst, etc.

Thank you in advance for any suggestions!

PuddingsAndPies Sun 24-Mar-13 19:56:49

Thank you for the advice on this before. Just as an update (& also as a record for myself), I have been sent blood forms for tests tomorrow. They will be testing:

Albumin
CRP
HbA1c
Calcium
ESR
Total CK
Full Blood Count

I'm not totally sure what they're looking for, but it should help rule things in / out.

digerd Sat 09-Mar-13 16:00:24

Rockin
How can they misread/ignore your kidney function blood test results. Or was it the results that were wrong?
That's terrible.

rockinhippy Sat 09-Mar-13 11:06:08

Sorry just spotted your update & see you've had the kidney test done too - good luck with your endo appointment

rockinhippy Sat 09-Mar-13 10:51:06

I'd also be asking if they did a kidney function test & ask about a celiac disease test - its unlikely this one was done with weight gain, but as I'm just finding out now as with kidney function problems it can actually be fluid retention rather than actual weight, but the weight could also be a red herring & be down to the ADs as already suggested

I've had similar problems for years, diagnosed as fibromyalgia & the hen M.E as I kept on pushing for answers - I too thought thyroid & thanks to great advice from RD above pushed for more in depth tests, but after restless etc they came back within normal range - my problem has now just been diagnosed as stage 3 Chronic Kidney Disease, not sure how the hell they missed that one as it was the first thing I asked about as I've a history of kidney troublehmm

That said I am currently doing a gluten (wheat, barley, rye) load to prepare for doing a home celiac test, as the more I read on that, it looks likely its the correct diagnosis for both myself & DD - left untreated it affects thyroid, kidneys & much much more - we have been tested, but were given no advice on loading up on gluten prior to testing, which is needed for an accurate result - the way eating so much gluten is making me feel I am convinced this test will be positive.

good luck getting answers

Kewcumber Sat 09-Mar-13 10:20:23

I developed severe sleep apnoea on high dose steroids and haven't quite shifted it even though the weight has now gone from my neck - though it has improved dramatically and there is hope my airway may recover enough eventually to get off CPAP.

You can do an Epworth sleep questionnaire online to assess your level of sleepiness. I seem to recall that its the first thing the sleep clinic did with me.

narmada Fri 08-Mar-13 21:17:58

Hey interesting you say that Kewcumber because I developed nighttime breathing issues on Mirtazapine - a bit apnoea-like. Got a fat neck on it too....

Kewcumber Fri 08-Mar-13 13:50:23

sleep apnoea more linked to neck size than overall weight. Some drugs deposit fat around the neck.

Yes you can have low iron but not be anaemic but IME is more often results in generally low/depressed/tired feeling rather than exhaustion.

mollymole Fri 08-Mar-13 13:49:11

Your GP has referred you to the endocrinologist - they should be able to give you much more help than the GP and are specialists in thyroid treatments so things are actually moving in the right direction for you.

PuddingsAndPies Fri 08-Mar-13 13:44:27

I'm not massive, but I've steadily been putting weight on & I'm the heaviest I've ever been. No sleep apnoea.

They haven't tested b12, though they tested for anaemia, which I apparently don't have, but I think there are other tests for iron? I'm not sure.

They tested kidney & liver function, & my blood glucose, all of which came back normal.

Kewcumber Fri 08-Mar-13 13:42:19

whats your weight like? Sleep apnoea?

Have they tested b12 and iron?

PuddingsAndPies Fri 08-Mar-13 13:38:50

Saw the doctor. I've never seen him before, & he was really rude - I went in with a list of symptoms I wanted to talk about, & he took it straight off me & turned it upside down, & left me to flounder a bit. He said that at 2.9 there's nothing to worry about, & said it was all just my depression, which I don't think it is. Eventually I ended up crying & said that whether or not it's a thyroid thing, I can't keep being this ill. Then he essentially said that I was too mentally weak to stand any further investigation because I was so tearful hmm
After some debate, he decided that he was going to actually examine me, ask about my family history & talk about my symptoms properly, & I've ended up with a referral to an endocrinologist. But what an absolute nightmare that was.

PuddingsAndPies Thu 07-Mar-13 22:16:52

Thank you for the list, Rockin!

& no, the mirtazapine was introduced to tackle some of the symptoms. The symptoms predate the meds.

narmada Thu 07-Mar-13 20:56:44

Have these symptoms only started since you began mirtazapine? As a PP said it is massively sedating (which can be useful if you are agitated-depressed) and it causes huge weight gain.

I seem to remember being told that in rare cases it can also change blood counts.

The coloured patches.... aren't they symptomatic of diabetes? Mirtazapine can do odd things to your insulin levels....

RockinD Thu 07-Mar-13 19:23:06

Round here you don't get a FT4 result, even if the GP asks for it, if the TSH is within range. The lab considers that it is unnecessary!

2.9 is high enough to flag as something that needs looking at, even though your lab range may go up to 6 or thereabouts.

You need to be asking for FT4, FT3, TPO and TgAb (antibodies) and also vitamin D, vitamin B12, folate and ferritin so your GP can make a proper diagnosis with all the information he needs.

Good luck!

PuddingsAndPies Thu 07-Mar-13 17:34:15

Thank you - that's very reassuring & helpful.

Apparently there was no other thyroid result, but I have decided that I will be phoning for another appointment tomorrow. I am fairly sure from what I've read that I have hypothyroidism - & even if I don't I have many symptoms which fall into that category, which are preventing me from doing what I need to do in my life.

duchesse Thu 07-Mar-13 17:31:29

And I would ring back and ask for your T4 result as well- that's quite important. Receptionists don't know what they're telling you on the whole.

duchesse Thu 07-Mar-13 17:30:48

2.9 is your TSH result. TSH is the hormone that prompts your thyroid to produce T4. The more TSH is present, the harder it means your thyroid is being pushed to maintain normal levels of T4. Do you remember what your t4 level is?

2.9 is within clinically "normal" levels, but as the doctor who put me on levothyrozine said, "you're not sub-clinical if you have symptoms". Alleged normal is something in the order of 1-4.7. In the US they treat when you go above 2. In the UK they tend not to treat until 5+. Even in the UK in pregnancy they like to keep you below 2. I think that says quite a lot.

If you feel symptomatic, in your shoes I would keep going back. My GP was not sympathetic alas and tried to put me on antidepressants instead. I wasted 5 years of my life thanks to him.

PuddingsAndPies Thu 07-Mar-13 17:12:27

Okay, there is only one result for the thyroid test, & that is 2.9, which is apparently 'normal' (although 'normal' seems to vary, & there seem to be more than one thing that should be tested for an accurate result).

Does anybody know what 2.9 means? Is that actually okay?

PuddingsAndPies Thu 07-Mar-13 15:15:11

& ThatBint - I'm really hoping not to be fobbed off like you were, but interesting that acupuncture helped. I wouldn't have thought of that.

PuddingsAndPies Thu 07-Mar-13 15:14:21

I've just phoned again & got a different receptionist, who was much more helpful & said that if I phone back between 5-6pm today, they'll be able to give me exact figures. I think, having done a lot of reading, that either way I will try to get an appointment tomorrow, but I would like to be armed with as much knowledge as possible. From what I've read, they may not have done a full range of thyroid tests, and it can be difficult to get a proper result without it - and like mummytime said, the ranges can differ within that. Who knew it would be so complicated to essentially get a yes / no diagnosis?!

ThatBintAgain Thu 07-Mar-13 13:14:53

I've had similar for 6 months - only just now starting to feel better. After a load of tests I was told it was "a virus". hmm Got no further help and turned to acupuncture out of desperation. (It worked, by the way!) Hope you feel better soon.

mummytime Belgium Thu 07-Mar-13 13:11:57

Do get the levels of the Thyroid test, as they often don't treat levels in the UK that would be treated in other countries.

mummytime Belgium Thu 07-Mar-13 13:06:43

Do get the levels of the Thyroid test, as they often don't treat levels in the UK that would be treated in other countries.

PuddingsAndPies Thu 07-Mar-13 13:04:13

I was on citalopram before this & had the same symptoms - I got switched to mirtazapine to try to help me get to sleep at night / improve the quality of my sleep, to try to reduce my tiredness during the day. It hasn't really helped.

When I started this thread this morning, I was wondering if the exhaustion was just a symptom of the depression, or something else. Hypothyroidism would explain so much, but having been told that my blood results require no further action, I feel really confused! I will phone the surgery in the morning to try to make an appointment for tomorrow, to try to work out what's going on.

digerd Thu 07-Mar-13 13:01:49

opps
what not was.

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