What blood tests should I ask for to diagnose fatigue?

Oh also, does anyone think I should try starting drinking coffee? I don’t drink it at all now. Maybe it would help.

Also, I get more than eight hours of sleep most nights too.

Definitely your iron levels. Anaemia makes you feel absolutely exhausted. However, it can sneak up on you. You don’t realise quite how tired you are.
Perhaps blood glucose tests. With all the problems you’ve had with your digestive tract, could you have diabetes?

Jesus I hope I don’t have diabetes on top of everything.

I have been at least mildly anemic for like 10 years now. Don’t think I’ve ever gotten completely on top of it. I recently finished a regimen of iron pills so I guess we’ll see if that did anything for me. I’d think I’d be used to being anemic by now but I dunno.

Thanks!!

Welcome, and I hope you aren’t diabetic, however, there is a genetic link. Not that I’ve read the link means if you have one, you’re more likely to have the other. However, people do have both. My reason for suggesting it is really only your tiredness, but also the problems you’ve had with your digestive tract. I’m sure it has put pressure on your whole system.

My money would be on anaemia. I hope you feel better soon. I used to suffer from anaemia often and it’s really not pleasant.

Vitamin D is easy to check and easy to correct if it is low. Anyone who lives above the 40th parallel and works indoors likely as low levels.

You didn’t mention any current medications, I assume you’ve ruled those out.

Is there any possibility that you might be pregnant?

When you say “lately”, about how long would that be in your best estimation? Are you experiencing, or have you experienced, any weight gain?

When my thyroid first went bad, I started experiencing extreme fatigue like I never had before. Then the weight gain happened and really bad anxiety followed. It wouldn’t hurt to ask your doctor for a simple TSH test to make sure your thyroid is holding up alright.

You sound stressed…I am saying this because I have been in those same shoes. In a last ditch effort to do something on my own to combat my fatigue I immersed myself in exercise and since I have done this I am not only feeling better but sleeping like a baby again.

Not pregnant. All medications I’m on I’ve been on for years and years. I wish I were putting on weight but no on that as well.

Thanks all.

Oh, also, it’s been really bad for about a month but has been bothering me to some degree for almost a year now.

Are you sleeping well at night? I know you have been under stress lately, and sometimes that can manifest in your body wanting to shut down.

I feel like I sleep fine at night? I sleep nine hours most nights. I wake up sore and sweaty a lot of the time though. There’s a certain amount of discomfort my body goes through at night but it rarely wakes me up.

What others have already said: iron levels, vitamin D, depression. I’m a huge believer in fish oil coupled with vitamin D. With your health history though it could be just about anything nutrition wise. B vitamins sure help me a lot. If you have been drinking any alcohol I would be sure to get a good B vitamin complex. You can sure try coffee but the effects will only mask your fatigue.

@Mariah I felt the same way about my meds I was on and mentioned to my Doc about cramps I was having and it turns out the meds for my Gerds strips my body of Magnesium and she suggested a Magnesium supplement and weeks later all is good. Do check with your doc on your symptoms first before you ask here.

TSH, iron, D. Tell the doctor what your issues are and she or he will know what you need to be tested for.

I have the same problem. When I talked about it with an RN (who was supposed to be my PCP…), she tested my thyroids. I never got the results, even after calling, so I guess nothing was wrong. This test involved taking out some blood.

Iron
CBC
TSH
T4 free
T3 total
CMP
Vitamin D
Vitamin B12
HCG

Remember to fast minimum 12 hours before the test (in other words schedule in the morning, so your fast is overnight).

If nothing turns up on those then more extensive tests might need to be done.

Check for iron poor tired blood. Or get some Geritol.
Also, low B-12 levels.

Bun, and creatine. Liver panel.

Surely the whole point of going to the doctor with your symptoms is because they’re the experts and they know what tests to order?

You are more than covered by the above answers which is what is tested for fatigue. You may also be a bit depressed due to all that has been going on. Depression, even in a mild form tends to lead to fatigue.

FYI: my list captures everything mentioned above by all jellies unless I overlooked something. Jellies can feel free to correct me.

My list has panels that cover individual items mentioned by jellies. For example creative and BUN are within the CMP, and the CMP also tests glucose, electrolytes and liver function. The panels are very commonplace to run and capture more.

Also, I mention the panels, because you might go in to the doctor saying you want your thyroid tested, and he will order TSH, T4free, T3, and you might not know what it means. The CBC is good to look at since you are anemic. It analyzes the red blood cells quantity and ratio, and other blood cell counts.

You can google each of the tests I suggested and it will give the detail of each panel.

My guess is iron deficiency. Just a guess.

Edit: I think you are likely vitamin D deficient too, but I don’t think that is causing your exhaustion. I do think it is a probable cause of the discomfort in your body. The iron deficiency also might be part of the aches.

You might want to test your magnesium too. That affects the muscles. However, be warned if you take magnesium don’t take a large amount. I say this specifically for you. It can be hard on the digestive system, can loosen stool. Also, too much is bad for everyone. You can also try magnesium spray. It absorbs very well through the skin. Spray right on the muscles that hurt the most. Don’t overdo. Just a few sprays two or three times a week.

Do the tests. Don’t just start popping high doses of B, D, iron, etc.

@Lightlyseared As I already mentioned in the OP, I’ll be asking the doctor what tests she suggests. I just want to come armed with knowledge of what should be in the list, in case she doesn’t take me seriously enough or something.

Thanks all.

Yes, come with the list written out. That way you can feel comfortable she is addressing your concerns. The one she most likely won’t order unless asked is the vitamin D, it really depends on the doctor. I would think in your case, digestive issues and thin, a doctor would seriously consider nutritional dificiencies, but your age works against you. Young people are often dismissed.

What in the goddamned fuck, I’ve been good for two days now and not napped but it looks like my body has forgotten how to sleep at night??? I literally just laid awake all night. It’s 5am here and I haven’t been asleep for a minute. Sorry for ranting, it’s just so frustrating. I don’t usually have problems sleeping at night and I’m pissed my body won’t do it now but will happily do it at 2pm every day.

Definitely check your thyroid. Don’t let the doctor only do TSH. He needs to do TSH T4free, and the T3 total.

It might not be thyroid, but you have to rule it out.

Don’t drink alcohol for a few weeks.

You can also try quitting caffeine, but it will really suck at first. You’ll be exhausted for a couple of weeks most likely. If you’re not working it’s a good time to try it. Wean down. Don’t quit cold turkey in one day.

@Mariah, I don’t think you should up the caffeine either. That’s just going to mask the problem. Eat healthy food, and sleep when you need to. You’ve had a really full-on time recently.

A thought occurred to me while typing this, do you feel depressed at all? Depression can make you feel exhausted. You’ve had some relationship problems, then you lost your job – both major life events. So just think about whether the cause of your tiredness could have been triggered by mental rather than physical health ailments.

As to the lack of sleep last night, weren’t you trying meditation? Perhaps if this happens again, try meditating to help you still your mind. Even if you don’t sleep, you will feel more relaxed and hopefully refreshed. It might help you go to sleep.

Feel better @Mariah.

@Earthbound_Misfit Did she say she was going to increase her caffeine? I missed that.

I don’t drink any caffiene now but was considering trying it to combat the fatigue. I might have some tea today because I really want to get through today without napping. If I nap today it’ll turn into a 5 hour event and then I’ll be all kinds of fucked.

Yeah I’ve been depressed as hell lately. But I’m seeing a counselor and I’m on medication. I don’t know what else I can do.

Thanks guys.

@Mariah is going to respond herself, but in her first post she said she was thinking of drinking coffee. Perhaps try green tea @Mariah. Still has caffeine in it. Just don’t overdo it. It will leave you feeling jittery and it really is addictive.

If you’re depressed, that is quite likely at the heart of your problem. There may be health problems too, but depression is just draining. I know when I’ve been depressed I’ve felt totally without energy AND it messes with your sleep. It’s very common for people with depression to suffer from insomnia. So they might not be able to go to sleep OR they wake up very early and can’t go back to sleep. Then you have a vicious circle, because sleep deprivation is going to affect your mood.

Try the meditation again. I’d prefer to see you doing that than increasing your caffeine intake.

How much exercise are you getting?

Pretty much none. Sometimes I hike but on those days I really need a nap.

You started a new medication? That could easily fuck up your sleep. Which drug is it? Buspar is known for sleep interruption, and also some of the SSRI’s.

No I haven’t started a new medication. I’ve been on celexa for years.

If you have low Vitamin D levels, that could affect your body’s release of melatonin.

I’m anemic. Ferritin 9. That’s a bit low even for me, I was at a 12 last November. Been asked to do another three months of iron pills. Just finished the last course in February. What else is new…

My guess what right! LOL. Thanks for the update. Easy guess since we already knew you tend to be anemic. The most obvious is often the right diagnosis.

Why just three months? You need them forever probably. Maybe you can cut the dose once your level gets up. Or, if you suddenly start eating lots of green leafy vegetables.

Did they run other tests? I just ask, because you could have more than one thing going on.

Yeah I figured I was anemic because I’m literally always anemic, but since my fatigue has been unusual lately I wasn’t so sure anemia was the root. Well, looks like I’m a bit worse off than usual right now on the anemia front so that must be it.

Thyroid and electrolytes were normal. Didn’t end up doing any vitamin tests.

Well, if you’re not tan all summer long I hope you do the vitamin D test one day. Not for the fatigue, but for so many other things.

Meanwhile, iron is fairly easy to fix (usually) so you should feel better in a few weeks. That’s good.

Iron is easy to fix?? I’ve been anemic for 10 years. I hope you’re right though.

Yeah I’ll order myself some chewable caltrate with D. I’m pale as a ghost.

No no. Why Caltrate with D? Why are you taking extra calcium? I didn’t tell you to take anything, I said get the test. Did a doctor tell you to take calcium?

I know what you mean about the iron. I need to take a lot, but it does go up when I take it. All I meant was at least it isn’t surgery or some “drug” you need to take.

I know you didn’t say to take anything, my understanding with vitamins though is you just piss out the excess so it’s OK to take them even if you don’t know you need them. It’s easier for me to just buy the vitamins than to schedule another appointment.

Vitamins A, D, E, K are fat soluble vitamins and get stored not pissed out. It builds up if you OD and can actually be toxic. It’s hard to get toxic with D, you need to take a ton of it, but for some people it can cause their calcium to go up, or it also is a concern if the person has a parathyroid problem.

Vitamin A is a real thing to worry about, especially for women. Acutane, the acne med, is like a huge megadose of A, and women need to sign forms (unless that has changed) stating they understand it causes birth defects, and doctors prescribe women BC pills while they take it (I think doctors have to by law prescribe BC pills, or put in an IUD, or some sort of reliable method). If a woman becomes pregnant while taking a urbane she is counseled to terminate. Megadoses of regular vitamin A a woman would also be told it might have caused fetal damage. A also has been linked to some bowel diseases. Basically, I’m just saying not all vitamins just pee out.

Minerals, like calcium, iron, magnesium, also don’t just pee out.

Your calcium probably has been tested many times, because it’s included in a panel that is usually done if a patient is tired, or not feeling well in general.

If you take calcium, don’t take a lot. Possibly, since you are very thin, some extra calcium might be a good idea, but if I were you I wouldn’t take large doses. If you have some at home you can take it a few days a week, and that’s basically the same as a lower amount every day.

Good to know, thanks! Did not realize D doesn’t get pissed out, I won’t take it till I get tested, then.

That’s all very interesting about Accutane – it was already on my shit list for being one probable cause of Crohn’s and UC but I didn’t know all that other garbage about it. How doctors can sleep at night after prescribing such poison for something as minor as acne I’ll never understand.

My doctor told me people often don’t know they’re low on D until their bones start breaking and they get osteoporosis, and by then it’s too late. In other words, get tested for it and take care of the problem asap.

Re: Accutane, my sister, when she was around 19 or 20 (in college) went from being a beautiful girl to being a beautiful girl with a very pimpled face. She didn’t want to go out and was embarrassed about her appearance. Accutane may have been a drastic step, but it took care of the acne and gave her her social life back. She only took it for a few months (or maybe less) and then the problem went away. I don’t think she regrets it at all.

@Mariah Wait, are you saying you took acutane?!

I think almost everyone should take some D if they aren’t tan. Just don’t take the high doses I talk about until your tested. Why not just take a multivitamin that has 100% of the USRDA values. They are all low, they are basically minimums to avoid severe disease. they come with and without iron. Make sure it has D.

No, I didn’t take accutane, but it has been known to be a cause of Crohn’s and colitis for some people, and one of my buddies who has UC took it. NOT a trade off anybody wants to make, no matter how bad your acne is, I promise you!

Yeah I’ll get a multivit, can’t hurt, thanks.

Yeah, my girlfriend I have told you about who was diagnosed with pan ulcerative colitis and then years later they decided she doesn’t have it, she had taken acutane. I have another girlfriend with Crohns who I wondered if she had taken it. I remember she had acne when we were in high school, but not very severe, I really don’t know.

Lawsuits have been one against the manufacturer.

I think like any medical procedure and any medication, you hear about the bad stories but don’t hear about the good. I had a urethral sling put in about six years ago. You hear about lawsuits about that, but not about the thousands or millions of people that have had them put in without any problems.

Oh @jca, I understand that the vast majority of accutane users did not get Crohn’s or UC and that lots of them had their acne cleared up by it. I just think that acne is never a good enough reason to take even a small risk of getting Crohn’s. I’m obviously biased here, but I just can’t fathom it ever being worth it. It’s the same reason I wouldn’t ever get plastic surgery – the risk of infections and whatnot are not worth it for something aesthetic.

@jca Absolutely. I know many many people very grateful for Acutane. It would be awful if they pulled it off the market.

I’d be fine with it leaving market, as would anyone who now gets to compare the embarrassment of shitting their pants in public or bleeding from their ass to the embarrassment of having zits :)

@Mariah What I would want to know, and I don’t, is if the symptoms start while taking the drug, and if stopping the drug immediately causes a reversal in any negative side effects. See, if it’s the idiot doctors who didn’t figure out; the patient is on a new drug that purposely causes tissues to oral away and now is having new issues with some internal organs maybe we should stop the new drug for now; then I am angry with the doctors. Do you now how many people I know who gave had bad side effects from medication and the doctors dismissed it or didn’t believe it? It’s boggles the mind, trust me. I know people who have been practically crippled and one died from a station drug. I could go in an on with examples of other people and myself.

If in the case of acutane there is no clue until weeks or months after the drug was given then that’s a different thing. I just don’t know the situation well with that drug.

It does make me wonder if a lower dose would work. Very iften the minimum effective dose is unknown. Also, dose iften is not adjusted for petite women. This is a huge problem in my opinion. Lastly, most likely, studies were done on adults, but young teenagers often take it. Maybe by now they did a study on young people. The problem is testing on minors is often tricky, because there is a big ethical question, so a ton of drugs are given off label to children and teens.

I haven’t done intense research on it or anything, but my understanding is that it causes actual IBD (as opposed to something like C. diff), as in, it’s chronic and doesn’t go away or get better after you stop the medication. I don’t know if it happens soon after being on the medication, but there have been studies showing that IBD is more common in people who have taken accutane which definitely implies a causal link. Looks like a lower dose does carry less risk.

Yeah trying to get meds as a minor is fucking infuriating, and I’m guessing you’re right that it’s because of limited testing on minors. I’ll never forget being goddamn 17 years old and not able to take a medication that could have helped me a lot, because it was only approved for 18+, as if my biology was going to change overnight on my 18th birthday. So annoying.

The causal relationship between IBD and isotretinoin use has been discredited

My 2 cents – there are types of acne caused by auto immune disease so the IBD and the acne could be symptoms of the same underlying disease process but the acne is spotted sooner so treated before the IBD (common problem with bowel diseases is that people are often to embarrassed to go to the doctors until the symptoms are really bad).

@Mariah Like I said, tons of drugs are given to minors that have never been tested in minors. It happens every day all day long.