December 15, 2004

8:14 PM

I've been having muscle fatigue problems for several years. It's mostly specific to my legs, which rules out Chronic Fatigue Syndrome (according to my doctor).
Recently, I tried eliminating various categories of food from my diet again, because I've had problems with certain things before. When I mostly eliminated cow's milk from my diet (I think I slipped once and accidentally had some ice cream), the problem mostly disappeared. Last night, I had a big mug of my friend's real hot chocolate, which she makes with milk for that extra unhealthfulness. Today, I could barely operate the clutch in my car. My doctor says that he's never heard of a connection like that before. Could a protien in milk be causing muscle fatigue in a particular part of my body?
posted by SpecialK to (11 comments total)

Note that my legs are also the most muscular part of my body; I hardly have any muscle in my upper body except for my back, which has its own problems that don't seem to match the fatigue problems in my legs (lower back tension unless I spend a specific amount of time doing a specific exercise to relax it.)
posted by SpecialK at 8:15 PM on December 15, 2004

Fibromyalgia can have dietary triggers, and dairy is one of the big ones. Muscle fatigue is one of the ways it manifests. Do a little homework on that and see if it sounds familiar.
posted by padraigin at 8:36 PM on December 15, 2004

Could a protien in milk be causing muscle fatigue in a particular part of my body?

Kinda looks that way. Has your doctor ruled out all the nasty diseases (MS, MD, etc.)? Also, do you have any discoloration on your legs? Do you sleep well at night?

My wife has a few conditions, including fibromyalgia and something related to scleroderma that are tricky to diagnose and can vary from person to person. Thankfully, none of her conditions are fatal, but since diagnosis she has received treatment that has helped her significantly.

When you mentioned your back, I thought of fibromyalgia, because the doctor actually prescribed an elliptical machine and my wife has to work out every morning to loosen up, otherwise she is sore all day.
posted by Doohickie at 8:37 PM on December 15, 2004

Has your doctor tested your B12 level? More importantly, has he done an MMA level, which is more specific?

Subactute combined degeneration is a reversible form of B12 deficiency that is uncommon but quite often overlooked. A "normal" B12 level is not enough to rule it out. Have you had an EMG?

It could be a mitochondrial problem, or a variant of muscular dystrophy. The list is quite expansive, so you might be better off at a medical center, i.e. OHSU.

Fibromyalgia is an inappropriate dx unless you have been ruled our for other things, i.e., a normal B12/MMA, EMG, MRI, even a muscle biopsy. Have you talked to family to see if anyone in preceding generations has had this?
posted by docpops at 8:50 PM on December 15, 2004

Your own observations are probably better than your doctor's on this, because very few people--including rheumatologists and kinesiologists--understand how selective muscle weaknesses, etc., work. If eliminating dairy helps to alleviate the symptoms, then by all means eliminate dairy.

And, as docpops suggested, do see a specialist. Very few GPs know much, if anything, about neuromuscular disorders. If, heaven forbid, this is something progressively degenerative, you want to know as early as possible so you can follow an aggressive treatment regime.

Good luck, K.
posted by Sidhedevil at 8:57 PM on December 15, 2004

The doctor says that I don't have any symptoms (spasming, twitches in particular places, reflexes, inability to move in certain directions, etc.) that warrant any further tests for MS. No discoloration that I've noticed on my legs. Sleep? Quite honestly, I sleep both well and poorly since I had mono 2 years ago. I'm insomniac so bad it hurts, and then when I do finally fall asleep I crater so hard that a nuclear blast won't wake me up (and my alarm clock has NO chance at all). It's actually made it impossible for me to hold a 'normal' job... I'm self employed now mostly due to my ability to hold a sleep cycle. Right now I'm on 'fall asleep after midnight and then wake up around 9-10 am'.

By the way, the lack of diagnosis isn't specific to one doctor. I've been through several who've told me various things, esp about the sleep disorder: they told me to cut caffeine and alcohol out of my diet and to get more exercise. :-p

I haven't had an EMG or any physical tests, and I have had "full" blood work done, including tests for STDs and checks for mineral levels and extraneous proteins or something like that. (Christ, they took, like, a pint... for the tests...) The tests were done by a sattelite OHSU location (Sellwood, to be precise.) The blood work showed no abnormalities except for a high level of 'fatigue indicators'.

Now, I'm with Kaiser, and thankfully I've got a primary care physician who's willing to explore it. She's not too sure that it's fibro or CFS; she says she feels that particular ailment is overdiagnosed. Her general feeling is that it's stress related.
posted by SpecialK at 8:59 PM on December 15, 2004

I'm insomniac so bad it hurts, and then when I do finally fall asleep I crater so hard that a nuclear blast won't wake me up (and my alarm clock has NO chance at all).

That was EXACTLY my wife before they diagnosed the fibro. Her treatment consists of a mild sedative at night to get her sleeping and helping her sleep soundly, coupled with the elliptical machine when she wakes up. The amount of energy she has now, compared to before diagnosis, is almost scary. She was sliding into that "cannot keep a normal sleep schedule" kind of life, but now is finishing her last year of college finally.

Remember, though, YMMV. In agreement with what your doc said, I've heard that fibro is often misdiagnosed as something else or even nothing at all, and that other things are called fibro when they ain't. The key is to see a rheumatologist and maybe a neurologist. You owe it to yourself and your quality of life to see if there is something treatable going on. Make sure your doctor follows through, and fight to get the proper referrals.
posted by Doohickie at 9:16 PM on December 15, 2004

I am not a doctor, but, having had a bad bout of CFS a few years back, I can appreciate the difficulties one has when unusual symptoms are involved.

It sounds flaky, but my doc gave me the ALCAT test when I was ill. It showed that I had a number of food sensitivities. I didn't start to recover from CFS until I avoided those foods. The theory was that I was stressing my body enough with foods I was sensitive to (but not allergic to) that it didn't have enough resources left over to heal. It sounded like a load of crap to me. It also worked.

IVs of various vitamins, heavy on the Bs, were another thing he inflicted on me. It took over a year, but I can now work full time and lead a fairly normal life.

While I no longer follow the restrictions the ALCAT suggested, I did learn how to listen to my body and to pay attention to which foods affect it in what ways. I'd second suggestions to avoid dairy, if it is causing problems.

One of the foods I had to avoid was cow dairy. Sheep and goat dairy were fine. YMMV.
posted by QIbHom at 9:21 PM on December 15, 2004

SpecialK:

Good luck. If you put your faith in naturopathy then you will reap the benefits of junk science. Allopathic medicine isn't always pretty, but it is based on controlled analysis. If you haven't seen a neurologist, you ought to. Blood work is useless for diagnosing neurologic disorders, so all the blood work in the world isn't worth squat. If it turns out that your workup is normal, then by all means embark on an inquiry into as many possible etiologies for your symptoms as you wish. Ultimately you'll be the beneficiary, with or without a specific diagnosis.
posted by docpops at 10:41 PM on December 15, 2004

Also - perhaps it's time for a second opinion, since your doctor doesn't know what to do with your complaint?
posted by agregoli at 7:45 AM on December 16, 2004

SpecialK, I feel your pain. Quite literally; you are describing symptoms that are very similar to some of the symptoms I have experienced in my past two-plus years of illness.

I, too, have had all the world's most expensive blood tests, with wacky results that were clearly way, way off the norms (NK cells 10+ norm, for example) but didn't indicate any specific known infection or disease process. My lovely doctor, who is a professor at one of the world's Most Expensive Medical Schools, thinks it is something viral (based on symptomatology and blood results) and has advised me to treat symptoms and generally rest/drink fluids/exercise, etc., as one might in a mild case of flu.

Of course, a mild case of flu that goes on for more than a year bites the big wang, but it's better than the previous year, which was spent with something that was the symptomatic equivalent of a bad case of flu.

I agree with docpops that you need a neurological workup, just to rule out muscular dystrophy, multiple sclerosis, etc. My doctor insisted I have one, and it was a tremendous load off my mind to have those ruled out.

You might want to take a look at the work of David S. Bell, MD. He was a pediatrician in Lyndonville, New York, who treated a number of area residents in a highly localized epidemic of what he calls "Chronic Fatigue and Immune Disorder Syndrome" which he believes, on the basis of clinical studies and epidemiological history, was caused by a virus related to polio. Bell wrote a couple of books for the lay reader on his experiences and his patients' clinical outcomes, and my husband and I found them quite helpful.

As someone who had an ulcer that was unsuccessfully treated by a very high-profile, very pleasant and concerned gastroenterologist for more than a year with the Sippy Diet and Propulsid--one of which was ineffective and the other of which turned out to be downright dangerous--and which was cured in two weeks with antibiotics, more than two years after I had read an article in The New Yorker that suggested that most ulcers were caused by Helicobacter pylorii, I am not as sanguine as docpops that allopathic medicine can, or does, deal successfully and aggressively with all illnesses.

To me, the key is to find a doctor you like, work with him or her as an informed consumer, and make as many lifestyle changes as you need to to support your general health and wellness. If eating dairy makes your legs hurt, then don't eat the dairy! Even if your doctor doesn't see how it could be connected, it can't hurt to make any lifestyle change that makes you feel better/stronger.
posted by Sidhedevil at 9:03 AM on December 16, 2004