What sort of tests should I ask my for doctor for?

December 5, 2007 1:44 PM

What sort of tests should I ask my for doctor for? I am a 36 year old male with a healthy lifestyle (plenty of exercise, fruit/vegetables, no meat, no smoking or alcohol) but the last three months I have been getting ill or feeling under the weather an awful lot. Nothing major (mostly swollen glands and feeling very tired) but still really frustrating. I like to figure what is going on with me. Tomorrow I am going to see my doctor to ask for some tests. It is my experience with this doctor that I should do my homework before going because otherwise they will just run a limited set of standard tests which might not include what I'm looking for. So I would like to ask the hive mind: what sort of tests should I ask for? Iron and B12 deficiencies spring to mind but what else?
posted by dinkyday to health & fitness (21 comments total)

Thyroid?
posted by tristeza at 1:49 PM on December 5, 2007

How is your mental health?
posted by tiburon at 1:58 PM on December 5, 2007

Mono or something like the flu comes to mind.
posted by sutel at 1:59 PM on December 5, 2007

Yeah. Thyroid.

Or allergies.

I had thoes same symptoms. Do you have any sinus issues? It turned out to be allergies.

I never had allergies until my late twenties. It right after I went crazy with being a full on vegan. Turns out eating all vegetable proteins helped kick start allergies and my body was not used to them.
posted by tkchrist at 2:00 PM on December 5, 2007

How is your mental health?

That's a good question, but keep in mind that mental health issues can be a symptom, rather than a cause. My grandmother had terrible depression for several years, and it cleared up almost immediately when her thyroid condition was diagnosed and treated.
posted by craichead at 2:01 PM on December 5, 2007

It sounds like you might have mononeucleosis.

Sorry, but there's also an outside chance of leukemia. In either case you should probably get a blood count done.
posted by Steven C. Den Beste at 2:04 PM on December 5, 2007

Just ask for expanded testing and also STD testing.
posted by damn dirty ape at 2:20 PM on December 5, 2007

Seconding sutel's recomendation of mono. I came down with it years ago and it fit your scenario perfectly.
posted by enobeet at 2:21 PM on December 5, 2007

Lyme Disease fits your symptoms too and is rarely considered unless the patient knows they have been bitten by a tick and/or they have the bull's eye rash. Symptoms can appear years after the initial bite, and some people never get the tell-tale bull's eye rash.
posted by ellenaim at 2:31 PM on December 5, 2007

Mono/chronic fatigue/Epstein-Barr or MS or various autoimmune disorders are all possibilities. It could also be something environmental -- some allergies or sensitivities first present in adulthood or after repeated exposure, or something may have changed in your environment that you may or may not be aware of. If you've changed your diet in the last year or so (even if it seems to be a healthier diet), that may be a factor as well -- you may have a gluten sensitivity or be reacting to sugar substitutes. Good luck getting better.
posted by notashroom at 2:35 PM on December 5, 2007

"mostly swollen glands and feeling very tired"

IANAD but when you get thee to a D, insist on a full blood work-up. Could be many things, mono, other chronic things, but there very much is, as Steven C. Den Beste mentioned an outside risk of leukemia. Also HIV. Also MS. Also Lupus. Also much else. Doctor would likely test for that just based on your symptoms, insist he or she does. These are most definitely not likely, but you don't want to be a statistic, rare or otherwise.

Please let us know, within the context of not being too prying into your private life, that you got a good work-up.
posted by xetere at 2:47 PM on December 5, 2007 [1 favorite]

Thyroid and full bloods.
posted by fire&wings at 2:57 PM on December 5, 2007

swollen glands suggests some kind of infection--that's an immune system response. make sure you tell your doctor.

and go soon. 3 months is a long time to have those symptoms.
posted by thinkingwoman at 3:15 PM on December 5, 2007

IANAD, but I think the doctor's standard tests should be a good start.

what glands are swollen - thyroid? lymph nodes? are they tender? Your doctor could feel for their margins and distribution tomorrow.

Labs:
TSH, T4 could catch hypothyroidism
CBC would catch anemias
Peripheral blood smear and/or monospot could catch EBV
ELISA for HIV risk

how's your mood??

Chronic Fatigue Syndrome is a diagnosis of exclusion
Lyme disease is over-reported in the media and has a relatively low incidence rate.

Have you had coughing / nightsweats / weight loss? (TB)
Travelled out of the country?
Needle use, sex history also helpful
posted by alex3005 at 3:24 PM on December 5, 2007

There are many many causes for nonspecific symptoms like that. You never know what will show up on a blood smear. It could also be very much something psychological like needing a different activity, sleep, exercise, etc. If you have great insurance, I guess that you can get a whole bunch of expensive serology done. Before you go think REALLY REALLY hard about where you've traveling in the last 5 years or so, camping, walking around barefoot, eating rare/raw unusual food.
posted by a robot made out of meat at 4:51 PM on December 5, 2007

Celiac disease.

But don't consider the test the final word. Some folks who don't test positive for celiac disease still find that removing gluten from their diet still makes a world of difference. It's a big-time hassle, but if it makes you feel better, might be worth it.
posted by quinoa at 5:29 PM on December 5, 2007

I was shocked at how much better I felt after my previously undiagnosed allergies were treated with the right meds and weekly shots. I hope it turns out to be something similarly simple for you.
posted by cooker girl at 6:06 PM on December 5, 2007

So you feel non-specific crumminess and you think your glands are swollen? My suggestion is to carefully think through your symptoms, their time course, and any alleviating or exacerbating factors. Write them down and show up with an organized history to your appointment. This will be a lot more useful for your doctor than armchair quarterbacking and putting the cart before the horse by walking in with a laundry list of tests a bunch of strangers who don't know a damn thing about you might think you need.

Or you can just go in and ask for a bone marrow biopsy, exploratory laparotomy and radical neck dissection. That might get to the bottom of things if it doesn't kill you first.
posted by drpynchon at 10:10 PM on December 5, 2007 [2 favorites]

I had these symptoms, along with difficulty focusing, anxiety, and frequent colds/sore throats after being a vegetarian for 2-3 years also. Solved by adding back fish/chicken to my diet (2-5 meals per week). For many years (about 20) I've noticed that after 5 days or so without a high protein meal, I'll get symptoms like this, and if I'm unlucky end up with a throat infection. I used to be able to get enough protein by eating a lot of tofu etc. but on the basis of current evidence I'm limiting my soy intake to 1 meal per week.

I also have to limit how much wheat/gluten I eat, which I don't consider such a big hassle because I don't care for fast food anyway.
posted by lastobelus at 2:58 AM on December 6, 2007

Why don't you just let the good doctor find out what's wrong with you? I could understand a patient looking for extra tests after a doctor fails to diagnose him/her, but before?

You know, the doctor has 4 year of med school and at least 3 years of graduate medical education more than you. ;)
posted by Ervin at 6:20 AM on December 6, 2007

Though this doesn't sound likely given your lifestyle, I wouldn't rule plain old stress. I'm pretty healthy myself, but if I don't actively de-stress (yoga, meditation, just plain quiet), I find myself struggling with minor ailments.

According to who you ask (I'm a fan of the "YOU:" books by Dr. Oz), stress is one of the major factors in life-span reduction and general malaise.

Just something to consider. Good luck.
posted by gb77 at 11:44 AM on December 7, 2007