Blood tests to sort out reason for fatigue
August 14, 2017 2:28 PM   Subscribe

I have been dealing with symptoms of extreme fatigue for about a month now, sleeping 10+ hours a night and still desperate to take naps during the day. I am so drowsy sometimes that I feel it might be unsafe for me to drive and do other necessary functions during the day.

I requested a blood workup from my doctor, and the tests she decided to run came back normal, but I am definitely not feeling normal. Wondering what next steps are.

These are the tests she ordered: fasting glucose, fasting lipid panel, TSH, hemoglobin A1C, potassium, creatinine, blood urea nitrogen, CBC, alanine aminotransferase.

I feel like Vitamin D should also have been tested, and perhaps even urine. I would appreciate some advice about what else might be useful to have tested to try to get to the root of this problem. Thank you.
posted by massofintuition to Health & Fitness (15 answers total) 6 users marked this as a favorite
Pregnancy, if that's a possibility for you.
posted by lalex at 2:30 PM on August 14, 2017

Sleep apnea test, for sure. You might not be actually sleeping at all.
posted by pixlboi at 2:33 PM on August 14, 2017 [9 favorites]

And of course a sleep study. TSH alone isn't enough to really see if thyroid is the issue. Ferritin and iron binding are good to check too. If your GP isn't taking seriously your need for 10+ hours of sleep plus naps, then you need a new doctor. You deserve some quality of life.
posted by PorcineWithMe at 2:34 PM on August 14, 2017 [4 favorites]

Oh! And mono- but the whole panel. Most people have been exposed to Epstein Barr - you want to see if you have an active infection.
posted by PorcineWithMe at 2:35 PM on August 14, 2017 [2 favorites]

posted by belladonna at 2:44 PM on August 14, 2017 [4 favorites]

Depressive episodes for me often are associated with a lot of fatigue. Maybe something that explains the lack of unusual blood test combined with fatigue.
posted by dismas at 2:46 PM on August 14, 2017 [2 favorites]

B12. B6. Full thyroid panel. Ferritin.
posted by Stonkle at 2:46 PM on August 14, 2017 [5 favorites]

posted by tooloudinhere at 2:51 PM on August 14, 2017 [3 favorites]

Yeah, definitely make sure you're getting a full thyroid panel and not just TSH.
posted by radioamy at 3:02 PM on August 14, 2017 [2 favorites]

Please do check up on the vitamin D. One woman I know was effectively bedridden until she was put on 50,000 units a week; she's now doing great. Another friend of mine (who has multiple other chronic health issues and something new and intense happening just recently) is currently on 50,000 units a day.
posted by kimota at 3:03 PM on August 14, 2017 [2 favorites]

I'd check iron and ferritin to make sure you aren't anemic.
posted by AppleTurnover at 3:48 PM on August 14, 2017 [3 favorites]

If you're taking Melatonin (especially extended release), please stop it. It can cause drowsiness during the day. Nthing sleep study.
posted by getawaysticks at 4:21 PM on August 14, 2017

it could definitely be one of the above mentioned things but for me recently the thing that was causing me to pass out all over the place into a snoring drooling narcoleptic-esque sleep was just plain old allergies. i had no other symptoms of seasonal allergies except dry eyes.
posted by poffin boffin at 5:10 PM on August 14, 2017 [1 favorite]

Absolutely iron, ferritin, b-12, & full thyroid panel (including antibodies).
Do you have a carbon monoxide detector in your home, and have you tested it recently?
posted by Iris Gambol at 6:55 PM on August 14, 2017 [1 favorite]

To be honest, I think you are approaching this wrong (or at least, your doctor is if their diagnostic process is really to just let you have whatever blood test you ask for without any guidance).

Rather than just ticking every box on the blood test request form, I think you need to make another appointment with your doctor and have a full history and examination. Your doctor should have a fair idea whether this is something infective, autoimmune, etc after they've assessed you fully. That's far more likely to get you a diagnosis than just running every test AskMe can think of until something comes back abnormal. There needs to be some sort of method to this.
posted by tinkletown at 9:33 PM on August 14, 2017 [2 favorites]

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