Hello doctor, I have frequent fatigue with recent weight loss. In the past one year, I have been facing quite a few health issues. It all started late last year when I first experienced frequent chest pain, followed by an episode of sinus tachycardia. My 2D echo, stress test, troponin-I (1.5 ng/L) and CP-MB (14) levels were normal at the time. The doctor put me on Nebicard SM 2.5 mg just to keep my palpitations under control. This year mid, I was diagnosed with GERD with ulcers in the esophagus and a small sliding hiatus hernia. I followed a strict diet which reduced the acid reflux substantially. But, last month, I was diagnosed with mild appendicitis. The doctor put me on antibiotics and probiotics when they found out giardiasis in blood tests. The appendicitis seems to have improved as I do not have any symptoms now. But during investigations, my ECG showed ST-T changes. The doctor said these are nonspecific changes and the ECG is normal. I still went ahead and asked a cardiologist. He asked me to do troponin-I and CP-MB. The results were again normal [Troponin-I 1.5ng/L and CP-MB 5]. My concern is, despite all the tests showing normal outcomes, I do not feel healthy. I feel fatigued most of the times. My brain becomes foggy. I have become a lot more forgetful. I have lost five kg in the last three to four months. The chest pain still exists. I go through a lot of mood swings. I cannot concentrate well. There is regular muscle pain in my neck, shoulders, upper/middle back, breast bones, etc. I need to know why such drastic change in health has occurred.
Hello. I understand your concerns. I have checked all the reports you attached (attachment removed to protect patient identity) and all are within the normal range except a hiatus hernia and GERD II, but you should not worry, as you can improve with the medications. From what you mentioned, I suggest that you need psychiatric evaluation as you may have generalized anxiety disorder, chronic fatigue syndrome, mid-life crisis or atypical depression. Moreover, we have to exclude hyperactive thyroid by testing for TSH (thyroid-stimulating hormone), free T3, T4 (cause palpitations). All these conditions may cause fatigue, muscle pains and/ or weight loss. You have to answer these questions in order to reach an appropriate diagnosis: I suggest the following: Revert with more information to an internal medicine physician online -->