Hello doctor, I am a 47-year-old male. I have chronic fatigue being on healthy diet. I am not on any medication. There is also low libido. In the blood test report, the levels of UIBC, DHEA, estradiol, vitamin D, progesterone, phosphorus, and platelets were low from the normal level and high B12 level. In the past, my blood test has shown low RBC. Can you tell me what is going on?
Hello. Your chronic fatigue can be explained by low levels of vitamin D, low phosphorus, and low DHEA (dehydroepiandrosterone). I will explain why do you have these low levels. There are many causes of vitamin D deficiency, but most common is inadequate exposure to sunlight which I think is the cause in you. Other causes of vitamin D deficiency are malabsorption of vitamin D, kidney disease (not in your case). Vitamin D is essential in the absorption of phosphorus in the intestines. So, a low vitamin D will eventually lead to low phosphorus. And both low vitamin D and low phosphorus can cause chronic fatigue. Remedies are, increase your exposure to sunlight. There is no need for vitamin supplementation at present. Your LDL cholesterol and total cholesterol is on the higher side. I advise you to take tablet Rosuvastatin 5 mg at night after dinner for one year and repeat lipid profile after one year. Also, go on a low-fat diet. Now coming to your low DHEA and low estradiol levels, DHEA levels usually decreases with increasing age so that it could be an age-related issue in your case. It can also be reduced in conditions like adrenal insufficiency, diabetes, kidney disease, but there is nothing in your reports to suggest these diseases. Low DHEA can explain for low libido and chronic fatigue, but low libido can also be due to depression and even abnormalities in prolactin levels (which has been not tested in you). Also, get one serum prolactin level tested. My advice is to increase your physical activity and decrease your calorie intake, this will help in increasing DHEA levels. There is no need for taking DHEA supplements. Low estradiol is also due to low DHEA, but that is not significant. Increased vitamin B12 levels are usually seen in liver diseases or myeloproliferative disease (diseases of the bone marrow ), but one more common cause is if you were on multivitamin tablets it might have caused increased levels. But if you were not on multivitamins, then I advise you get one bone marrow biopsy done for the evaluation or detection of myeloproliferative diseases because even low platelets are seen in these diseases. Kindly revert for any further queries or clarification.