Thanks for your question at DoctorSpring.com.
Have you considered another possible reason for your joint pains and fatigue? The reason why I ask is that your Vitamin D levels seem to be up and normal but you are still experiencing symptoms. Here is what I suggest:
1. Get a full blood profile done including red blood cells, white blood cells, and platelets. This will reveal whether or not you have anemia or any platelet abnormality.
2. Consider the possibility of a metabolic myopathy. This is a defect in the metabolic pathway and can interfere with ATP (energy) production causing pain and cramping in muscles and joints and easy fatigue after and during exercise.
3. To diagnose you may require clinical examination, graded exercise tests, and a muscle biopsy.
This might give you a different approach to your illness and help you arrive at a diagnosis and/or solution sooner.
I hope this helps. Please ask any follow up questions, if any. Take care.
Patient replied :
Thank you for your response.
1. I have got the mentioned tests done, Please find the results attached.
2. With reference to your second point, kindly suggest what needs to be done. This may also be true because i do more short duration, high intensity exercises which rely primarily on ATP Stores.
3. With reference to your third point, kindly suggest which speciality (Doctor), should be consulted.
Your blood tests do not show any significant abnormality. There is no anemia as your counts and hemoglobin levels appear normal. You can continue to do further testing if you feel that this could be an issue related to metabolism as I suggested. Make an appointment with your local general medicine practitioner or a sports medicine specialist and discuss with him further testing you can do to support this. There is a blood test for serum creatinine kinase that is available, and also exercise testing (for lactic acid levels in the blood during exercise) can be done. In the meantime, work closely with a physiotherapist in doing exercises and routines to help you get back to your comfortable level of fitness.