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HELLO doctor,
I am suffering with chronic fatigue,lack of sleep and concentration from last 4 years, initially i visited India(2011) and done with tests.result suggested it is due to lack of vitamin deficiency D3.
I continued medicines but not cured and checked my D3 level which are normal after 6 months(USA).Thyroid,CBC,T4,TSH,HEMOGLOBIN,MRI,CT scan all are normal and continued meclizine for 6 months initially i was fine but it not cured.
1 year back again i visited India and doctor given medicines and said i have chronic migraine.
I continuing valance *OD 500, ciplar-LA, opiprol 50 Medicines but still having all symptoms.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 21 Doctors Online

Thanks for choosing

I understand your concern.

You were diagnosed with migraine one year back. But in your history you did not mention anything about headaches. You have mentioned about chronic fatigue and lack of sleep. Migraine can indeed cause lack of sleep and definitely make you fatigued all the time. So kindly mention in the follow up question, whether you also have headaches or any migraine aura symptoms? Such as visual aura : Colored spots in front of eyes, zig zag lines ( e.t.c ) . Migraine is mostly diagnosed from history.

All the medicines you have mentioned are useful in treatment of migraine.Since all your other reports are normal, then the diagnosis of migraine can be made. But along with medicines you also have to identify the cause of your migraine. Migraine can be triggered by a lot of things such as - too much coffee or caffeine, loud music, bright light, food allergies- allergy from dairy products, egg plant ( e.t.c), stress, anxiety. So you need to find a correlation between your symptoms and the triggering factor. See if there's any common factor each time you get a migraine. If you can identify the triggering factor, and avoid it all together migraine attacks can be prevented in the future.

Lack of sleep further can induce more migraine episodes. So its like a vicious cycle. The only good thing as of now is that all your other reports are normal. You can post all your problems, if there is any stress related issue or anything. It will help us to understand your symptoms better. Meanwhile you can start taking a multivitamin supplement like Cobazinc, one tablet daily before sleeping. This can help you with your fatigue.

Do get back to us with more details,


Patient replied :

Thanks for reply. I dont have headache but have zig-zag lines when i go outside (sunlight). Due to fatigue i am not able to eat more.When i go outside i feels like fainting all the time and cannot communicate with others while talking(lost focus). I am also using Zincovit along with medicines i provided before, is it same as cobazinc and can i get in usa where i stay now.


Yes, Zincovit is the same and you can continue with it. And the zig zag lines on going out in sunlight is due to your migraine.

The loss of focus, inability to concentrate, sleeplessness, fatigue could all be due to underlying anxiety and depression which is not well controlled by the medications you are currently on such as Valance OD, Opiprol 50, or the Ciplar-LA. You will need to consult a psychiatrist who can change these medications to those which will work best for you. Also, you can also take various therapies available which can really help you. Once you start with these, all your symptoms will be taken care of.

For problems getting sleep, you have to make sure you follow strict sleep hygiene measures such as:

1) Have some aerobic workouts during day preferably in the morning.

2) Have a light dinner.

3) Completely avoid coffee/tea/alcohol/energy drinks/coke/smoking.

4) Have a warm water bath before going to sleep.

5) Dont try very hard to go to sleep. If you are not sleepy then sit on a couch or sofa and do some reading and go to the bed only when you are sleepy.

6) Avoid watching tv or working on laptop/computer or bright screens at night.

7) Keep the lighting of your bedroom dim and make your bed every morning after you wake up so that you get a cozy bed to sleep at night.

8) Use your bedroom only for sleeping and resting and do not do any other work there.

9) Avoid afternoon nap for any reason.
This will help you get good quality sleep at night and your other symptoms will also improve.

I hope this was helpful. Let me know if I can assist you any further.

Thank you.

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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