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Fit woman with waves of fatigue and sleepiness

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Hello there. I'm a fit generally healthy 45 year old female..... (mother of 4 work part time) I run between 20 -25 km per week with a couple of longer races per month. I completed my third Half marathon nearly 2 weeks ago. A couple of days afterwards is when my symptoms began.....severe fatigue and sleepiness, I literally could fall asleep at any moment if I had the opportunity. Breathlessness and tightening of the chest. A feeling of a lump in the throat. Sometimes a little faint and dizzy. The fatigue would come and go in waves peaking in the middle of the day. Intermittent waves of hot and cold....but no fever. I haven't had the flu or any other apparent virus/infection. This is the first time I have ever experienced symptoms of this severity. I'm not on any other medication. My GP ordered a full CBC and everything came back within the normal ranges. We are still waiting for the iron study results. THS (thyroid) levels ere also within the normal parameters.
If bloods have come back normal then why do I still have these symptoms and what can I do to recover. I'm supposed to be doing a 12km race in a couple of days. This constant mantle of fatigue and feeling of a lump in the throat is distressing to say the least. My GP hs not been very Informative or supportive thus far. Thank you in advance for your advice and suggestions.


Category: Family Physician-GP

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Category: Family Physician-GP
Dr. Mayank Bhargava is online now

Expert:  Dr. Mayank Bhargava replied 4 Days.

Hi,

Thank you for your query at DoctorSpring. Please let me know your other associated symptoms.

Do you have difficulty in swallowing/ choking sensation/ pain while swallowing?

Are you getting menses regularly at normal interval or have some abnormality?

Are you getting lump feeling in throat while eating or after few minutes/ hours of eating?

Do you have some sort of stress?

Let me explain your query one by one.

As you have already mentioned that you have normal complete blood count, there appears to be high possibility of normal iron studies and least correlation between defined symptoms and iron studies.

There could be high possibility of perimenopausal symptoms with globus hysterics.

Perimenopausal symptoms could be associated with hot & cold feeling with multiple vague weird symptoms as you have.

There could also be possibility of few psychiatric symptoms also.

Globus hystericus is a disease in which patient may have lump feeling in throat while all relevant investigation are found to be normal.

As such there is no defined cause for excessive sleep and no particular medication is available which can reduce the sleep.

You should consult with internal medicine specialist and gynecologist (if menstrual abnormalities are present) simultaneously and should go for thorough check up.

You should also go blood sugar, serum LH & FSH level, chest x ray, electrocardiogram (to rule out heart ailment for your symptoms).

You should also go for endoscopy if lump feeling exist.

Treatment depends on exact diagnosis.

If all relevant investigation are found to be normal then you should consult with psychiatrist.

In my personal opinion, low dose tricyclic antidepressants with isoflavone may help in your condition.

Take care,

Let me know your other query.

Get well soon.

Dr. Mayank Bhargava


Patient replied :

Dear Doctor.
Thank you for your reply,
You asked if I have any trouble/swallowing/choking etc. No swallowing issues but intermittent tightening of the chest and throat. I have just completed a 12 k race and felt aerobically very well but a mild aching in my chest. Heart rate was normal. My menses are normal and regular. Stress levels ok. No history of psychiatric ailmennts anxiety or depression. Still have fatigue that comes and goes throughout the day. These symptoms have onset very suddenly and I am not imagining them. I am generally fit and healthy and in tune with my body and I am not functioning at 100percent. Something is not right.
Thank you for your ongoing consult and support.
S.


Expert:  Dr. Mayank Bhargava replied 3 Days.

Hi,

With the available details, there could also be possibility of respiratory ailment i.e. silent.

Asthma which is also called as cough variant asthma.

You should also consult with chest physician.

Wishing a speedy recovery.
Dr. Mayank Bhargava


Dr. Mayank Bhargava
Category: Family Physician-GP
Experience: 
Fellowship: Gastroenterology, Chotiram Hospital & Research centre, Indore, 2009
Residency: General Medicine, Rajasthan University Jaipur, 2008
Medical School:  MBBS, Rajasthan University Jaipur, 2004
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